Form - Food Safety Self Inspection Form

	Yes	No
Do you manufacture, process or pack any food items that are sold for human consumption?	Yes	No
Do you sell food by retail?	Yes	No
Do you sell any food by wholesale?	Yes	No

	Yes	No
Dairy products	Yes	No
Eggs	Yes	No
Prepacked cooked meats	Yes	No
Loose cooked meats	Yes	No
Loose raw meats	Yes	No
Sandwiches prepared on the premises	Yes	No
Sandwiches brought in	Yes	No

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Form - Food Safety Self Inspection Form

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