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Farm Inventory Questionnaire

1. Farm Point of Contact *This question is required.

First Name

Last Name

Email Address

Mobile Phone Number (###-###-####)

Point of Contact Role

Please enter an 'other' value for this selection.

2. Farm Information *This question is required.

Farm Name(s)

Farm Phone Number (###-###-####)

Farm Street Address
(PLEASE PROVIDE THE PHYSICAL STREET ADDRESS OF THE BUSINESS; USE EMS ADDRESS FOR RURAL ROUTES)

City

State

Zip

3. Mailing Address *This question is required.

Please enter an 'other' value for this selection.

4. How do you prefer to be contacted?

Please enter an 'other' value for this selection.

5. Does your farm have a Food Safety Coordinator, or other position related to food safety? *This question is required.

6. Please provide the following information for your Food Safety Point of Contact *This question is required.

First Name

Last Name

Title

Email Address

Phone Number (###-###-####)

6. Please categorize your farm's size based on approximate average income over the last three years: *This question is required.

7. Is your farm growing, harvesting, handling, or holding produce covered by the the FSMA Food Safety Rule?
For help determining if your produce is covered see the list below, or click here for guidance.

*This question is required.

8. What is your farm's seasonal growing period?

Example: for May - July growing season enter: 05/01-07/31 *This question is required.

Please enter an 'other' value for this selection.

9. Are you interested in participating in an On-Farm Readiness Review*?

*On-Farm Readiness Review (OFRR) is a voluntary, non-regulatory, pre-inspectional "readiness" review tool developed to help operators assess a produce farm's readiness for compliance with the FSMA Produce Safety Rule. OFRRs will be conducted in partnership by the Oregon Department of Agriculture and OSU Extension. For more information, or to request an OFRR click here.

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