Form SFN59075 "Weed Seed Free Forage Certification Request to Inspect" - North Dakota

What Is Form SFN59075?

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

Form Details:

  • Released on February 1, 2019;
  • The latest edition provided by the North Dakota Department of 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 printable version of Form SFN59075 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Agriculture.

ADVERTISEMENT
ADVERTISEMENT

Download Form SFN59075 "Weed Seed Free Forage Certification Request to Inspect" - North Dakota

Download PDF

Fill PDF online

Rate (4.8 / 5) 53 votes
WEED SEED FREE FORAGE CERTIFICATION REQUEST TO INSPECT
600 E Boulevard Ave, Dept 602
Bismarck, ND 58505-0020
NORTH DAKOTA DEPARTMENT OF AGRICULTURE (NDDA)
800-242-7535
NOXIOUS WEEDS DIVISION
SFN 59075 (2-2019)
Inspector list available on web:
www.nd.gov/ndda/program/weed-seed-free-forage-program
Please submit this form to an inspector
Applicant Name
Address
City
State
ZIP Code
E-mail Address
Telephone Number
Cell Phone Number
County
INSPECTION MUST BE DONE WITHIN 10 DAYS OF HARVEST
LEGAL
*NOXIOUS WEEDS PRESENT
PLANNED
FIELD
ACRES
DATE AND *TREATMENT MADE
IN FIELD AND FIELD BORDERS
CUTTING DATE
NUMBER
DESCRIPTION & COORDINATES
Lat:
Long:
Lat:
Long:
Lat:
Long:
Attach FSA map of each field. Highlight clearly the area to be inspected. Be sure the field number is legible.
*NOTE: All North American Invasive Species Management Association (NAISMA) listed noxious weeds present in the field must be controlled prior to
inspection and before the weeds have reached the bud or boot stage. Control methods include herbicides, mowing, tillage, or burning.
I hereby request the property highlighted on the attached map and listed above be inspected for certification under the North American Invasive Species
Management Association standards for weed seed free forage, and agree to the following terms:
1. An inspector ("inspector") may enter the property as necessary for inspection and certification of forage located on the property.
2.
I will pay the following fees to NDDA: $2 for each acre inspected, $30 per hour for the inspection and travel time, and mileage at the posted state rate.
3.
Forage will not be certified if it does not meet NAISMA standards.
4.
I will abide by the appropriate standards during all stages of production, including harvesting, labeling, and storage.
NDDA may conduct an investigation of any forage in my possession to verify that I am abiding by the appropriate standards during all stages of
5.
production, as required by this agreement. In conducting this investigation an inspector may enter anywhere certified forage is located or stored.
6.
I understand that during forage certification, the first two bales will NOT be tagged and certified as a precaution against contaminated equipment.
7.
The certification of the forage may be revoked if I fail to abide by the terms of this agreement.
8.
I understand that certification is not a warranty of any kind as to the quality of the product from an inspected and certified location, and that the only
representation is that forage for sale or resale has been inspected for contamination by weed seeds under the NAISMA standards.
9.
The inspector and NDDA are not responsible to any third parties for any damage caused by an applicant's use of inspection reports, certifications, or
labels. I agree to hold harmless and indemnify the inspector and NDDA, from any claims based on such damage or loss.
Applicant's Signature
Date
White: NDDA
Yellow: Inspector
WEED SEED FREE FORAGE CERTIFICATION REQUEST TO INSPECT
600 E Boulevard Ave, Dept 602
Bismarck, ND 58505-0020
NORTH DAKOTA DEPARTMENT OF AGRICULTURE (NDDA)
800-242-7535
NOXIOUS WEEDS DIVISION
SFN 59075 (2-2019)
Inspector list available on web:
www.nd.gov/ndda/program/weed-seed-free-forage-program
Please submit this form to an inspector
Applicant Name
Address
City
State
ZIP Code
E-mail Address
Telephone Number
Cell Phone Number
County
INSPECTION MUST BE DONE WITHIN 10 DAYS OF HARVEST
LEGAL
*NOXIOUS WEEDS PRESENT
PLANNED
FIELD
ACRES
DATE AND *TREATMENT MADE
IN FIELD AND FIELD BORDERS
CUTTING DATE
NUMBER
DESCRIPTION & COORDINATES
Lat:
Long:
Lat:
Long:
Lat:
Long:
Attach FSA map of each field. Highlight clearly the area to be inspected. Be sure the field number is legible.
*NOTE: All North American Invasive Species Management Association (NAISMA) listed noxious weeds present in the field must be controlled prior to
inspection and before the weeds have reached the bud or boot stage. Control methods include herbicides, mowing, tillage, or burning.
I hereby request the property highlighted on the attached map and listed above be inspected for certification under the North American Invasive Species
Management Association standards for weed seed free forage, and agree to the following terms:
1. An inspector ("inspector") may enter the property as necessary for inspection and certification of forage located on the property.
2.
I will pay the following fees to NDDA: $2 for each acre inspected, $30 per hour for the inspection and travel time, and mileage at the posted state rate.
3.
Forage will not be certified if it does not meet NAISMA standards.
4.
I will abide by the appropriate standards during all stages of production, including harvesting, labeling, and storage.
NDDA may conduct an investigation of any forage in my possession to verify that I am abiding by the appropriate standards during all stages of
5.
production, as required by this agreement. In conducting this investigation an inspector may enter anywhere certified forage is located or stored.
6.
I understand that during forage certification, the first two bales will NOT be tagged and certified as a precaution against contaminated equipment.
7.
The certification of the forage may be revoked if I fail to abide by the terms of this agreement.
8.
I understand that certification is not a warranty of any kind as to the quality of the product from an inspected and certified location, and that the only
representation is that forage for sale or resale has been inspected for contamination by weed seeds under the NAISMA standards.
9.
The inspector and NDDA are not responsible to any third parties for any damage caused by an applicant's use of inspection reports, certifications, or
labels. I agree to hold harmless and indemnify the inspector and NDDA, from any claims based on such damage or loss.
Applicant's Signature
Date
White: NDDA
Yellow: Inspector