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Appendix 2: Application to handle screenings resulting from the cleaning of seed or grain imported from off-continent

Name of Processing/Cleaning Facility: space

Address of Facility (physical location receiving product): space

Name Facility Contact: space

Telephone Number of Facility Contact: spacespace

Commodity
Grain or Seed for Cleaning: Yes No

Source (Country of Origin): space

Volume (e.g. No. of Import Transactions Expected): space

Period of Importation: space (Maximum of one year)

A. If importing Grain or Seed for Cleaning

Commodity names: space

Describe transportation, handling and storage conditions for grain or seed prior to cleaning to prevent spills, scattering or unauthorized spread:
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space
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Identify location and method of disposal of screenings derived from cleaning of imported grain or seed (e.g. incineration or deep burial):
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space
space
space
space

Describe handling and storage conditions for screenings derived from cleaning of imported grain or seed, including during transportation to disposal site:
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Approval by a CFIA inspector is required before a Permit to Import will be issued authorizing movement to the cleaning or processing facility of imported grain or seed for cleaning.

Applicant's statement:

I agree to act as the person responsible for the above facility's management of foreign origin screenings.

I have read and agree to comply with the provisions of D-96-07. In particular, I agree:

I have read and understand the above statement.

Dated: space at: space Province: space

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Applicant's Signature
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Name Printed

The following section must be completed by a CFIA Inspector designated under the Plant Protection Act

Approved for:

Receipt of Grain or Seed for Cleaning: Yes No

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CFIA Inspector
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Date
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Name Printed
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CFIA Office

Date modified: