Use This Form to Make Changes to Your Registration. Click in the Shaded Gray Areas

Use this form to make changes to your registration. Click in the shaded gray areas.

After completing the form, you may either print and fax or email this form to WSDA. To email this form, you must save it (“SAVE AS”), and then attach the saved file to the email message.
Facility Name: /

TF #

Phone

/ Fax / Contact Person (s) /

Associate Companies

Room ID: List room exactly the way you will identify it throughout the season.

Room Type:Indicate whether the room is controlled atmosphere (“CA”) or regular storage (“RS”).
Room Status:Indicate whether the room is new, was not approved for the program last season, or if it has had structural or equipment changes since approved last season. If the room was approved last season and has had no structural or equipment change, then choose “Not New/No Change.

Check
one / Room ID / Room Type / Location
(Physical Address) / Lease
From / Room
Status / Room Capacity / Temp Recorder
Cu. Ft. / Bin Count / Manufact. / Type
Add
Remove / CA
RS / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change
Add
Remove / -- Choose One --New this seasonNot new/No ChangesStructural ChangeEquipment Change

Return completed form FAX (509) 575-2537