Form 79-018 "Application for Permit to Remove Inedible Materials From a Rendering Plant" - California

What Is Form 79-018?

This is a legal form that was released by the California Department of Food & Agriculture - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2018;
  • The latest edition provided by the California Department of Food & Agriculture;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 79-018 by clicking the link below or browse more documents and templates provided by the California Department of Food & Agriculture.

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Download Form 79-018 "Application for Permit to Remove Inedible Materials From a Rendering Plant" - California

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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
79-018 (Rev. 04/18)
APPLICATION FOR PERMIT TO REMOVE INEDIBLE
MATERIALS FROM A RENDERING PLANT
Check one
Routine Removal (Expires 2 years from date of issue)
Mail this application to the Meat, Poultry and Egg Safety Branch Headquarters
Equipment Failure or Power Outage
Submit this application to the Meat, Poultry and Egg Safety Branch. If acceptable, a pre-approved permit will be returned to
you and will be kept in a pre-approval status until equipment failure or power outage necessitates temporary activation. See
attached instructions to activate the permit.
Catastrophic Event
If more space is needed,
(Unforeseen circumstance e.g. earthquake, severe weather, etc.)
please use the back of this
Specify Catastrophic Event
form
Permit for catastrophic purpose is requested to be valid for
days.
Fax this application to the Meat, Poultry and Egg Safety Branch Headquarters office at (916) 900-5334 prior to shipment. In
addition, you may call the Area Supervisor at the phone number listed above to discuss the request prior to shipment.
I hereby apply for a Permit to remove inedible material from the rendering plant named below. Application for the Permit is with the understanding that,
according to Section 1180.29 of the California Code of Regulations, Inedible material may only be removed to a site that has been approved in writing by
the Department. To prevent its use as human food, this material must be denatured or otherwise identified by approved methods prior to transport.
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.
RENDERING PLANT SHIPPING INEDIBLE MATERIAL:
Rendering Plant Name:
Mailing Address:
Location Address (if different):
Telephone Number:
FAX Number:
*Providing false information on applications for licenses or registration application shall be a violation and shall be justification for denial of
an application.
*I declare under penalty of perjury that the information provided on this application is true and accurate to the best of my knowledge.
Name of Plant Official:
Signature:
Date:
DESTINATION(S) RECEIVING INEDIBLE MATERIAL:
Name:
Name:
Address:
Address:
Transportation Company:
Transportation Company:
Description of Inedibles and reason for removal:
Description of Inedibles and reason for removal:
STATE OF CALIFORNIA
DEPARTMENT OF FOOD AND AGRICULTURE
Meat, Poultry and Egg Safety Branch
1220 N Street
Sacramento, CA 95814
(916) 900-5004
79-018 (Rev. 04/18)
APPLICATION FOR PERMIT TO REMOVE INEDIBLE
MATERIALS FROM A RENDERING PLANT
Check one
Routine Removal (Expires 2 years from date of issue)
Mail this application to the Meat, Poultry and Egg Safety Branch Headquarters
Equipment Failure or Power Outage
Submit this application to the Meat, Poultry and Egg Safety Branch. If acceptable, a pre-approved permit will be returned to
you and will be kept in a pre-approval status until equipment failure or power outage necessitates temporary activation. See
attached instructions to activate the permit.
Catastrophic Event
If more space is needed,
(Unforeseen circumstance e.g. earthquake, severe weather, etc.)
please use the back of this
Specify Catastrophic Event
form
Permit for catastrophic purpose is requested to be valid for
days.
Fax this application to the Meat, Poultry and Egg Safety Branch Headquarters office at (916) 900-5334 prior to shipment. In
addition, you may call the Area Supervisor at the phone number listed above to discuss the request prior to shipment.
I hereby apply for a Permit to remove inedible material from the rendering plant named below. Application for the Permit is with the understanding that,
according to Section 1180.29 of the California Code of Regulations, Inedible material may only be removed to a site that has been approved in writing by
the Department. To prevent its use as human food, this material must be denatured or otherwise identified by approved methods prior to transport.
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.
RENDERING PLANT SHIPPING INEDIBLE MATERIAL:
Rendering Plant Name:
Mailing Address:
Location Address (if different):
Telephone Number:
FAX Number:
*Providing false information on applications for licenses or registration application shall be a violation and shall be justification for denial of
an application.
*I declare under penalty of perjury that the information provided on this application is true and accurate to the best of my knowledge.
Name of Plant Official:
Signature:
Date:
DESTINATION(S) RECEIVING INEDIBLE MATERIAL:
Name:
Name:
Address:
Address:
Transportation Company:
Transportation Company:
Description of Inedibles and reason for removal:
Description of Inedibles and reason for removal: