| Specifications | Department of Health and Human Services \r\nFood and Drug Administration\r\nInterstate Shellfish Deal\ er s Certificate FDA-3038 bdoyle |
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| Specifications | Department of Health and Human Services \r\nFood and Drug Administration\r\nInterstate Shellfish Deal\ er s Certificate FDA-3038 bdoyle |
| Business section |
| Specifications | Department of Health and Human Services \r\nFood and Drug Administration\r\nInterstate Shellfish Deal\ er s Certificate FDA-3038 bdoyle |
| Suggested Link Details/Purchase | |
| Content | DEPARTMENT OF HEALTH AND HUMAN SERVICES(Check One) FOOD AND DRUG ADMINISTRATION (See Reverse of Part III for Instructions) Form Approved: OMB No. 0910-0021 Expiration Date: March 31, 2013 See Burden Statement on back of Part III. Certification Cancellation SECTION I- COMPLETED BY STATE SHELLFISH CONTROL AUTHORITY 1. SHELLFISH DEALER / SHIPPER (Name) FACILITY ADDRESS (Include Street No., City, State, & ZIP) TELEPHONE 2.CERTIFICATION DP - DepurationRP - Repacker e) CATEGORY SYMBOL 3. DATE OF ON-SITE INSPECTION THIS CERTIFICATE MUST BE KEPT ON FILE FOR A PERIOD OF TWO (2) YEARS. 6. CANCELLATION DATE b) SIGNATURE8. a) STATE SHELLFISH CONTROL AUTHORITY DESIGNEE (Print Name) 4. STATE SHELLFISH STANDARDIZATION INSPECTOR (Print Name) 5. EXPIRATION DATE OF INSPECTOR S STANDARDIZATION SP - Shucker-PackerSS - Shell Stock Shipper 7. REASON FOR CANCELLATION (Check One) RS - Reshipper FORM FDA 3038 (7/10) (Replaces Forms FDA 3038b and FDA 3038c which are obsolete.) Decertification Other (Please Specify) Out of Business c) DATE CERTIFICATE SENT TO FDA SECTION II- COMPLETED BY DIVISION OF COOPERATIVE PROGRAMS - FDA 9. DATE CERTIFICATE RECEIVED10. DATE CERTIFICATE PUBLISHED INTERSTATE SHELLFISH DEALER S CERTIFICATEPART 1 - HFS-625 Change Renewal MAILING ADDRESS (If different than above) a) CERTIFICATE NUMBERb) DATE CERTIFIED c) STATEd) EXPIRATION DATE PSC Graphics: (301) 443-1090 EF PHP - Post HarvestProcessor() |
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| Following Datasheets | UCM076880_1 (1 pages) UCM079504 (2 pages) UCM079936_1 (21 pages) UCM080534 (14 pages) UCM080778_1 (2 pages) UCM080788_1 (4 pages) UCM080796_1 (2 pages) UCM080814_1 (2 pages) UCM080839_1 (3 pages) UCM080858_1 (3 pages) |
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