First receiver/shorebased processor economic data survey

West Coast Groundfish Trawl Economic Data

FirstReceiverShorebasedProcessorSurvey 3_4_2014

Economic data collections for catcher vessels, catcher-processors, motherships and first receivers

OMB: 0648-0618

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OMB Control No. 0648-0618 Expiration Date: 04/30/2015


Economic Data Collection (EDC) Form



WEST COAST GROUNDFISH

FIRST RECEIVER

AND SHOREBASED PROCESSOR

2013



NOAA Fisheries – Northwest Fisheries Science Center




Who is responsible for submitting:

  • All owners of a first receiver site license in 2013; or

  • All owners and lessees of a shore-based processor (as defined under “processor” at §660.11, subpart C, for purposes of EDC) that received round or headed-and-gutted IFQ species groundfish or whiting from a first receiver in 2013.

  • A separate EDC form is required for each processing facility.

Complete all questions. If a question is not applicable, write "NA" in the answer box. The survey will not be considered complete unless there is an answer to every question.

Submit by September 1, 2013. Completed and signed EDC forms must be mailed and postmarked by or hand-delivered to NMFS no later than September 1, 2014. Mail or deliver to

Economic Data Collection Program (FRAM Division),

Northwest Fisheries Science Center

2725 Montlake Boulevard East

Seattle, WA 98112

Retain a copy. Retain a copy of the completed form.

Fillable forms and more information: www.nwfsc.noaa.gov/edc.

Questions: Visit the website above or contact Erin Steiner at (866) 791-3726 or [email protected].









Public Reporting Burden Statement

Public reporting burden for this collection of information is estimated to take 20 hours per response, including time for reviewing the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden to Erin Steiner, National Marine Fisheries Service, Northwest Fisheries Science Center, 2725 Montlake Blvd E, Seattle, WA 98112.

Additional Information

Before completing this form, please note the following: 1) Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number; 2) This information is mandatory and is required to manage commercial fishing efforts under 50 CFR part 660 and under section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.); 3) Responses to this information request are confidential under 402(b) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.). They are also confidential under NOAA Administrative Order 216-100, which sets forth procedures to protect the confidentiality of fishery statistics.

  1. Contact Information and Facility Characteristics


  1. Provide the buyer identification number issued by the state fish and game agencies associated with this entity or facility. Enter “NA” if this is a processing facility that does not have a buyer identification number.

Processor/Buyer IDs

Washington Department of Fish and Wildlife


__________

Oregon Department of Fish and Wildlife


__________

California Department of Fish and Game


__________



  1. Provide the following information about this receiving or processing facility.


Name of Facility

First Receiver Site License Number for 2013

Business Mailing Address

Street / PO Box




Business Phone

( )

Business Fax

( )

City

State

Zip Code

Business Email




  1. Individual completing this report. If your address, phone, and email are provided above, you do not need to repeat them here, but please provide your name and title.


Name

Title

Business Mailing Address

Street / PO Box




Business Phone

( )

Business Fax

( )

City

State

Zip Code

Business Email

  1. Answer the following questions related to the most recent appraisal of this facility.


What was the year of this facility's last appraisal?

_________

yyyy

What was the market value of this facility from the appraisal,

rounded to the nearest 100 dollars?

$_________

What was the replacement value of the facility from the appraisal, rounded to the nearest 100 dollars?

$_________

Did the survey values given above include the value of all processing equipment* contained on-site?

Yes No



  1. For the remainder of the survey, report values from your 2013 fiscal year. When did this facility’s 2013 fiscal year begin?

_____/_____/__________

mm dd yyyy



Please report values from your 2013 fiscal year for the remainder of this survey.



  1. Capitalized Expenditures


  1. Provide the 2013 capitalized expenditures associated with the facility buildings, machinery, and equipment. Round all answers to the nearest 100 dollars.


Capitalized Expenditure Category

Total Capitalized Expenditures

Capitalized expenditures on buildings (exclude land but include building improvements)

$___________________

Capitalized expenditures on new and used machinery and equipment (include only equipment used to process*, transport on-site, or store fish on-site)

$___________________








  1. Employees and Payroll


Provide the following information about the number of employees and wages. Include full and part-time employees and temporary employees working at this facility. The information is requested separately for production workers and all other employees, which are defined below.


