InForms Ppq525a.wpf 525A Ppqform525a
User Manual: 525A
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Print Form Print Form No permit can be issued to move soil until an application has been received (7 CFR 330). According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0054. The time required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing instructions, searching ex isting data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. FORM APPROVED OMB NO. 0579-0054 U.S. DEPARTMENT OF AGRICULTURE - ANIMAL AND PLANT HEALTH INSPECTION SERVICE - PLANT PROTECTION AND QUARANTINE APPLICATION FOR PERMIT TO RECEIVE SOIL INSTRUCTIONS: SEE ATTACHED INSTRUCTION SHEET NOTE: If you intend to isolate and/or culture live organisms (such as fungal plant pathogens or nematodes) from the soil, then you must hold a valid plant permit based on PPQ Form 526. PPQ Form 525A cannot be used for this purpose. To apply for a plant pest permit, see our website at http://www.aphis.usda.gov/plant_health/permits/organism/index.shtml 2. Method of Shipment 1. Origin of shipment(s) Hawaii or Puerto Rico Mail Baggage Air Cargo Sea Cargo Overland Other__________ Various foreign countries One country (Specify)_______________________________ 3. Method of packaging (Must be sturdy and leakproof; please describe.) 4. Port(s) of arrival desired (Specify) 6. Quantity per shipment 5. Approximate date for arrival of first shipment 3 lbs. or less (go to #6a) over 3 lbs. (go to #7) 6a. Will heat sterilization at the port of arrival interfere with intended use? Dry Heat 6b. If no, check preferred treatment and then go to #10. Yes - Go to #7 No - Go to #6b Steam Heat NOTE: If you are importing over 3 lbs. of soil per shipment, or if you are importing 3 or less lbs. of soil per shipment and you answered "Yes" to question 6a, then your facility must be inspected and approved to receive, handle, store, and dispose of the soil under the conditions of a compliance agreement. Complete the rest of the form and submit it to the State Plant Health Director of the State of destination. Contact Permit Services at (301) 734-5519 or access the website at http://www.aphis.usda.gov/ppq/sphd/ for a list of State Plant Health Offices. 7. Intended use (Please provide specific information.) Chemical or physical analysis _______________________________________________________________________________________ As a growing medium for plants _____________________________________________________________________________________ For the isolation and/or culture of Deoxyribonucleic Acid (DNA) or Ribonucleic Acid (RNA) _______________________________________ Other __________________________________________________________________________________________________________ 8. Precautions to be used to prevent pest dissemination (Please describe) 9. Method of Final Disposition Incineration Autoclaving Other _________________________________________ NOTE: Please attach a detailed explanation if soil is to be moved or removed from the receiving facility without a sterilizing treatment. 10. Name and address of receiving facility 11. Applicant's Name (type or print clearly) 12. Signature and Date Applicant's Phone ( ) Applicant's Fax ( ) TO BE COMPLETED BY STATE AND FEDERAL REGULATORY OFFICIALS Recommendation Approve Conditions Recommended Disapprove Accept USDA Decision Signature of State Official Title State Date Signature of PPQ Official Title Work Unit Date PPQ FORM 525A (JAN 2008) Instructions for Completing Form 525A Application for Permit to Receive Soil NOTE: If you intend to isolate and/or culture live organisms (such as fungal plant pathogens or nematodes) from the soil, then you must hold a valid plant pest permit based on PPQ Form 526. PPQ Form 525A cannot be used for this purpose. To apply for a plant pest permit, see our website at http://www.aphis.usda.gov/plant_health/permits/organism/index.shtml Please TYPE or PRINT legibly. Complete every block except for blocks 4 and 5 which may be left blank if the information is unknown. 1. Indicate the origin of the soil shipment. If you check “one country,” enter the name of the country on the line provided. 2. Indicate the method of shipment. If you want to hand-carry soil, check “Other” and enter on the line ‘hand carry.’ Hand carried items must be approved with the port of entry before arrival. 3. Briefly describe the packaging being used (i.e., Tupperware, cooler, etc.). 4. Enter the city and State of the first port of arrival. If unknown leave blank 5. Enter the approximate or estimated date of arrival. If unknown leave blank. 6. Indicate the weight of soil per shipment. If 3 or less lbs., continue to block 6a. If more than 3 lbs., continue to block 7. 6a. If you are importing 3 or less lbs. of soil per shipment, answer “Yes” or “No” if heat sterilization will interfere with the intended use. If you answered “No” to 6a, the soil must be treated at a USDA Plant Inspection Station. Continue to block 6b. If you answered “Yes” to question 6a, continue to block 7. 6b. indicate the preferred method of sterilization, and then skip to block 10. 7. Indicate all that apply. If you intend to isolate and/or culture live organisms (such as plant pathogens or nematodes) from the soil, then you are using the wrong form. See the note at the top of this form for instructions for the PPQ Form 526. Selection of ‘Other’ includes landfill. 8. Enter a brief description of the precautions to be used to prevent pest dissemination. If no pests exist, enter “N/A.” 9. Indicate the method of final disposition. Selection of “Other” may include landfill. Please attach a detailed explanation if soil is to be moved or removed from the receiving facility without a sterilizing treatment. All attachments must have a company name, a contact name, and Form 525A typed or printed at the top of each page. 10. Enter the name, address, and phone number of the receiving facility. Enter the applicant’s telephone and facsimile numbers, including the Area Code. 11. Enter the applicant’s name; this should be the person directly responsible for the soil received by the facility. 12. Enter signature of applicant and the date. Do not enter information following block 12. Forwarding Instructions: - Note: If you are importing over 3 lbs. of soil per shipment, or if you are importing 3 or less lbs. of soil per shipment and you answered "Yes" to question 6a, then your facility must be inspected and approved to receive, handle, store, and dispose of the soil under the conditions of a compliance agreement. Complete the rest of the form and submit it to USDA/APHIS/PPQ/Permit Services, 4700 River Road, Riverdale, MD 20737. You may Contact Permit Services at (301) 734-5519 or your state Plant Health Director: Access the website at http://www.aphis.usda.gov/services/report_pest_disease/report_pest_disease.shtml for a list of State Plant Health Offices. *Please Note: APHIS IS IN THE PROCESS OF REVISING FORM OMB- PPQ FORM 525A (JAN 2008) THAT CURRENTLY DIRECTS THE APPLICANT TO SUBMIT THEIR APPLICATION TO THE STATE PLANT HEALTH DIRECTOR OF YOUR STATE. PLEASE DISREGARD THAT GUIDANCE. ALL PERMIT APPLICATIONS ARE NOW RECEIVED AT THE ADDRESS ABOVE.
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