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Organic System Plan – Livestock Use this form if you are requesting organic certification of dairy stock or livestock slaughter stock. Poultry producers must use the Organic System Plan - Poultry. A separate Organic System Plan - Crops must be filled out if you are growing your own feed or other organic crops for sale. Use additional sheets if necessary. If you are a new applicant, attach a completed General Information form. Do not leave any applicable sections blank, write ”none” or “not applicable”. Remember to sign this form on the last page. Section numbers refer to National Organic Program regulations (7 CFR, Part 205). SECTION 1: General Information §205.406(a)(2) and §205.401(b) First Name: MI: Last Name: Farm Name: Today’s Date: Address: Email: City: State: Zip code: Does this operation engage in any processing of organic livestock or livestock products? (e.g. slaughtering, feed processing) Yes No If yes, describe: You may need to complete a Processor/Handler Organic System Plan. Contact PCO to confirm applicability. Please check any of the following countries to which you intend to export organic livestock or livestock products in the next 18 months: Canada European Union Taiwan Japan If you intend to export any of your organic products to Japan, Taiwan, European Union or Canada, complete Section 16 of this form. SECTION 2: Organic Livestock Operation Profile §205.201 Table 1. Livestock Requested for Certification: Complete the following table for all livestock requested for certification Type of Livestock # of animals Projected annual production Table 2. Transitional/Non-Organic Livestock: Complete this table for transitional or non-organic livestock on your farm: Page 1 of 23 OSP Livestock-Dairy V4, 2/11/14 Organic System Plan Office Use Only Received:

Organic Livestock Plan Questionnaire: … · Web viewFor dairy livestock in transition, all feed must be either third year transitional material from your own farm or 100% organic

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Page 1: Organic Livestock Plan Questionnaire: … · Web viewFor dairy livestock in transition, all feed must be either third year transitional material from your own farm or 100% organic

Organic System Plan – Livestock

Use this form if you are requesting organic certification of dairy stock or livestock slaughter stock. Poultry producers must use the Organic System Plan - Poultry. A separate Organic System Plan - Crops must be filled out if you are growing your own feed or other organic crops for sale. Use additional sheets if necessary. If you are a new applicant, attach a completed General Information form. Do not leave any applicable sections blank, write ”none” or “not applicable”. Remember to sign this form on the last page. Section numbers refer to National Organic Program regulations (7 CFR, Part 205).

SECTION 1: General Information §205.406(a)(2) and §205.401(b) First Name:       MI:  Last Name:      Farm Name:       Today’s Date:

     

Address:      Email:      

City:      State:      Zip code:     

Does this operation engage in any processing of organic livestock or livestock products? (e.g. slaughtering, feed processing) Yes NoIf yes, describe:      

You may need to complete a Processor/Handler Organic System Plan. Contact PCO to confirm applicability.Please check any of the following countries to which you intend to export organic livestock or livestock products in the next 18 months:

Canada European Union Taiwan JapanIf you intend to export any of your organic products to Japan, Taiwan, European Union or Canada, complete Section 16 of this form.

SECTION 2: Organic Livestock Operation Profile §205.201Table 1. Livestock Requested for Certification: Complete the following table for all livestock requested for certification

Type of Livestock # of animals Projected annual production

                 

                 

                 

                 

                 

Table 2. Transitional/Non-Organic Livestock: Complete this table for transitional or non-organic livestock on your farm:

Type of Livestock # of animals

Transitional or non-organic?

Describe how these are separated from organic livestock or products:

Projected annual production

                             

                             

                             

                             

1. If not yet certified: Page 1 of 17 OSP Livestock-Dairy V4, 2/11/14

Organic System PlanLivestock/ Dairy

Office Use OnlyReceived:

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Organic System Plan – Livestock

a) Do you plan to transition a dairy herd? Yes No N/AIf Yes, date transition started:      

b) Estimated milk ship date (if known):      

2. Provide milk company name and contact information:      

SECTION 3: Source of Animals §205.236All organic livestock must be from certified organic sources unless breeding stock was purchased prior to the last third of the gestation period. Dairy herds are permitted a one-time whole herd conversion over a 12-month period - see §205.236(a)(2).