  1. Provide the number of production workers in the following table. Production workers include those workers at this facility (up through and including the line-supervisor level) engaged in fabricating, processing, assembling, inspecting, receiving, packing, warehousing, shipping, maintenance, repair, janitorial, product development, or transporting product on-site. If your fiscal year does not follow the calendar year, use the month that corresponds with your fiscal year.


For the week including

Number of production workers

(full time, part time, and temporary)

Total Hours Worked

January 12th

___________workers

___________hrs

February 12th

___________workers

___________hrs

March 12th

___________workers

___________hrs

April 12th

___________workers

___________hrs

May 12th

___________workers

___________hrs

June 12th

___________workers

___________hrs

July 12th

___________workers

___________hrs

August 12th

___________workers

___________hrs

September 12th

___________workers

___________hrs

October 12th

___________workers

___________hrs

November 12th

___________workers

___________hrs

December 12th

___________workers

___________hrs



  1. Provide the number of all other employees in the following table. All other employees includes those involved in supervision above line-supervisor level, sales, advertising, credit, collection, installation, cafeteria, recordkeeping, clerical and routine office functions, guard services, executive, purchasing, finance, and legal. If hours are not tracked for salaried employees, please assume a 40-hour work week. If your fiscal year does not follow the calendar year, use the month that corresponds with your fiscal year.


For the week including

Number of all other employees (full time, part time, and temporary)

Total Hours Worked

March 12th

___________________employees

___________________hrs



  1. Provide the total number of individuals who worked at this facility during 2013 in production activities and in all other activities. Note that this value should indicate the number of individuals employed at any point during the year rather than the number of positions

  • Include full-time and part-time workers, contract workers, temporary workers, and workers on paid leave.


Labor Category

Total Number of Individuals

Production workers (see definition in Question 7)

___________ individuals

All other employees (see definition in Question 8)

___________ individuals



  1. Provide the total 2013 labor expenses for production workers and all other employees.

  • Include wages, bonuses, benefits, payroll taxes, and unemployment insurance.



Labor Category

Total Expenses

Production workers (see definition in Question 7)

$__________________

All other employees (see definition in Question 8)

$__________________




  1. Quota Costs


  1. Provide the total cost of quota pounds and quota shares purchased or leased during 2013 in the West Coast limited entry fisheries. Purchase of quota reflects a permanent transfer, whereas lease implies a temporary transfer.

  • If you did not incur a particular expense, please write “0”.



Purchase or Lease of Quota

Total Costs

Lease of quota pounds

$__________________

Purchase of quota pounds

$__________________

Lease of quota shares

$__________________

Purchase of quota shares

$__________________











  1. Expenses and Depreciation


  1. Provide the total expenses on utilities at your facility in 2013.


Utility Expense Category

Total Expenses

Electricity

$__________________

Natural gas

$__________________

Propane gas for transportation and processing

$__________________

Other gas (not gasoline)

$__________________

Water

$__________________

Sewer, waste, and byproduct disposal

$__________________


  1. Provide the total expenses on rental or lease payments for this facility.



Rental or Lease Payments

Total Expenses

Rental or lease of buildings, job-site trailers, and other structures (including land)

$__________________

Rental or lease of processing machinery or equipment

$__________________



  1. Provide total repair and maintenance expenses on facility buildings, machinery, and equipment (see definitions on bottom of page 3) expensed in 2013?



Total Repair and Maintenance Expenses

$__________________



  1. What was the total depreciation for all capital investments on buildings, new and used machinery and equipment (see definitions of equipment on page 3) taken in 2013?



Total Depreciation

$___________________



  1. Provide the following information on 2013 custom processing of fish you owned that was performed by another processor outside of this facility.




Total weight of fish supplied to

custom processors

Custom Processing

Fees Paid

Whiting

_________________lbs

$_________________

Non-Whiting Groundfish

_________________lbs

$_________________

Other

_________________lbs

$_________________

  1. Provide the total amount expensed during 2013 in each of the categories below for this facility.



Expense Category

Total Expenses

Shoreside monitoring costs

$______________________

Offloading expenses paid to other facilities

$______________________

Production supplies (boots, smocks, hairnets, knives, etc.)

