Pistachios Grown in California

Notification of Aflatoxin Levels

Lab Name

Work 
Number

Certificate 
Number

OMB No. 0581-0215
SCI FV187 
Number 
Issued

Customs 
Entry 
Number

Importer

Applicant

Country of 
Commodity
Origin

Date
Sampled

Date 
Date
Date Tested Certificate 
Received
Issued

Tester 
Name

Container 
Number

Total 
Weight

Unit of 
Measure

Inspection 
Result

Aflatoxin 
Lot Number
Result

Sample 
Number

Testing 
Methodolo
gy

SC-249 (Rev. 02/2017)
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0581-0215.
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information.
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