3. Do you raise all slaughter animals on farm (including organic cull animals)? Yes No N/A

4. Do you raise replacement animals on farm? Yes No N/A

5. Do you purchase any livestock? Yes No

Table 3. Purchased Livestock: If yes, give specific information on livestock purchased within the past 12 months: Please write the type of livestock purchased, their identification no./name, date of purchase, projected real birthing date, the purchase source and what agency certified them.TYPE OF LIVESTOCK

PURCHASEDIDENTIFICATION NO./

NAMEDATE OF

PURCHASEPROJECTED OR REAL

BIRTHING DATEPURCHASE

SOURCECERTIFIED BY

WHAT AGENCY?                                   

                                   

                                   

SECTION 4: Livestock Feed and Feed Supplements §205.237For dairy livestock in transition, all feed must be either third year transitional material from your own farm or 100% organic. Dairy livestock in transition must comply with the Pasture Rule requirements during the one year transition, including receiving at least 30% dry matter intake from pasture over the grazing season, minimum of 120 days. Also, you must document the amount of each type of feed actually fed to each type and class of animal. You may use PCO’s Feed Ration/ DMI Calculation Worksheet.6. Describe your grazing season, including dates/total number of days:      

7. How will you calculate dry matter intake for each type/class of ruminant livestock? Using the tables and worksheets provided by PCO Using other calculation method (explain) and published reference material (list source):      

8. Describe the classes or groups of animals you manage (i.e. lactating cows, bred heifers, unbred heifers, dry cows). Include the breed and average weight for each class/group:      

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Table 4: Proposed Feed Ration. Provide a description of the total feed ration for each class of ruminant livestock you manage. This should include all feed produced on-farm and purchased from off-farm sources. You may provide the information in your own format as an attachment. Feed Ration(s) Attached

No ruminant animals

Type / Class Ration Period

# of Days Dry Matter Demand (DMD) Ration

EXAMPLE:Lactating Jersey

Cows

Early Spring 15 Days 28 lbs. 6 lbs Org. Corn Silage, 10 lbs Org. Dry Hay, 4 lbs Org. Baleage

                             

                             

                             

                             

                             

                             

                             

                             

                             

                             

                             

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Table 5. Dry Matter Value of Feed: List the dry matter value for each type of feed listed in Table 4. If no values are reported, PCO will use an average dry matter book value to evaluate your feed ration. No ruminant animals

Type of FeedExample: Corn Silage

Dry Matter Value of FeedExample: 40%

          

          

          

           

           

           

           

           

           

           

           

           

           

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9. Do you process feed (mix, grind, roast, extrude, etc.) on-farm? Yes No

If Yes, is the equipment also used to process conventional products? Yes NoIf Yes, how is equipment cleaned prior to processing organic feed to prevent contamination?      

10. What is your plan for emergency feed supplies?a) Grazing season emergency feed and pasture plan:     

b) Non-grazing season emergency feed plan:     

11. Do you provide feed supplements and additives in amounts greater than those needed for adequate nutrition (i.e. above labeled rates of consumption)? Yes No

If Yes, list all feed supplements and additives, silage inoculants, preservatives, etc. on the enclosed Livestock Materials/ Medicine Cabinet Inventory form. All feed supplements and additives must be reviewed and approved PRIOR to using.

Table 6. Feed Storage: Describe your feed storage locations in the table below:Type of Storage Storage ID# Type of feed stored Capacity Organic (O),

Conventional (C), Buffer (B)                             

                             

                             

                             

                             

SECTION 5: WaterWater used for organic livestock must be potable and readily accessible. Water tests for coliform bacteria, nitrates and/or known contaminants may be required.

12. How do you provide clean water to your livestock? On-site well Municipal River/Creek/Pond Spring Other (specify):     

13. How do you monitor water quality? Water testing Visually By taste By smell Other (specify):     

14. Do you test your water? Yes NoIf Yes, what was the date of the last test?      (Have results ready to show inspector)

15. Were results of this test satisfactory? Yes No If No, please explain:      

16. If you use additives in the water, list them and state reason for use:      

No additives used

*Be sure to add all water additives to your Livestock Materials/ Medicine Cabinet Inventory form.

17. If livestock have access to a river, creek, or pond, how do you prevent bank erosion?      

No access

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SECTION 6: Housing §205.239Livestock living conditions must provide reasonable freedom of movement, lack of crowding, proper sanitation, fresh air, sunshine, appropriate shelter and adequate bedding. Pasture is required for ruminants.