$______________________

Cleaning and custodial supplies

$______________________

Packing materials

$______________________

Freight costs for supplies to the facility

$______________________

Non-fish ingredients (additives)

$______________________

Off-site product freezing and storage

$______________________

Insurance payments (property, product, personal liability and fire liability)

$______________________

Taxes (property and excise)

$______________________

Licensing fees

$______________________

Other Specify________________

$______________________

Other Specify________________

$______________________



  1. Provide the following information about the landing origin of groundfish received at this facility in 2013.

  • If this information is not available, place an “NA” in the answer box.

  • Do not include fish received that you custom processed for others.



Landing Origin

Total Weight of Groundfish Received

Total Cost of Groundfish Received

Whiting



West Coast (WA, OR, CA)

____________lbs

$_______________

Canada

____________lbs

$_______________

Other Specify_______________

____________lbs

$_______________

Non-whiting groundfish



West Coast (WA, OR, CA)

____________lbs

$_______________

Alaska (excluding pollock)

____________lbs

$_______________

Canada

____________lbs

$_______________

Other Specify_______________

____________lbs

$_______________

  1. Fish Received. In the table below provide the weight and cost of fish received in 2013. Please note that there are separate columns for fish that were not paid for and fish that were paid for.

  • Do not include fish received for custom processing.

  • Include fish purchased by you that are custom processed by another processor outside of this facility.

  • Include any post-season adjustments.

  • LE Trawl Vessels: fish acquired directly from a vessel registered to a Limited Entry (LE) permit with a trawl endorsement and caught either with trawl or fixed gear (longline or pots).

  • LE Fixed Gear Vessels: fish acquired directly from a vessel registered to a LE permit with a fixed gear endorsement. Do not include fish caught with fixed gear using a LE permit with a trawl endorsement.

  • Other Vessels: fish acquired directly from a vessel without a limited entry trawl or fixed gear endorsement, including open access fisheries.

  • Non-Vessel Sources: includes fish acquired from other entities, including first receivers, processors, wholesale dealers, brokers, aquaculture producers, and transfers from outside this facility.

  • Gross Cost of Fish Paid for includes the value of any taxes paid on behalf of delivering vessels.


Type and Source

of Fish

Fish NOT PAID for


Fish PAID for

Total weight not paid for

due to quality or size reasons

Total weight not paid for

transfers from outside this facility

Total weight of fish paid for

from vessels or non-vessel sources

Gross cost of fish paid for

from vessels or non-vessel sources

Whiting




LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Arrowtooth flounder





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Dover sole





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

English sole





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Lingcod





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

19. (Continued)

Type and Source

of Fish

Fish NOT PAID for


Fish PAID for

Total weight not paid for

due to quality or size reasons

Total weight not paid for

transfers from outside this facility

Total weight of fish paid for

from vessels or non-vessel sources

Gross cost of fish paid for

from vessels or non-vessel sources

Pacific sanddab





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Petrale sole





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Rex sole





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Rockfish





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Sablefish (black cod)





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Thornyheads





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Sharks, skates, rays





LE Trawl Vessels

____________lbs


____________lbs

$____________

LE Fixed Gear Vessels

____________lbs


____________lbs

$____________

Other Vessels

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Coastal pelagic (include sardines and mackerel)


Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

19. (Continued)

Type and Source

of Fish

Fish NOT PAID for


Fish PAID for

Total weight not paid for

due to quality or size reasons

Total weight not paid for

transfers from outside this facility

Total weight of fish paid for

from vessels or non-vessel sources

Gross cost of fish paid for

from vessels or non-vessel sources

Crab





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Echinoderms (include sea urchins and sea cucumbers)


Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

California Halibut





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Pacific Halibut





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Herring





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Salmon





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Shrimp





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Squid





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Sturgeon





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Tuna





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Other Shellfish





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

Other Species (please list)


__________________





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

__________________





Vessel Sources

____________lbs


____________lbs

$____________

Non-Vessel Sources

____________lbs

____________lbs

____________lbs

$____________

  1. Annual Earnings


  1. Fish Production. Provide the 2013 value of production FOB plant (after discounts and allowances and excluding freight charges).

