NOAA Form 89-819 "Specification and Label Submittal Action Request"

What Is NOAA Form 89-819?

This is a legal form that was released by the U.S. Department of Commerce - National Oceanic and Atmospheric Administration on March 1, 2006 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2006;
  • The latest available edition released by the U.S. Department of Commerce - National Oceanic and Atmospheric Administration;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of NOAA Form 89-819 by clicking the link below or browse more documents and templates provided by the U.S. Department of Commerce - National Oceanic and Atmospheric Administration.

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Download NOAA Form 89-819 "Specification and Label Submittal Action Request"

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Print Form
OMB Control #0648-266
Expires 02/29/2012
NOAA FORM 89-819
U.S. DEPARTMENT OF COMMERCE
1. DATE SUBMITTED
(03-06)
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
Prescribed by NOAA Inspection Manual
SEAFOOD INSPECTION PROGRAM
2. PLANT CODE(S)
SPECIFICATION AND LABEL SUBMITTAL ACTION REQUEST
INSTRUCTIONS – Please print for complete by typewriter. Submit a set
3. PROCESSOR OR PACKER (Name, address and Phone Number)
of 5 specifications and/for labels with each product label indicated on
form. All copies except field copy to be submitted to the address below or
action. Field copy to be retained by requestor until specifications and/or
labels are returned by Approving Officer.
4. DISTRIBUTOR (Name and full address)
TO: DOCUMENTATION APPROVAL and SUPPLY SERVICES
P.O. DRAWER 1207 – 3207 FREDERIC ST., SUITE B
PASCAGOULA, MISSISSIPPI 39568-1207
USDC No. (Item 5) to be assigned by Approving Officer. Indicate USDC Number of approved specifications or labels in Remarks when submitting
replacements with minor changes, or when submitting or verification for cancellation. Indicate primary logo, packer or distributor name, or other identification
for item 6. Use numbers only or item 9: 1 - No. Shield
2 - Combination Grade A & PUFI.,
3 - PUFI Mark,
4 - Grade A,
5 - Lot Inspected Mark
5. USDC NUMBER
6. PRODUCT IDENTIFICATION
7. COMMODITY
8. CONTENT
9. SHIELD
(Use official terminology including type, style and size;
indicate in ounces or count/pounds. Enter 10 digit commodity code)
OR
CODE
(Brand and identifying number if any)
LABEL
SPEC.
PRODUCT
COMMODITY CODE
(See Above)
NET WEIGHT
10. USDC INSPECTOR (Signature)
Inspector Number
HACCP
11. HAVE SPECIFICATIONS AND/FOR LABELS BEEN
REVIEWED FOR COMPLIANCE WITH USDC AND FDA
REGULATIONS?
COMPANY OFFICIAL (Signature)
BY INSPECTOR?
BY FIELD INSPECTION OFFICER?
YES
NO
YES
NO
12. ACTION REQUESTED
LABEL/SPEC. REVIEW
NEW LABEL SKETCH/PROOF REVIEW
NEW LABEL APPROVAL (FINAL)
NEW SPEC. APPROVAL (FINAL)
REPLACEMENT SPEC. OR LABEL
CANCEL APPROVAL
OTHER (SPECIFY IN REMARKS)
USDA/FNS (CN) LABEL OR SPECS ACTION
EXTEND TEMPORARY APPROVAL (SPECIFY IN REMARKS)
APPROVAL BY THE USDC IS BASED ON THE INFORMATION SUPPLIED AND DOES NOT IMPLY CONCURRENCE FOR ACCEPTANCE BY OTHER
FEDERAL STATE FOR LOCAL GOVERNMENTAL AGENCIES UNLESS SPECIFICALLY NOTED, NOR DOES IT RELIEVE THE COMPANY FROM
COMPLIANCE WITH OTHER APPLICABLE LAWS, REGULATIONS OR RULINGS. THIS APPROVAL BECOMES VOID IF CHANGES ARE MADE IN THE
SPECIFICATION OR LABEL WITHOUT THE CONCURRENCE OF THE USDC APPROVING OFFICER.
