State of California-Health and Human Services Agency California Department of Public Health
REQUEST FOR pH CONTROL
Firm Name:
Telephone
:
Facility Address:
City
:
Zip Code:
Mailing Address:
City:
Zip Code:
Product:
Formula
Number/Code:
Type of Submission: New Product
Reformulation If reformulation must provide Process Letter
Existing
S-Number S-
Date
of Existing Process Letter
NOTE:
Highlight changes in formula. If changes are determined to be
significant, a new formula number must be assigned.
Container
Size(s):
Sample(s) submitted? Yes No
If yes, Laboratory Sample or Production Sample
INGREDIENTS: (List each ingredient by weight or percentage; and describe ingredient (fresh, frozen,
dried, brined, canned, acidified,etc.). Give pH if known. Attach extra sheet if needed.
Ingredient
Ingredient
Amount (Wt. or %)
Product Preparation: Indicate process
Cold-Fill Pasteurizer/ Water Bath Hot-Fill-Hold Other
Include minimum initial temperature where necessary. Indicate minimum time and temperature that the product is
heated and EXACTLY what parameters are monitored. Attach extra sheet, if needed. For HOT FILL HOLD: Also
include minimum temperature upon filling into the container, how long the product is held in the container prior to
cooling and how the container lid is sterilized – for example: is the container inverted?
pH
of acid ingredient(s) alone or with water (if
added):
Equilibrium
pH after low-acid ingredients are mixed-in but before any
acid is added:
Equilibrium
pH of finished product:
Approximate
time needed to achieve equilibrium pH:
For products where primary acidification is by addition of acid to a low-acid main ingredient (eg. cucumbers,
peppers):
A. If food is acid-blanched:
What
Acid is Used?
%
Acid in bath?
Time:
Temperature:
pH
of food after blanching:
B
. If Acid blanching is not used, how is acidification achieved?
For product with Water Activity ≤ 0.85, give equilibrium Water Activity of finished product (describe method
used):
Signature (required):
Title:
Date:
Print Name (required):
Email:
Submit to: University of California
Laboratory for Research in Food Preservation
12647 Alcosta Blvd., Suite 195
San Ramon, CA 94583
Telephone (925) 833-6941 [email protected]
 8589 (8/223)
840-210-0000
3212 E Olympic Blvd
Los Angeles
90023
3970 Seneca Ave
Los Angeles
90039
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