18. What type of housing do you use?      

19. Do you have an exercise yard or feeding pad for outdoor access during the non-grazing season? Yes NoIf yes, describe:

a) Number and type of animals per area:      

b) Square Footage of area:      

20. Describe the space provided for each type of livestock:

Animal Type Indoor Space (head / sq ft.) Outdoor Pens & Runs (head / sq. ft.)

                 

                 

                 

                 

                 

                 

21. Describe the type of bedding used:      

22. Is bedding certified organic? Yes No Not Applicable

*Keep organic certificates for bedding on file for the inspector to review.

23. How often and with what is housing cleaned out?      

*List sanitation or cleaning products used on Livestock Materials/ Medicine Cabinet Inventory form.

24. Do all ruminant animals have access to pasture, including calves over 6 months old? Yes No If No, explain:      

25. If you will temporarily deny livestock access to pasture during the grazing season, describe the reasons and duration: (example: 4:30-5:30 daily, cows in for milking)

     

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26. If you will temporarily confine livestock during the non grazing season, describe reasons and duration:

(example: temperatures unsafe (December and January))

     

27. How long are animals indoors (hours per day)?       Spring       Summer       Fall       Winter

28. If any wood treated with prohibited products is used, does it come into contact with livestock? Yes NoIf Yes, please describe and include date of installation or replacement and location:       None Used

29. Do you board livestock elsewhere? Yes No *If Yes, you must fill out an off Farm Boarding Supplement prior to moving livestock. Contact PCO to request the form.

SECTION 7: Health Management §205.238A proactive health management program is required to prevent health problems and potential use of prohibited materials. If prohibited treatments are used, the treated animals and/or their products must not be sold as organic. Records must be kept of all treatments, whether they are allowed or not, and whether administered by you or a veterinarian.

GENERAL INFORMATION:30. Identify the general components of your animal health management program:

Selective breeding Raise own replacement stock Isolation for purchased/diseased animals Culling

Vaccinations Good sanitation Access to outdoors Dry bedding Good ventilation in housing

Good quality feed Pasture rotation Nutritional supplements Probiotics Homeopathy

Other (specify):      

31. Describe how you monitor the effectiveness of your health care management:      

32. How often do you conduct health care monitoring?

Daily Weekly Annually As needed Other (specify):      

Include ALL HEALTHCARE TREATMENTS on the Livestock Materials/ Medicine Cabinet Inventory form, including any emergency treatments, prohibited treatments, parasiticides, vaccinations, etc. used by you or a veterinarian failure to do so could jeopardize your certification.*

33. Name and phone number of your veterinarian:      

34. Are any of the livestock and or their products been subject to the use of systemic pain killers or analgesics such as Lidocaine or Procaine? (Taiwan Export) Yes No

If yes, please identify which animals have been treated:     

B) PARASITE CONTROL: Not a problem35. Describe how you prevent or control internal and external parasites on your operation:      

*List all materials on your Livestock Materials/ Medicine Cabinet Inventory form.

C) FLY CONTROL: Not a problem

36. If flies are a problem in your operation, what do you do to prevent or control them?      

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*List all materials on your Livestock Materials/ Medicine Cabinet Inventory form.D) PREDATOR CONTROL: Not a problem

37. Check which predators you have problems with: Hawks Feral cats Raccoons/skunks Dogs Foxes Coyotes Other (specify):     

38. Describe how you handle predator problems in this table:Predator Problem Controls Used Materials Used*

                                                   E) SURGICAL PRACTICES:§205.238(a)(5) of the USDA regulations permits performance of physical alterations as needed to promote the animals’ welfare and in a manner that minimizes pain and stress.

39. Describe surgical practices you use, such as dehorning, castration, tail, docking and types of livestock, age of livestock, reasons for use and procedures used to minimize pain and stress:      

Not used*List all materials on your Livestock Materials/ Medicine Cabinet Inventory form.

SECTION 8: Manure & Pasture Management §205.239 & §205.240A. MANURE MANAGEMENTA producer of an organic livestock operation must manage manure in a manner that does not contribute to contamination of crops, soil or water by plant nutrients, heavy metals, or pathogenic organisms and optimizes recycling of nutrients.