13. REMARKS (Please initial)
TO BE COMPLETED BY APPROVING OFFICE(S) ONLY
PROOF APPROVED FOR PRINTING
AS IS
WITH CHANGES NOTED
APPROVING OFFICER (Signature)
DATE:
Temporary Approval Expires
(Spec)
(Label)
USDA/FNS USE ONLY
Final Approval Label
Final approval Spec.
SKETCH/PROOF
LABEL
CONCURRENCE
NON-CONCURRENCE
Disapproved label
Disapproved Spec.
USDA APPROVAL (Signature)
DATE:
Extends Approval
Cancelled
Reviewed
Print Form
OMB Control #0648-266
Expires 02/29/2012
NOAA FORM 89-819
U.S. DEPARTMENT OF COMMERCE
1. DATE SUBMITTED
(03-06)
NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION
Prescribed by NOAA Inspection Manual
SEAFOOD INSPECTION PROGRAM
2. PLANT CODE(S)
SPECIFICATION AND LABEL SUBMITTAL ACTION REQUEST
INSTRUCTIONS – Please print for complete by typewriter. Submit a set
3. PROCESSOR OR PACKER (Name, address and Phone Number)
of 5 specifications and/for labels with each product label indicated on
form. All copies except field copy to be submitted to the address below or
action. Field copy to be retained by requestor until specifications and/or
labels are returned by Approving Officer.
4. DISTRIBUTOR (Name and full address)
TO: DOCUMENTATION APPROVAL and SUPPLY SERVICES
P.O. DRAWER 1207 – 3207 FREDERIC ST., SUITE B
PASCAGOULA, MISSISSIPPI 39568-1207
USDC No. (Item 5) to be assigned by Approving Officer. Indicate USDC Number of approved specifications or labels in Remarks when submitting
replacements with minor changes, or when submitting or verification for cancellation. Indicate primary logo, packer or distributor name, or other identification
for item 6. Use numbers only or item 9: 1 - No. Shield
2 - Combination Grade A & PUFI.,
3 - PUFI Mark,
4 - Grade A,
5 - Lot Inspected Mark
5. USDC NUMBER
6. PRODUCT IDENTIFICATION
7. COMMODITY
8. CONTENT
9. SHIELD
(Use official terminology including type, style and size;
indicate in ounces or count/pounds. Enter 10 digit commodity code)
OR
CODE
(Brand and identifying number if any)
LABEL
SPEC.
PRODUCT
COMMODITY CODE
(See Above)
NET WEIGHT
10. USDC INSPECTOR (Signature)
Inspector Number
HACCP
11. HAVE SPECIFICATIONS AND/FOR LABELS BEEN
REVIEWED FOR COMPLIANCE WITH USDC AND FDA
REGULATIONS?
COMPANY OFFICIAL (Signature)
BY INSPECTOR?
BY FIELD INSPECTION OFFICER?
YES
NO
YES
NO
12. ACTION REQUESTED
LABEL/SPEC. REVIEW
NEW LABEL SKETCH/PROOF REVIEW
NEW LABEL APPROVAL (FINAL)
NEW SPEC. APPROVAL (FINAL)
REPLACEMENT SPEC. OR LABEL
CANCEL APPROVAL
OTHER (SPECIFY IN REMARKS)
USDA/FNS (CN) LABEL OR SPECS ACTION
EXTEND TEMPORARY APPROVAL (SPECIFY IN REMARKS)
APPROVAL BY THE USDC IS BASED ON THE INFORMATION SUPPLIED AND DOES NOT IMPLY CONCURRENCE FOR ACCEPTANCE BY OTHER
FEDERAL STATE FOR LOCAL GOVERNMENTAL AGENCIES UNLESS SPECIFICALLY NOTED, NOR DOES IT RELIEVE THE COMPANY FROM
COMPLIANCE WITH OTHER APPLICABLE LAWS, REGULATIONS OR RULINGS. THIS APPROVAL BECOMES VOID IF CHANGES ARE MADE IN THE
SPECIFICATION OR LABEL WITHOUT THE CONCURRENCE OF THE USDC APPROVING OFFICER.
13. REMARKS (Please initial)
TO BE COMPLETED BY APPROVING OFFICE(S) ONLY
PROOF APPROVED FOR PRINTING
AS IS
WITH CHANGES NOTED
APPROVING OFFICER (Signature)
DATE:
Temporary Approval Expires
(Spec)
(Label)
USDA/FNS USE ONLY
Final Approval Label
Final approval Spec.
SKETCH/PROOF
LABEL
CONCURRENCE
NON-CONCURRENCE
Disapproved label
Disapproved Spec.
USDA APPROVAL (Signature)
DATE:
Extends Approval
Cancelled
Reviewed