Report of Certification FDA-2359d PSC Publishing Services

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Specifications	Report of Certification FDA-2359d PSC Publishing Services
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PRODUCTMATERIAL 123456789101112131415161718192021 DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION FORM F

Specifications	Report of Certification FDA-2359d PSC Publishing Services
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Content	PRODUCTMATERIAL 123456789101112131415161718192021 DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION FORM FDA 2359d (10/10) REPORT OF CERTIFICATION (Fabrication of Single-Service Containers and Closures for Milk and Milk Products) 12345 FOR FDA USE ONLY IDENTIFICATION 20 1. NAME OF SINGLE-SERVICE FABRICATING PLANT 4. STREET 2. CITY3. STATE 5. MFG. CODE NO. 56575859 6. CODE 6061627. AGENCY PROVIDING ROUTINE INSPECTION 7.a. RATING AGENCY MONTH 7.b. DATE OF INSPECTION PRODUCT CODE (60) 7.c. EXPIRATION DATE * DAY 676869707172 YEAR SHD MATERIAL CODE (62) *EXPIRATION DATE Permission is hereby granted to release and publish the above stated certification for use by State and local milk control authorities and prospective purchasers. Certification of single-service manufacturing plants may be valid for a period not to exceed one (1) or two (2) years from the earliest survey date. The expiration date is one (1) or two (2) years from the earliest survey date. 8. SANITARIAN OR CONSULTANT 9. CERTIFICATION RECOMMENDED YES LABORATORY CONTROL 10. NAME AND ADDRESS (OR CODE) OF APPROVED LABORATORY 11. INSPECTION RESULTS (Place an X under Items involved) 12. PERMISSION TO PUBLISH It is understood and agreed by the undersigned that the official Rating Agency may review and appraise the single-service fabricating plant at any time during the period of time the above certification is in effect. It is further understood that failure to maintain the above certification will subject this plant to withdrawal from the IMS Listing. We will notify the Rating Agency of any significant changes made in the operation of this plant. 12.a. NAME OF PLANT 12.b. OFFICER AUTHORIZING RELEASE12.c. TITLE 13.c. SUBMITTED BY (Signature and Title)13.b. RECOMMENDED CLASSIFICATION ACCEPTED 13.a. DATE OF REPORT 14. DATE RECEIVED 16. DATE TRANSMITTED 15. PUBLICATION OF RATING RECOMMENDED 17. SIGNATURE (FDA Regional Milk Specialist) YESNO FOR FDA USE ONLY 13. SUBMISSION OF REPORT BY STATE MILK SANITATION RATING AGENCY YESNO(If NO , indicate why.) PSC Publishing Services: (301) 443-6740EF 1. Metal 2. Paper (Includes laminates) 3. Plastic 4. Metal and paper 5. Metal and plastic 6. Paper and plastic 7. Metal, paper and plastic 8. Glass 9. Rubber 10. Paper, metal, plastic and glass 1. Containers 2. Closures 3. Other products 4. Containers and closures 5. Containers and other products 6. Closures and other products 7. Containers, closures and other products 9a. LISTING TYPE SDA SDL Other NOFULLPARTIAL
Following Datasheets	UCM053528_1 (3 pages) UCM053529_1 (1 pages) UCM053532_1 (2 pages) UCM053635_1 (2 pages) ucm056731_1 (7 pages) UCM061463_1 (8 pages) UCM070945-1_1 (12 pages) UCM070981 (33 pages) UCM071234_1 (2 pages) UCM071253_1 (3 pages)
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