App 22/01
Issued by: C O’Kennedy
Issued: 24/11/11.
IRISH ORGANIC FARMERS’ AND GROWERS’ ASSOCIATION
Inspection & Certification Scheme
Application Form for Industrial products.
One application form for each product must be completed by the applicant and forwarded
together with the appropriate fee for the attention of the Certification Manager.
GENERAL DETAILS
Applicant: ……………………………………………………………………………………………………….
Company Trading Name: ……………………………………………………………………………………….
Company Registration No: ……………………………………………………………………………………...
Contact Name: …………………………………………………………………………………………………..
Company Address: ……………………………………………………………………………………………...
Tel No: ………………………………………
Fax No: …………………………………………
Email Address: …………………………….
Web Address: …………………………………...
Address & Contact details of processing plant/warehouse (if different from above):
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
Invoicing address: ………………………………………………………………………………………………
…………………………………………………………………………………………………………………..
Do you already hold an Organic Licence:
Yes
( )
No
( )
Name of person who directly controls day-to-day organic products: …………………………………………
Are you an affiliated member of IOFGA?
Yes
( )
No
( )
Have you every been certified by another certification body?
Yes
( )
No
( )
Did the previous Certification Body revoke your licence?
Yes
( )
No
( )
If Yes please state the reasons: …………………………………………………………………………………
Irish Organic Farmers' and Growers' Association, 16A Inish Carraig, Golden Island, Athlone, Co Westmeath
Tel: 090 64 33680; Fax: 090 64 49005; E-mail: info@iofga.org Web: www.iofga.org
App 22/01
Issued by: C O’Kennedy
Issued: 24/11/11.
PRODUCT DETAILS
What product are you applying to have certified: ………………………………………………………………
Does your product carry a brand name? If so, what is it? ……………………………………………………...
Do you manufacture the product and if not who does? …………………………………………………………
Address of the manufacturing plant …………………………………………………………………………….
…………………………………………………………………………………………………………………...
What are the product’s uses? (please specify target organisms etc) …………………………………………....
…………………………………………………………………………………………………………………...
…………………………………………………………………………………………………………………...
What market do you have for your product? ……………………………………………………………………
…………………………………………………………………………………………………………………...
Do you currently promote your product as organic? ……………………………………………………………
PACKAGING/LABELLING
A
If granted an IOFGA Licence, how do you intend to use the IOFGA Symbol?
( )
Label
( )
Packaging
( )
Promotional/point of sale material
( )
Other (please supply details)
…………………………………………………………………………………………………
B
Please provide details of all proposed packaging materials
…………………………………………………………………………………………………
…………………………………………………………………………………………………
………………………………………………………………………………………………….
NOTE: Any labels, packaging or promotional materials using or referring to IOFGA or the IOFGA
symbol, must be approved by IOFGA prior to a licence being granted.
Under what legislation does the product have clearance? ………………………………………………………
Please give details of the uses for which the product has been approved ………………………………………
…………………………………………………………………………………………………………………...
Note: Please attach documentation verifying clearance to this form.
Is there a complaints procedure in place? ……………………………………………………………………….
If yes please supply details: ……………………………………………………………………………………..
Irish Organic Farmers' and Growers' Association, 16A Inish Carraig, Golden Island, Athlone, Co Westmeath
Tel: 090 64 33680; Fax: 090 64 49005; E-mail: info@iofga.org Web: www.iofga.org
App 22/01
Issued by: C O’Kennedy
Issued: 24/11/11.
MANUFACTURING PROCESS
Please supply a list of ingredients including all additives, carriers, bases, wetters, preservatives etc and
analysis where applicable.
Ingredient
% Composition
Source
Synthetic
Analysis
What are the reasons for the inclusion of synthetic ingredients? (Note: for any synthetic products, please
supply chemical composition and relevant manufacturing data and toxicological data). ………………………
…………………………………………………………………………………………………………………...
…………………………………………………………………………………………………………………...
How much variability in formulation/ingredients is acceptable? ……………………………………………….
…………………………………………………………………………………………………………………...