40. What forms of manure do you use: Liquid Semi-solid/piled Fully composted Not used

41. If manure from your livestock is used on your fields, describe how it is used:      

42. List ingredients/additives (example: bedding, barn lime, inoculants, preservatives):      

43. During what months do you apply manure/compost?      

44. Acres of land available for manure application:      

45. Estimated quantity of manure generated per year:       tons

46. Describe how you monitor the effectiveness of your manure management:      

47. How often do you conduct manure management monitoring?

Weekly Monthly Annually As needed Other (specify):      

B. PASTURE MANAGEMENTA Pasture Management Plan must include the following: type of grazing methods and other management practices that ensure

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sufficient quality and quantity of pasture is available for all ruminants to graze throughout the grazing season; soil fertility, seeding systems, and erosion control of pasture; types of pasture; and a map identifying land used as pasture, the location and types of fences, and sources of shade and water sources. No ruminant animals, skip to Section 948. Do you have an existing pasture management plan developed in cooperation with a federal, state or local

conservation office? Yes, plan attachedIf Yes, attach plan NoIf No, complete the following questions. Attach a separate sheet if needed.

a) Describe your grazing methods:      

b) Describe your pasture soil fertility, seeding, and erosion control system:      

c) Describe the types of pastures you manage (i.e. clover, mixed grasses, alfalfa, sorghum sudan):      

d) What types of fencing do you use? Permanent Temporary

49. Do you sell your animals as organic slaughter stock? Yes NoIf No, skip to the next section.

50. What age are the animals at the time of slaughter?      

51. What is the length of your finishing period?      

52. Will your animals be fed in a feedlot during finishing? Yes No

53. Describe the feed ration of the slaughter stock during the finishing period:      

*Your farm map must identify all pastures, location/type of permanent fences, shade, and water sources. (Please attach on separate sheet of paper)

SECTION 9: Milk HandlingMilk handling procedures must meet regulatory requirements for sanitation.

54. What type of milk handling system do you use: We are NOT a dairy operation

Pipeline Automated Step saver Hand milking Parlor Tie stalls Stanchions

Other (specify):     

55. How are you licensed? Grade A Grade B Other (specify):     

56. Do you have a raw milk permit? Yes No

57. Do you:

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Bottle milk

If you pasteurize or bottle milk you must complete a Processor Handler Organic System Plan.

58. Describe cleaning cycle for milking equipment (water temperature, number of rinses, etc.):      

59. Do you do a final water rinse? Yes NoIf No, explain why not:     

*List detergent, acid cleaner and sanitizer used, and products used to clean animals, such as teat dips and udder washes on enclosed Livestock Materials/ Medicine Cabinet Inventory form.

60. How is wastewater from cleaning and sanitizing of milking equipment disposed of?

Municipal sewage Manure pit/lagoon On-farm septic Field drain Other (specify):      

61. How many animals do you currently milk?      

62. How often do you change inflations?       Not used

Report production for the last six milkings in the table below:Date Pounds produced Date Pounds produced Date Pounds produced

1.             3.             5.            

2.             4.             6.            

SECTION 10: Livestock TransportationIf livestock are transported for any reason, complete this section. If not, proceed to Section 11.

63. Are livestock transported? Yes NoIf No, skip to the next section.If Yes, What form of transportation is used and when are livestock transported?     

64. How are animals loaded?      

65. Do you use electric prods? Yes No

66. How long does transportation take?      

67. Are animals provided with food in transit? Yes NoIf Yes, is feed certified organic?

Yes No I don’t know, I am not responsible for providing feed during transit

68. Are animals provided with water in transit? Yes NoIf Yes, are any substances added to the water?

Yes No I don’t know, I am not responsible for providing water during transit

SECTION 11: Handling for Slaughter §205.270Meat to be sold or labeled as organic must be slaughtered at a certified organic facility. If you slaughter your livestock on farm, or at a certified organic facility and supply the label for this meat, an Organic System Plan Processor/ Handler is required. Contact PCO to request the form.

