Form 52.3 "Application: License for Operation of a Meat/Meat Processing Plant" - Nova Scotia, Canada

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Download Form 52.3 "Application: License for Operation of a Meat/Meat Processing Plant" - Nova Scotia, Canada

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APPLICATION: LICENSE FOR OPERATION OF A MEAT/MEAT PROCESSING PLANT
Environment - Meat Inspection
Applicant Contact Information:
_____________________________________
_________________
_______________________________________
First Name
Middle Initial
Last Name
________________________ ________
_______________________
________
Primary Phone Number
Ext
Secondary Phone Number
Ext
__________________________________
___________________________________________________________
Fax Number
Email Address
Applicant Mailing Address:
Street name and type, PO Box, RR #, Site #, Etc..
__________________ __________________ __________________ ________________________
____________
Country
Province
County
City/Town
Postal Code
Property details/location of proposed activities:
__________________ ______________________________________________________________
Civic number
Street name and type
_______________________________ _______________________________
County
Community
Name under which business is carried on:
Name Registered with Joint Stocks:
Registered Business Number:
Nova Scotia Premises ID: NS __ __ __ __ __ __ __
Owner of plant (if partnership, list names of all partners):
__________________________________________________________________________________________________
a) Meat Facility (slaughter) – species and number of animals to be slaughtered per week (include limitations):
Form 52.3
Page 1 of 2
APPLICATION: LICENSE FOR OPERATION OF A MEAT/MEAT PROCESSING PLANT
Environment - Meat Inspection
Applicant Contact Information:
_____________________________________
_________________
_______________________________________
First Name
Middle Initial
Last Name
________________________ ________
_______________________
________
Primary Phone Number
Ext
Secondary Phone Number
Ext
__________________________________
___________________________________________________________
Fax Number
Email Address
Applicant Mailing Address:
Street name and type, PO Box, RR #, Site #, Etc..
__________________ __________________ __________________ ________________________
____________
Country
Province
County
City/Town
Postal Code
Property details/location of proposed activities:
__________________ ______________________________________________________________
Civic number
Street name and type
_______________________________ _______________________________
County
Community
Name under which business is carried on:
Name Registered with Joint Stocks:
Registered Business Number:
Nova Scotia Premises ID: NS __ __ __ __ __ __ __
Owner of plant (if partnership, list names of all partners):
__________________________________________________________________________________________________
a) Meat Facility (slaughter) – species and number of animals to be slaughtered per week (include limitations):
Form 52.3
Page 1 of 2
APPLICATION: LICENSE FOR OPERATION OF A MEAT/MEAT PROCESSING PLANT
Environment - Meat Inspection
b) How may days per week are anticipated for slaughter operations?
__________________________________________________________________________________________________
__________________________________________________________________________________________________
c) Will operations be seasonal, if so, which months?
__________________________________________________________________________________________________
__________________________________________________________________________________________________
d) Meat Processing Facility (processing facility) – species and product to be processed (include limitations):
e) Will any Ready-to-eat products be processed? If yes, describe products/product types.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
I hereby apply for a license to engage in the business of operating a meat plant/meat processing plant under the Nova
Scotia Meat Inspection Act and Regulations.
I acknowledge it is an offense to provide false or misleading information, and confirm to the best of my knowledge and
belief the information provided in this form and supporting documentation is true and accurate and complies with the
relevant provisions of the Meat Inspection Regulations.
Dated at
this
day of
20
(city/town)
(date)
(month)
(year)
Applicant:
(print clearly)
(signature)
Completed application form should be sent to nearest Nova Scotia Environment district office.
OFFICE USE ONLY
Date Received: (yyyy/mm/dd)
Inspector Assigned:
Form 52.3
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