Please attach a flow chart outlining the manufacturing process.
Under what legislation is the product controlled? ……………………………………………………………..
What analysis is carried out on the product, by whom and how often? ………………………………………...
…………………………………………………………………………………………………………………...
Please describe all cleaning procedures used …………………………………………………………………...
…………………………………………………………………………………………………………………...
What other products are manufactured, used or packaged
On the same line ………………………………………………………………………………………………...
In your premises ………………………………………………………………………………………………...
What steps are taken to prevent adulteration through physical contact, residuals, dusts etc between the
organic and non-organic products?
…………………………………………………………………………………………………………………...
…………………………………………………………………………………………………………………...
What storage methods are used for both the ingredients and the finished product? ………………………….
…………………………………………………………………………………………………………………...
Irish Organic Farmers' and Growers' Association, 16A Inish Carraig, Golden Island, Athlone, Co Westmeath
Tel: 090 64 33680; Fax: 090 64 49005; E-mail: info@iofga.org Web: www.iofga.org
App 22/01
Issued by: C O’Kennedy
Issued: 24/11/11.
ENVIRONMENTAL ASPECTS
What are the waste products from your premises and how are they disposed of? ……………………………...
…………………………………………………………………………………………………………………...
What steps are taken to prevent pollution? ……………………………………………………………………...
…………………………………………………………………………………………………………………...
How is the product used, including method and recommended frequency of application, dilution rates etc?
(Please enclose all instruction sheets leaflets etc)
……………………………………………………………………………………………………………….......
…………………………………………………………………………………………………………………...
What precautions are recommended when using the product:for the worker? ………………………………………………………………………………………..
disposal of spent material & containers? ………………………………………………………………
protection of the environment and non-target organisms? ……………………………………………
What is the mode of action of the product? …………………………………………………………………...
What are the products hazards:to animal and human life? ………………………………………………………………………….
to microbial life? …………………………………………………………………………………...
What residual/breakdown products remain after use and what are their effects?
in soil / plants? …………………………………………………………………………………………..
in non-target organisms? ………………………………………………………………………………
in humans? …………………………………………………………………………………………….
Please provide a heavy metal analysis for any fertilisers, composts and soil amendments being manufactured
for the organic market.
What agrochemical residues are there (AB’s hormones, biocides)? ……………………………………………
…………………………………………………………………………………………...………………………
Irish Organic Farmers' and Growers' Association, 16A Inish Carraig, Golden Island, Athlone, Co Westmeath
Tel: 090 64 33680; Fax: 090 64 49005; E-mail: info@iofga.org Web: www.iofga.org
App 22/01
Issued by: C O’Kennedy
Issued: 24/11/11.
DECLARATION
I hereby declare that the information contained in this form is, to the best of my knowledge correct and true:
Signed:…………………………………………………………………………………………………………...
Block Capitals:…………………………………………………………………………………………………..
Position in company:…………………………………………………………………………………………….
Date:……………………………………………………………………………………………………………..
Customer Service
To improve our customer service we welcome your feedback. Please take a few minutes to complete the questions below.
Where did you find out about IOFGA?
At a show or event (please state)
Word of mouth
Previously licensed
Media (please state)
…………………………………………………………………………………………………………………
Other (please state)
Why did you choose us for organic certification?
IOFGA symbol on products
Marketing opportunities
Recommendation by associate
Certification integrity
Customer/retailer preference
Other (please state)
Not for profit
……………………………………………………….
Did you find this application form easy to understand?
Yes
No
Yes
No
Were there any sections that need to be clearer?
If yes, please detail here: ……………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………
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Could any part of the application process be made easier for you?
Yes
No
If yes, please detail here: ……………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………
…………..……………………………………………………………………………………………………………………………
Do you have any comments regarding the service you have received from us to date?
Yes
No
If yes, please detail here: ……………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
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Irish Organic Farmers' and Growers' Association, 16A Inish Carraig, Golden Island, Athlone, Co Westmeath
Tel: 090 64 33680; Fax: 090 64 49005; E-mail: info@iofga.org Web: www.iofga.org