H4
Electronic versions available at www.tilth.org Page 1 of 2
Operation Name: / Date:
► Complete this form if you produce, mill, or blend products sold as livestock feed. Organic livestock feed must contain only organically produced and handled agricultural ingredients, except that synthetic additives and supplements allowed by the National List may be used.
NOP §205.105 and NOP §205.306: An operation intending to formulate livestock feed must ensure that feed ration is composed of all organic agricultural ingredients and allowed non-agricultural materials as included on the National List.4.1 GENERAL INFORMATION
Describe specific handling activities included within this Organic System Plan (i.e. formulating, pelleting, etc.):
4.2 ORGANIC PRODUCT COMPOSITION
1) Attach a Master Product List (MPL-01) to list all products you would like included on your certificate, including blends and single ingredient products (i.e. corn, soy meal, ‘Complete Poultry Feed Blends’)
Attached
2) Attach a Master Ingredient List (MIL-03) listing all organic and non-organic ingredients/processing aids.
Attached
3) How do you verify that all supplier/ingredient organic certificates are current for all ingredients/products?
Maintain valid certificates onsite, updated annually.
Other (Explain):
4) How do you verify that only compliant ingredients and materials are used?
Submit to OTCO for review and approval prior to use.
Other (Explain):
5) How are you able to demonstrate that only organic agricultural ingredients and approved nonorganic materials were used in each lot produced?
Maintain batch/production records showing the identity and quantity of each ingredient used in each lot.
Other (Explain):
4.3 LIVESTOCK FEED LABELS
Labeling guidelines are available on our website.
1) How do you verify that only compliant labels are used?
Not applicable, no labels used. Explain:
Submit to OTCO for review and approval prior to printing Other (Explain):
2) Describe how finished products are labeled or identified if shipped in non-retail form (i.e. railcar, truck, tote, etc.)
3) Do you package any products for Private Label/Marketer customers? Yes No
If yes, is the Private Label Owner/Marketer certified for this product?
Yes, attach their current organic certificate No, attach a completed Private Label Agreement Form
4.4 FACILITIES
1) Are products handled at multiple facilities? No Yes
If yes, attach the following:
a) A list of the handlers or facilities and their certifiers or MPL-01
b) Organic certificates for facilities other than your own
2) If off-site facilities are used to store organic ingredients and products while unsealed or in permeable packaging, complete the following table, or provide an attachment with this information: Not applicable Attached
Storage Facility Name & Location / Ingredients/Products Stored / Documentation*OC ISIS
OC ISIS
OC ISIS
OC ISIS
OC ISIS
OC ISIS
OC ISIS
OC ISIS
*Attach the Organic Certificate (OC) for each certified organic storage facility listed above. For any non-certified facilities listed above, attach a completed OTCO Independent Storage Information Sheet (ISIS) form, available at www.tilth.org.
2525 SE 3rd Street, Corvallis, OR 97333, 503-378-0690 | 1-877-378-0690 |
H4-Livestock Product Summary rev. 5/1/14