525A Application for Permit to Receive Soil

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 existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.				OMB APPROVED 0579-0054 3/2013
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
1. Origin of shipment(s) Hawaii Various Foreign Countries One Country (Specify)_______________________________	2. Method of Shipment
	Air: (Specify) Bond Courier Hand-carry (Est. # Shipments ________)	Sea: (Specify) Bond Courier Hand-carry (Est. # Shipments ________)	Ground: (Specify) Bond Courier Hand-carry (Est. # Shipments ________)
	Other (Specify)_______________________________
3. Method of packaging (Must be sturdy and leakproof; please describe.)
4. Port(s) of arrival desired (Specify)	5. Approximate date for arrival of first shipment
6. Quantity per 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? Yes - Go to #7 No - Go to #6b 6b. If no, check preferred treatment and then go to #10. Dry Heat 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 USDA/APHIS/PPQ/Permit Services, 4700 River Road, Unit 133, Riverdale, MD 20737. If you need further guidance in completing this form, please Contact Permit Services at (866) 524-5421 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 safeguard soil samples (Please describe)
9. Method of Final Disposition Autoclaving Incineration Hydroclave EPA Approved Landfill 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 Applicant's Phone ( ) Applicant's Fax ( ) E-mail Address _________________________________________	11. Applicant's Name (type or print clearly)
	12. Signature and Date

PPQ FORM 525A

APR 2010

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, 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.

Forwarding Instructions:

- 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 USDA/APHIS/PPQ/Permit Services at (301) 734-5519 or access the website at Toll Free (866) 524-5421 or 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.

- If you are importing 3 or less lbs. of soil per shipment and you answered “No” in block 6a, then the soil must be treated at the port of arrival. Send the completed application by facsimile to Area Code (301) 734-5786 or by mail to:

USDA/APHIS/PPQ/Permit Services, 4700 River Road, Unit 133, Riverdale, MD 20737.

Please call 1-877-770-5990 if you have any questions.