COOK COUNTY DEPARTMENT OF PUBLIC HEALTH
COOK COUNTY DEPARTMENT OF PUBLIC HEALTH
ENVIRONMENTAL HEALTH SERVICES
2121 Euclid Avenue, Rolling Meadows, Il 60008
847-818-2844 phone
North District fax 847-818-2464
knagaraj@ (Kamala Nagaraj)
Application for Farmer’s selling only uncut produce, pet food, packaged meats, eggs, honey
Name of event:
Location or address of event:
Name of applicant:
Telephone number(s):
List all items that will be sold:
Please provide all licenses (egg license, pet food license, meat broker license)
Please provide a refrigerator or freezer for meats and eggs.
Please provide the source of mushrooms.
Are you sampling your produce? Yes No
(Do you have a sampling license from the State of Illinois) Yes No
[pic]Applicant’s Signature Date
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