  • Frozen includes fish that is frozen in the round or fish that is processed in any form (fillets, H&G, e.g.) and frozen.

  • Unprocessed includes fish sold in the round.

  • Include:

    • Products made or acquired during 2013 and held in inventory at the end of the year. Estimate the value on the basis of the average price received for similar products sold during the year.

    • Products shipped to other facilities of your company. Estimate the value on the basis of the average price received for similar products sold during the year.

    • Products made from custom processing performed for you.

    • Any post-season adjustments.

  • Do not include:

    • Revenue from products produced or acquired in previous years.

    • Products you produced as a custom processing service for others.

    • Any additional payment you received to cover any shipping, handling, or storage costs associated with the sale beyond the plant.

    • Discards.


Type of Fish

Total weight

of 2013 fish production

(both processed and unprocessed)

Total value

of 2013 fish production

(both processed and unprocessed)




Whiting



Surimi

_______________lbs

$_______________

H&G

_______________lbs

$_______________

Fillets

_______________lbs

$_______________

Roe

_______________lbs

$_______________

Frozen Whole

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other ____________

_______________lbs

$_______________

Other ____________

_______________lbs

$_______________

Arrowtooth flounder



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Dover sole



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

English Sole



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________


Type of Fish

Total weight

of 2013 fish production

(both processed and unprocessed)

Total value

of 2013 fish production

(both processed and unprocessed)




Lingcod



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Pacific Sanddab



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Petrale sole



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Rex sole



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Rockfish



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Sablefish



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Thornyheads



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Sharks, Skates, Rays



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Coastal Pelagic (include sardines and mackerel)


Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________



20. (Continued)


Type of Fish

Total weight

of 2013 fish production

(both processed and unprocessed)

Total value

of 2013 fish production

(both processed and unprocessed)




Crab



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Echinoderms (include sea urchins and sea cucumbers)


Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

California Halibut



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Pacific Halibut



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Herring


Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Salmon



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Smoked

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Shrimp



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________


20. (Continued)


Type of Fish

Total weight

of 2013 fish production

(both processed and unprocessed)

Total value

of 2013 fish production

(both processed and unprocessed)




Squid



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Sturgeon


Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Tuna



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Canned

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Other Shellfish



Processed Fresh

_______________lbs

$_______________

Frozen

_______________lbs

$_______________

Unprocessed

_______________lbs

$_______________

Other

_______________lbs

$_______________

Other Non-Species Specific Products


Fish Meal

_______________lbs

$_______________

Fish Oil

_______________lbs

$_______________

Bait

_______________lbs

$_______________

Other products

_______________lbs

$_______________

Other Species (please list)


__________________

_______________lbs

$_______________

__________________

_______________lbs

$_______________

__________________

_______________lbs

$_______________


  1. Other Earnings


  1. Provide the revenue received by you for custom processing of fish owned by another processor outside of this facility in 2013.




2013 Custom Processing Revenue

Whiting

$__________________

Non-Whiting Groundfish

$__________________

Other

$__________________



  1. Provide the revenue received in 2013 for each of the earnings sources listed below.


Earnings Source

2013 Total Revenue

Offloading earnings received from others

$__________________

Sale of quota pounds

$__________________

Leasing of quota pounds

$__________________

Leasing of quota share

$__________________

Sale of quota share

$__________________

  1. Read the following statement, and sign and date the box below.


I certify under penalty of perjury that I have reviewed all the information in this questionnaire and that it is true and complete to the best of my knowledge.

Signature

Date signed


_____/_____/_________

mm dd yyyy



Questionnaire Comments:
















































Shape1

Revised: 11/23/11: v6


* Processing equipment: All equipment present at this physical location that is used for preparation or packaging of seafood to render it suitable for human consumption, retail sale, industrial uses or long-term storage, including, but not limited to, cooking, canning, smoking, salting, drying, filleting, freezing, or rendering into meal or oil.

Transportation equipment: Equipment such as trucks, forklifts, etc. used to transport seafood within this physical location.

Storage equipment: Equipment present at this physical location for packaging and freezing of seafood.


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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePlease provide the following information about the person completing this questionnaire:
AuthorCarl Lian
File Modified0000-00-00
File Created2021-01-27

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