69. Are you selling meat products as organic? Yes NoIf No, skip to the next section.

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70. Describe who slaughters your animals (e.g. slaughter on-farm by you or off-farm at a slaughter facility):

     

71. If slaughtered off-farm, provide the name, address, and phone number of facility where your animals are slaughtered:

     

72. Is the facility certified organic? Yes NoIf Yes, by what agency?      

73. Where are animals kept after delivery to slaughter facility, but before slaughter?      

74. Are organic animals housed separately from non-organic animals? Yes No

75. How are organic meat products stored?      

76. Where are organic meat products sold?      

77. Who is identified as the final handler on the label (e.g. your farm name or the certified organic slaughter facility)?      

78. Who is identified as the certifier on the label (e.g. PCO)?      

SECTION 12: Facility Pest Management §205.271Complete this section to describe pest control practices and materials used in any facility where organic livestock or livestock products are produced, and/or stored, including but not limited to feed storage areas, inside milk house, inside barn, or outside barn (if animals have potential access).

79. Does this operation use any facilities, such as those stated above, in the production or storage of organic livestock or livestock products and have pest problems in those facilities? Yes NoIf No, skip to the next section.

80. Describe the facilities and the livestock products produced or stored in those facilities:      

81. What type of facility pest management system(s) do you use? In-house: name of responsible person:       Contracted pest control service (name, phone no.):      

82. Check all facility pest problems you encounter: Flying insects Crawling insects Spiders Birds Rats Mice Other(specify):      

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83. Check all pest management practices you use. Note: All materials used for facility pest management must be listed on your Materials Used Form.

Good sanitation

Removal of exterior habitat/food sources

Cleanup of spilled product

Mowing

Physical barriers

Monitoring devices

Repair of holes, cracks, etc.

Screened windows, vents, etc.

Inspection zones around interior perimeter

Electrocutors

Ultrasound/light devices

Release of beneficials

Sticky traps

Pheromone traps

Mechanical traps

Non-synthetic substances consistent with the National List

(e.g. pyrethrum)

Synthetic substance consistent with the National List (e.g.

vitamin D3 bait)

Synthetic substance NOT on the National List (e.g. most

commercially available rodent bait)*

Other (specify):      

*If you want to use a synthetic not on the National List you must receive authorization from PCO prior to use.

84. Describe monitoring, including frequency, used to determine effectiveness of management practices above:     

85. If pest control materials are used, where are they stored?      

86. What records do you maintain to document pesticide use and measures taken to prevent contamination of organic products?      

*Attach facility map showing location of pest traps and monitoring devices. Map Attached

SECTION 13: Animal Identification §205.236Records sufficient to preserve the identity of all organically managed animals must be kept.

87. Describe your animal identification system:      

88. If animals were to be treated with prohibited or restricted materials, how would you plan to identify and/or segregate those animals?      

SECTION 14: Record Keeping §205.236USDA regulations require documentation of purchased animals and/or breeding records; purchased feed and feed supplements; health records; and sales/shipping records. Have your records available for review by the inspector.

Check types of records you keep: Feed (including amounts and type of feed actually fed to each type and class of animal and seasonal feed rations changes) Documentation of purchased animals Purchased feed/feed supplements

Access to pasture Organic certificates for purchased feed/ organic bedding Breeding Feed labels Health

Somatic cell/plate count Milk production Sales Feed storage Shipping/transportation Slaughter

Other (specify):      

SECTION 15: Marketing §205.303TYPE OF MARKETING: Farmers market Direct to retail CSA/subscription service On-farm retail Wholesale Wholesale to processor Contract to buyer Other (specify):      

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89. Do you use or plan to use any labels and/or marketing materials? Yes NoIf No, proceed to the next section.If yes, include a copy of the labels/marketing materials.

90. Do your labels identify Pennsylvania Certified Organic as the certifying agent? Yes No

91. Do you use or plan to use the PCO logo on the label or marketing materials? Yes No

92. Do you intend to use the USDA logo on the label or marketing materials? Yes No

SECTION 16: International Export: Canada, European Union, Taiwan, JapanPlease provide the following information even if you do not currently intend to export any organic products to Canada, European Union, Taiwan, or Japan in order for PCO to review this information. This will expedite any export verification needs you or your customers may have in the future. However, this information is not required for your Organic System Plan to be considered complete.A. CANADA N/A

93. If exporting swine or swine products, provide the stocking densities for these animals:Indoor Space (head / sq ft) Outdoor Pens & Runs (head / sq ft)

                                            94. Are you using any labels for products exported to Canada other than labels already approved by PCO?

If yes, attach labels for PCO to review. Yes No*Note: The 100% Organic Label is not permitted in Canada. Labels must be bilingual (English and French).

