EN-QS-F-184-2 Rev. A, 2015.10.08Page 1 of 2
Operator #: / Operation Name: / Date:
At least 36 month of histories are required for all apiary areas that are or will eventually be requested for certification (including areas that are currently transitional or conventional).
- Apiary area histories must include the current year and show all areas, whether they are organic (O), in transition (T), or conventional (C), area numbers, size of each area (acres, hectares, etc.), crops/plant types grown in the area, and any inputs that were applied (must include specific dates and rates of application). Also attach maps of all areas which indicate hive sites, directions, size and shape, buffer zones and adjoining land use. There must also be an overview map that shows all areas in relation to one another. The sizes listed in the histories and maps must correspond.
- If legal description/address for each apiary area is not located on the history sheets and/or maps, please submit a sheet that provides this information. If all collection areas are connected in an entire unit, one legal description/address is sufficient.
1. Status of operation: Organic only Parallel production (organic/non-organic)
2. How long have you managed your operation?
3. How long have you been certified?
4. Total apiary area owned? / 5. Total apiary area rented?
6. Total number of hives? / 7. Total organic hives? / 8. Total hives in transition?
9. Have you managed all apiary areas requested for certification for 3 or more years? YES NO
If NO, you must submit signed statements from the previous manager stating the use and all inputs applied for the previous three years on all newly rented or purchased areas. A completed and signed OCIA Prior Land Use Affidavit (PLUA) will address this.
10. OCIA Standards – Are all non-organic apiary areas currently being transitioned to organic production?
Yes No Not Applicable. Organic only.
If NO, please submit your plan for converting all areas to organic production within the next five years.
11. If requesting any of the equivalency arrangements, where will the products be marketed? Please note which products will be marketed to other countries.
12. All apiary areas and honey products are requested for certification for the programs selected in your Application/Renewal Form unless specified below.
13. Please complete the following table to indicate the specific apiary areas and honey products that will be requested for certification.
Apiary Area Identification/Honey Product / Number of Hives
(only for apiary areas) / Projected Production Amounts
(including unit of measure)
To Be Signed At Inspection
I/We understand that filing and acceptance of this affidavit in no way implies granting of certification or attestation by OCIA International.
Before signing this document, please confirm that all programs are correctly marked and all products/services that you want to request for certification are listed. The products/services will be listed on the certificate addendum as described on this form.
Operator Signature: / Date (mm/dd/yyyy):
Inspector Signature: / Date (mm/dd/yyyy):
EN-QS-F-184-2 Rev. A, 2015.10.08