This is a Hay Examination Report. The following is the information is requested:
Number
Hay Location (Legal Description - use back if necessary)
Grower's Name and Address (and, if applicable, non-designated facility name and address)
Name of Company Requesting Examination
Country of Destination
Hay For Examination (Mixture %, Lot)
Bale Type
Total Number of Bales
Weight Per Bale
Total Weight
Foreign Material
Prohibited Material
Identify Lots Rejected
Number of Bales Passed x Weight Per Bale= Total Weight (metric tonnes)
Examined By:
(Print Name of Examiner)
Date
Number of phytosanitary certificate
Metric Tonnes
Balance
Date Examined
Signature