Livestock Requested for Export to Canada

Number of Animals

Livestock Products Requested for Export to Canada

Product Amount Estimated for Export

                       

                       

                       

                       

B. EUROPEAN UNION N/A

95. Are you using any labels for products exported to the European Union other than labels already approved by PCO?If yes, attach labels for PCO to review. Yes No*Note: The 100% Organic Label is not permitted in the European Union.

Livestock Requested for Export to European Union

Number of Animals

Livestock Products Requested for Export to European Union

Product Amount Estimated for Export

                       

                       

                       

                       

C. TAIWAN N/A

96. If livestock products are to be exported to Taiwan, were systemic painkillers or analgesics, including lidocaine or procaine used in the animals’ management? Yes No

If yes, list.      

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Livestock Requested for Export to Taiwan

Number of Animals

Livestock Products Requested for Export to Taiwan

Product Amount Estimated for Export

                       

                       

                       

                       

D. JAPAN N/A97. Are you using any labels for products exported to Japan other than labels already approved by PCO?If yes, attach labels for PCO to review. Yes No*Note: The 100% Organic Label is not permitted in Japan.

Livestock Requested for Export to Japan

Number of Animals

Livestock Products Requested for Export to Japan

Product Amount Estimated for Export

                       

                       

                       

                       

SECTION 17: “PCO 100% Grassfed” Certification

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☐ We are not requesting “ PCO 100% Grassfed” certification.

98. List the livestock and/or livestock products requested for “ PCO 100% Grassfed” certification:

99. Will your operation be:☐ All “PCO 100% Grassfed” certified animals☐ Some “ PCO 100% Grassfed” certified animals and some animals not certified as “PCO 100% Grassfed” (split operation)

If managing a split operation, how do you identify certified and non-certified “PCO 100% Grassfed” livestock?

100.Do you plan to transition a “PCO 100% Grassfed” herd? YES NOIf yes, date transition started:

If no, did you purchase a certified grassfed herd? YES NO

If purchased, what is the source and who are they certified by?

101. Do you raise replacement animals on farm for “PCO 100% Grassfed” certification? YES NO

102.Do you purchase any replacement animals that are certified grassfed? YES NO If yes, give specific information on livestock purchased within the past 12 months: Please write the type of livestock purchased, their identification no./name, date of purchase, projected real birthing date, the purchase source and what agency certified them.

Type of Livestock Identification No./Name

Date of Purchase Projected or Real Birthing Date

Purchase Source Certified Grassfed by What Agency?

103.Describe feed ration (if different than ration listed in Table 4): Same ration as described in Table 4

104.Do you feed: Milk (after weaning) Grain and grain by-products Corn kernels or corn kernel by-products Cake or meal feedstuffs Concentrates Food processing by-products or waste Small grain or corn allowed to mature past the vegetative (pre-grain/pre-boot) state

105.Do you feed sprouted grains with the root portion attached? YES NO N/A

106.How do you ensure that pastures that contain grain or corn crops are not intentionally managed to allow grain or corn crops to mature past the vegetative (pre-grain/pre-boot) state?

107.Do you board “PCO 100% Grassfed” certified livestock elsewhere? YES NO

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If yes, you must complete an Off-Farm Boarding Supplement form prior to moving livestock. Contact PCO to request form.

108.Do you label any products as “PCO 100% Grassfed”? YES NOIf yes, you must complete a Processor/Handler Organic System Plan and Organic Product Profile for each product.

109.Does your organic recordkeeping system address the additional requirements of the “PCO 100% Grassfed” standard? YES NOIf not, what additional records are kept to ensure compliance with the “PCO 100% Grassfed” standards?

110.Additional Comments:

SECTION 18: Conflict of Interest §205.501111.Have you used any organic production consultants for your operation in the last 12 months? Yes

No (This does not refer to your inspector, certification specialist, or other PCO representative involved with your certification review.)

If yes, list the name and contact information for organic production consultant(s) your operation has used in last 12 months (7 CFR §205.501(a)(11)(ii)):      

SECTION 19: Previous Organic Certification §205.401112.List current organic certification by other agencies and dates:      If currently certified by another agency, submit a copy of your current certificate and verification of the items you are certified to produce/sell.

