Application for Designation of Establishment For Export of Beef/Offal to Japan

Application requires the following information:

ESTABLISHMENT NUMBER:

NAME AND ADDRESS OF ESTABLISHMENT:

DESIGNATED FOR:

checkbox SLAUGHTER
checkbox CUTTING/BONING

PART 1. OPERATOR

We, the operator of above mentioned registered establishment, hereby request to be added to the list of establishments eligible to export beef/offal to Japan. We have reviewed the export requirements applicable to the export of beef/offal destined to Japan, developed the required procedures for our establishment and our establishment meets the applicable structural and operational requirements.

DATE:

NAME OF THE AUTHORIZED REPRESENTATIVE OF THE OPERATOR OF REGISTERED ESTABLISHMENT

TEL:

SIGNATURE OF THE AUTHORIZED REPRESENTATIVE OF THE OPERATOR OF REGISTERED ESTABLISHMENT

PART 2. CFIA INSPECTOR IN CHARGE / CFIA VETERINARIAN IN CHARGE

This is to confirm that I reviewed the operations and written program developed by the operator and that the above mentioned registered establishment meets applicable export requirements for beef/offal destined to Japan. I recommend on-site inspection by the RVO as per the designation procedures in section 11.7.3.2 b)3-Japan.

DATE:

NAME OF CFIA INSPECTOR IN CHARGE / VETERINARIAN IN CHARGE:

TEL:

SIGNATURE OF CFIA INSPECTOR IN CHARGE / VETERINARIAN IN CHARGE:

PART 3. REGIONAL VETERINARY OFFICER (RVO)1

I conducted an on-site evaluation of the above mentioned establishment and determined that it meets all applicable requirements for beef/offal destined to Japan. I recommend this establishment for external audit as per the designation procedures in section 11.7.3.2 b)3-Japan.

DATE:

NAME OF RVO:

SIGNATURE OF RVO:

PART 4. EXTERNAL AUDITOR

I conducted an on-site audit of the above mentioned establishment as per the designation procedures in section 11.7.3.2 b)3-Japan and determined that it meets all applicable requirements for beef/offal destined to Japan.

DATE:

NAME OF EXTERNAL AUDITOR:

SIGNATURE OF EXTERNAL AUDITOR:

PART 5. REVIEW COMMITTEE

We reviewed the application documentation and the report of the External Auditor and determined that the designation procedures prescribed in section 11.7.3.2 b)3-Japan were followed. As a result I recommend the designation of the establishment for export of beef /offal to Japan effective________________________.

DATE:

NAME AND SIGNATURE OF THE CHIEF VETERINARY OFFICER:

REMARKS:

1 The RVO can be replaced by a Program Network Specialist to perform this evaluation