Form MJ19-3002 "Processor Extract Processing Equipment" - Oregon

What Is Form MJ19-3002?

This is a legal form that was released by the Oregon Liquor Control Commission - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 6, 2019;
  • The latest edition provided by the Oregon Liquor Control Commission;
  • 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 MJ19-3002 by clicking the link below or browse more documents and templates provided by the Oregon Liquor Control Commission.

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Download Form MJ19-3002 "Processor Extract Processing Equipment" - Oregon

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OREGON LIQUOR CONTROL COMMISSION
Processor Extract Processing Equipment
What is this form?
Prior to licensure or renewal a processor applicant seeking an extract endorsement must list all equipment used in extraction as
required by OAR 845-025-3260(2). If the processor is proposing to use hydrocarbon solvents, they must additionally provide
proof that the installed equipment and process has been inspected by a certified mechanical or electrical engineer, industry
recognized third party, or manufacturer.
Any change in the equipment listed on this form, including replacing an extraction unit or adding additional extraction units
requires prior written approval under OAR 845-025-1175 because it materially alters the usage of the licensed premises.
Only equipment used to process extracts needs to be listed on this form. Equipment used only for processing other types of
products may be omitted.
Section 1 – Business Information
Applicant Name:
Application ID:
Premises Address:
City:
ZIP:
Section 2 – Extract Processing Equipment
Below is the current list of extract processing equipment for this premises:
Serial Number
Common Name of Equipment
Manufacturer
Model Number
(only needed for extractor units)
Attach additional pages if needed
Section 3 – Acknowledgement & Agreement
On behalf of the applicant (“Applicant”), I acknowledge and agree to the following:
Applicant will use only the equipment listed above for extract processing at the licensed premises.
If any of the equipment listed above is an extractor designed for use with hydrocarbon solvent, the equipment
has been inspected in accordance with Commission rules.
Applicant must obtain written approval from the Oregon Liquor Control Commission prior to operating any extract
processing equipment not referenced in this list. Failure to do so may result in the Commission taking
administrative action against the license, which could result in a civil penalty, suspension or revocation of the
license.
Signature:
Date:
Name:
Title:
[FORM MJ 19-3003] mj_app_prc_equipment (20190206) Page 1 of 1
OREGON LIQUOR CONTROL COMMISSION
Processor Extract Processing Equipment
What is this form?
Prior to licensure or renewal a processor applicant seeking an extract endorsement must list all equipment used in extraction as
required by OAR 845-025-3260(2). If the processor is proposing to use hydrocarbon solvents, they must additionally provide
proof that the installed equipment and process has been inspected by a certified mechanical or electrical engineer, industry
recognized third party, or manufacturer.
Any change in the equipment listed on this form, including replacing an extraction unit or adding additional extraction units
requires prior written approval under OAR 845-025-1175 because it materially alters the usage of the licensed premises.
Only equipment used to process extracts needs to be listed on this form. Equipment used only for processing other types of
products may be omitted.
Section 1 – Business Information
Applicant Name:
Application ID:
Premises Address:
City:
ZIP:
Section 2 – Extract Processing Equipment
Below is the current list of extract processing equipment for this premises:
Serial Number
Common Name of Equipment
Manufacturer
Model Number
(only needed for extractor units)
Attach additional pages if needed
Section 3 – Acknowledgement & Agreement
On behalf of the applicant (“Applicant”), I acknowledge and agree to the following:
Applicant will use only the equipment listed above for extract processing at the licensed premises.
If any of the equipment listed above is an extractor designed for use with hydrocarbon solvent, the equipment
has been inspected in accordance with Commission rules.
Applicant must obtain written approval from the Oregon Liquor Control Commission prior to operating any extract
processing equipment not referenced in this list. Failure to do so may result in the Commission taking
administrative action against the license, which could result in a civil penalty, suspension or revocation of the
license.
Signature:
Date:
Name:
Title:
[FORM MJ 19-3003] mj_app_prc_equipment (20190206) Page 1 of 1