113. If currently certified organic, has your operation received a non-compliance(s) or been issued a proposed suspension or proposed revocation that has not yet been resolved?

Yes NoIf yes, submit a copy of any adverse action notice including: notification of noncompliance, notification of proposed suspension or proposed revocation issued to you and a description of any actions taken by you to correct the non-compliance(s) noted in the adverse action notice, including evidence of such corrections an resolution letter from certifier, if any.

114. If previously certified, list names of agencies, dates, non-compliances and reasons for surrender or termination of certification:      

115. Have you ever been denied organic certification or has your organic certification ever been withdrawn, surrendered suspended or revoked? Yes No

If yes, submit a copy of any adverse action notice, including suspension, revocation or denial of certification issued to you and a description of any actions taken by you to correct the non-compliances noted in the notification, including evidence of such corrections and resolution letter from certifier or the National Organic Program Administrator, if any. If certification was withdrawn or surrendered, provide reason:      

116. Gross organic sales of organic crops in previous calendar year: $      If none sold, enter 0.

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Information provided on this application is held in strict confidence and will be used only for certification purposes. I affirm that all statements made in this application are true and correct. To the best of my knowledge no prohibited products have been used, applied or otherwise allowed to compromise the integrity of the organic crops, livestock or products for which I am requesting certification.

I agree to comply with the requirements set forth by the National Organic Program in 7 CFR Part 205 and in the PCO Certification Manual including but not limited to:

1. Establish, implement and update annually the Organic System Plan that will be submitted to PCO.2. Cooperate with the certification process by completing all documentation requested by PCO.3. Permit on-site inspections with complete access to all production and handling areas of my operation, including non-

certified production and handling areas, structures or offices by PCO. These inspections may be announced or unannounced at the discretion of PCO or as required by the Administrator or State organic program’s governing State official.

4. Maintain all records applicable to the organic operation for not less than five (5) years beyond their creation.5. Allow authorized representatives of PCO, the Secretary and the applicable State organic program’s governing State

official access to these records under normal business hours for review and copying to determine compliance with the Act and the regulations (7 CFR Part 205).

6. Make accessible all agricultural products that are to be sold labeled or represented as organic for examination (such as residue testing) by the Administrator, the applicable State organic program’s governing State official, or the certifying agent to ensure compliance with the National Organic Program.

7. Pay all certification fees as outlined on the most current fee schedule and be responsible for delinquent account fees, such as reasonable attorney fees, court costs and cost of collections.

8. Immediately notify PCO concerning any application, including drift, of a prohibited substance to any field, production unit, site, facility, livestock, or product that is being requested for certification.

9. Immediately notify PCO of any significant changes in my certified operation or portion of the operation that may affect its compliance with the applicable standards or regulations (7 CFR Part 205), including substances to be used as a production or handling input.

10. Ensure that my certificate, certification report or other documents or information are not used in a misleading manner and does not harm PCO.

11. Discontinue use of certification claims, PCO and NOP names and logos, upon suspension, revocation, surrender, or termination of certification and return or destroy any certification documents or materials requested by PCO.

12. Acknowledge that acceptance of this organic system plan in no way implies granting of certification by the certifying agent.

I understand that failure to abide by the above requirements may result in denial, suspension or revocation of my organic certification, prosecution for fraud or misrepresentation, denial of services, or any other remedy allowed by law.I give permission for PCO to release information about my operation to other NOP-accredited certifying agents upon obtaining a confidentiality agreement from the requesting certifier before releasing information. PCO has my permission to obtain information, documents, or materials related to my operation or previous operations, concerning certification, denial of certification, suspension, revocation, surrender or termination from other certifiers.

Your signature(s):       Date:      

Typing your name in the signature line(s) constitutes a signature.

If applicable:Signature of Contracted Grower:       Date:      

Required attachments: These records must be returned with your application or it may be returned to you resulting in a delay of the certification process.

General Information Form (if new applicant) Maps of the operation (including field #’s, acreage, buildings and adjoining land use) Field and Pasture Records (with prior land use statements if not managed by you for the past three years) Livestock Materials – Medicine Cabinet Inventory Labels used on your organic product(s) (if applicable) Brochures and/or other marketing materials (if applicable)

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