Form PPQ Form 519 PPQ Form 519 COMPLIANCE AGREEMENT

Irradiation Treatment; Location of Facilities in the Southern United States

PPQ 519 SEP 2012

Business

OMB: 0579-0383

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UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE
1. NAME AND MAILING ADDRESS OF PERSON OR FIRM

OMB APPROVED
0579-0054/0088/0129/
0198/0257/0310/0317/
0322/0337/0346/0363/
0369 and 0383

COMPLIANCE AGREEMENT
2. LOCATION

3. REGULATED ARTICLE(S)

4. APPLICABLE FEDERAL QUARANTINE(S) OR REGULATIONS

5. I / WE AGREE TO THE FOLLOWING:

6. SIGNATURE

7. TITLE

8. DATE SIGNED

9. AGREEMENT NUMBER

The affixing of the signatures below will validate this agreement which shall remain in
effect until canceled, but may be revised as necessary or revoked for noncompliance.
11. PPQ/CBP OFFICIAL (NAME AND TITLE)

12. ADDRESS

13. SIGNATURE

14. U.S. GOVERNMENT/STATE AGENCY OFFICIAL (NAME AND TITLE)

15. ADDRESS

16. SIGNATURE

PPQ FORM 519
SEP 2012

All previous editions are obsolete.

10. DATE OF AGREEMENT


File Typeapplication/pdf
File TitleUNITED STATES DEPARTMENT OF HOMELAND SECURITY
Authorkastratchko
File Modified2016-02-02
File Created2012-09-24

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