Form 79-015A Registration of Transporters of Uncooked Parts or Products of Animals That Are Not Intended for Use as Human Food - California

Form 79-015A or the "Registration Of Transporters Of Uncooked Parts Or Products Of Animals That Are Not Intended For Use As Human Food" is a form issued by the California Department of Food & Agriculture.

Download a PDF version of the Form 79-015A down below or find it on the California Department of Food & Agriculture Forms website.

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STATE OF CALIFORNIA
DEPARTMENT OF FOOD AND AGRICULTURE
Meat, Poultry and Egg Safety Branch
1220 N Street
Sacramento, CA 95814
(916) 900-5004
79-015A (Rev. 04/18)
REGISTRATION OF TRANSPORTERS OF UNCOOKED PARTS OR PRODUCTS
OF ANIMALS THAT ARE NOT INTENDED FOR USE AS HUMAN FOOD
Name of Transporter:
Address, City, Zipcode:
Telephone Number:
FAX Number:
E-mail Address:
Description of Animal Material To Be Transported
Origin of Animal Material To Be Transported
Name and location of the establishment where animal material is obtained:
Destination of Transported Animal Material
Name and location of the rendering plant, pet food plant, collection center or other approved disposal site to which
the animal material is to be transported:
Transport Vehicle(s)
Make:
Year:
License Number:
Make:
Year:
License Number:
Make:
Year:
License Number:
Signature of Transporter:
Date:
This registration and notice of changes of the above information are to be sent to:
Meat, Poultry and Egg Safety Branch, 1220 N Street, Sacramento, CA 95814
*
Any change in the information contained in the license or registration application shall be reported in writing
to the Meat, Poultry and Egg Safety Branch within (10) business days of such change.
*
Providing false information on applications for licenses or registration application shall be a violation and
shall be justification for denial of an application.
Signature of MPES Branch Authority
Title
Date
STATE OF CALIFORNIA
DEPARTMENT OF FOOD AND AGRICULTURE
Meat, Poultry and Egg Safety Branch
1220 N Street
Sacramento, CA 95814
(916) 900-5004
79-015A (Rev. 04/18)
REGISTRATION OF TRANSPORTERS OF UNCOOKED PARTS OR PRODUCTS
OF ANIMALS THAT ARE NOT INTENDED FOR USE AS HUMAN FOOD
Name of Transporter:
Address, City, Zipcode:
Telephone Number:
FAX Number:
E-mail Address:
Description of Animal Material To Be Transported
Origin of Animal Material To Be Transported
Name and location of the establishment where animal material is obtained:
Destination of Transported Animal Material
Name and location of the rendering plant, pet food plant, collection center or other approved disposal site to which
the animal material is to be transported:
Transport Vehicle(s)
Make:
Year:
License Number:
Make:
Year:
License Number:
Make:
Year:
License Number:
Signature of Transporter:
Date:
This registration and notice of changes of the above information are to be sent to:
Meat, Poultry and Egg Safety Branch, 1220 N Street, Sacramento, CA 95814
*
Any change in the information contained in the license or registration application shall be reported in writing
to the Meat, Poultry and Egg Safety Branch within (10) business days of such change.
*
Providing false information on applications for licenses or registration application shall be a violation and
shall be justification for denial of an application.
Signature of MPES Branch Authority
Title
Date

Download Form 79-015A Registration of Transporters of Uncooked Parts or Products of Animals That Are Not Intended for Use as Human Food - California

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