Queen Anne's County Environment Health Farmers Market Form

Exactly as extracted, unformatted — for checking against the original. The readable version is easier to read.

Queen Anne’s County Department of Health
Environmental Health Division
206 N. Commerce St, Centreville, MD 21617
Phone: (410) 758-2281 Fax: (410) 758-6602
FARMER’S MARKET VENDOR APPLICATION
Instructions:
 Submit application at least 2 weeks prior to participating in a farmer’s market.
 If participating in more than one farmer’s markets within Queen Anne’s County (Kent
Island/Centreville), include information for both markets.
 If offering cottage food products, provide copies of your labels.
 All food products must be labeled.
 If licensed as food service facility, provide copy of your current license.
Name of Farmers Market:
Location of Farmers Market:
Dates of Operation: to Hours of Operation:
Applicant Name:
Applicant Address:
Phone: Email Address:
1. Do you currently hold a license issued by MDH Food Control, Milk Control or Maryland
Department of Agriculture for egg production and packing? If so, please provide our office with a
copy of the State license: Yes No
Foods and/or Beverages To Be Offered Source of Each Item Will you be sampling
product?
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

2. Do you intend to offer samples of your product: Yes No
If you are offering sampling of the following products, then you must have a Seasonal
Farmers Market Sampling License issued by this department:
 Raw agricultural products
 Products processed in a private home kitchen (Cottage Food)
 Non potentially hazardous foods processed and packaged in a licensed food processing
plant
3. Describe how the food or beverage products will be transported to the Farmers Market:
4. Describe how you will maintain the proper internal temperatures of the food or
beverages during transport and display at the Farmers Market and how this
temperature will be monitored throughout the operation:
5. Describe the method you will use to protect food and beverages from
contamination during transport and display and preparation at the Farmers
Market:
6. List equipment used for cold-holding and/or hot-holding foods (if applicable):
o I have reviewed and read the above application and know the same is true and correct and that in operating as a food service
vendor, I agree to comply with all applicable laws and regulations including, but not limited to, those of the State of Maryland
and Queen Anne’s County.
o I understand that falsification of this application may result in the denial, suspension or revocation of the permit.
_ _
Applicant Signature Printed Name of Applicant Date
ENVIRONMENTAL HEALTH OFFICE USE
Date Received:
Environmental Health Specialist:
Date of Approval:

Cottage Food Business Labeling Requirements
Products must be labeled with the following information:
 The name and address of the cottage food business (a P.O. BOX is not permissible);
 The name of the cottage food product;
 The ingredients of the cottage food product in descending order of the amount of each ingredient by weight;
 The net weight or net volume of the cottage food product
 Allergen information as specified by federal labeling requirements as defined in COMAR 10.15.03.02. A
major food allergen means: milk, egg, fish (such as bass, flounder, or cod, etc.), shellfish (such as crab,
lobster, or shrimp, etc.), tree nuts (such as almonds, pecans, or walnuts, etc.), wheat, peanuts, soy or a food
ingredient that contains protein derived from milk, egg, fish, tree nuts, wheat, peanuts, or soybeans;
 Nutritional information as specified by federal labeling requirements, if any nutritional information claim is
made; and
 Required Font: Printed in 10 point or larger type in a color that provides a clear contrast to the background
of the label: “Made by a cottage food business that is not subject to Maryland’s food safety
regulations.”
Sample Label:
Bonnie’s Baked Goods
206 North Commerce Street
Centreville, MD 21617
Chocolate Chip Cookies
Ingredients: Flour, Semisweet Chocolate Chips, Butter, Sugar, Brown Sugar,
Walnuts, Eggs, Vanilla Extract, Water, Baking Soda, Salt.
Allergens: Contains Wheat, Eggs, Milk, Soy, Tree Nuts.
Net Wt: 17.6 Ounces (or Net Volume: 6 cookies)
Made by a cottage food business that is not subject to Maryland’s food safety regulations

LABELING REQUIREMENTS
COMAR 10.15.03.12
Products must be labeled with the following information:
 The common name of the food or a descriptive identity statement;
 If made from two or more ingredients:
o A list of ingredients in descending order of prominence by weight; and
o A declaration of artificial color or flavor and chemical preservatives;
 An accurate declaration of the quantity of the package contents by weight in both metric and English units;
 The name and place of business of the manufacturer, packer, or distributor;
 The name of the food source for each major food allergen that is contained in the food unless the food source
is already part of the common or usual name of the respective ingredient. A major food allergen means: milk,
egg, fish (such as bass, flounder, or cod, etc.), shellfish (such as crab, lobster, or shrimp, etc.), tree nuts (such
as almonds, pecans, or walnuts, etc.), wheat, peanuts, soy, sesame or a food ingredient that contains protein
derived from milk, egg, fish, tree nuts, wheat, peanuts, sesame, or soybeans;
 Nutritional information as specified by federal labeling requirements, if any nutritional information claim is
made.
Sample Label:
Bonnie’s Baked Goods
206 North Commerce Street
Centreville, MD 21617
Chocolate Chip Cookies
Ingredients: Flour, Semisweet Chocolate Chips, Butter, Sugar, Brown Sugar,
Walnuts, Eggs, Vanilla Extract, Water, Baking Soda, Salt.
Allergens: Contains Wheat, Eggs, Milk, Soy, Tree Nuts.
Net Wt: 17 Ounces (481 g)