ORGANIC SYSTEM PLAN
PRODUCER
.......................................................................................................................................
1900 Hendon Ave, St. Paul, MN 55108 ~ tel 855-213-4461 ~ fax 612-625-3748 ~ mncia@mncia.org ~ www.mciaorganic.org
Please fill out this questionnaire if you are requesting organic farm/crop certification. Submit farm maps and field
history sheets as well as all other supporting documents (soil, tissue or water tests, rented or recently purchased
land histories, etc) outlined in this questionnaire. Use additional sheets as necessary.
SECTION 1: General Information
NOP Rule §205.401
Applicant (Name/Company):
Applicant No:
FOR OFFICE USE ONLY
Contact Person:
Check #:
Address:
Amount:
DR #:
City:
State:
Phone:
Cell:
Base Fee:
Fax:
E-Mail:
Final Fee:
Legal Status:
Year first certified
organic:
Zip code:
Corporation
Legal partnership
Trust or non-profit
Other (specify):
List previous organic certification:
Mem/Appl Fee:
Sole proprietorship
List current organic certification:
Has certification ever been denied, suspended or revoked?
If yes, describe the circumstance & attach documentation:
Yes
No
List all noncompliance issues from last year's certification contract and state how they have been addressed.
Not applicable
Do you have access to a current copy of MCIA’s Organic Handbook?
Yes
No
Do you have access to a current copy of the NOP Standards?
Yes
No
Preferred time for inspection:
AM
PM
Yes
No
Give directions to farm:
Do you intend to sell any livestock or livestock product as organic this year?
If yes, you will need to complete an Organic System Plan for Livestock and submit it with your Organic System Plan Producer. Please call MCIA with questions, to request an Organic System Plan for Livestock, or download the form online at
www.mciaorganic.org.
Do you do any off-farm or on-farm processing (Cleaning, bagging, bottling, etc.)?
Yes
No
If yes, you may need to complete an Organic System Plan for Handlers and submit it with your Organic System Plan Producer. Please call MCIA with questions, to request an Organic System Plan for Handlers, or download the form online at
www.mciaorganic.org.
Do you plan to ship any organic product to :
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Canada
Europe
Organic
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Japan
Taiwan
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© 2014 Minnesota Crop Improvement Association
SECTION 2: Farm Plan Information
NOP Rule §205.202 (a) and (b)
Please complete the table below and attach updated Field History Sheets and Field Maps that show all organic or transitional fields
with their distinct, defined boundaries and buffer zones. The Field History Sheets represent the primary documentation source for how
acreage is being handled. Pastures are considered a crop and must be listed. At least 36 months of history with no application of
prohibited material is required for all fields prior to achieving organic status.
LIST CROPS/PRODUCTS INCLUDED IN CERTIFICATION
FIELD NUMBER(S)
TOTAL
ACRES
Are all fields requested for certification located at the main farm address listed in Section 1:
ALSO GROWN
CONVENTIONAL
Yes
SECTION 3: Seeds and Seed Treatments
No
NOP Rule §205.204
NOP Rule requires the use of organically grown seeds, unless an equivalent organically produced variety is not commercially available.
If using non-organic seeds, you must have records of your attempts to source organic seed. Synthetic seed treatments including
fungicides and inoculants are prohibited unless included on the National List. Genetically engineered/modified (GMO) seeds and
inoculants are prohibited in organic production. NOP Rule uses the phrase "excluded methods" to refer to GMO products. NOTE: A
prohibited treatment may be used if such treatment is a Federal or State phytosanitary requirement.
Please list each lot of seed planted for organic production. Submit an example of each label attached to each lot (seed labels,
inoculant labels, and/or treatment labels). *Seek MCIA approval prior to use.
KIND/VARIETY/BRAND
LOT NO.
ORGANIC
UNTREATED
TREATED
Did you plant all organic seed?
If no, state why and submit documentation of your attempts to purchase organic.
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TYPE/BRAND OF TREATMENT*
Yes
No
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© 2014 Minnesota Crop Improvement Association
SECTION 4: Seedlings and Perennial Stock
NOP Rule §205.204
Certified operations must use organic seed, annual seedlings, and planting stock. Annual seedlings must be produced according to
organic standards. Use of non-organic planting stock is subject to commercial availability. If planting stock is from a non-organic source
and is used to produce perennial crops, then that planting stock may be sold, labeled or represented as organic planting stock after 12
months of organic management. Attach Greenhouse and Seedling Information Sheet.
Not applicable – Go to Section 5
PLANTING STOCK (Use additional sheets if necessary)
NONTYPE
PLANTING STOCK SOURCE
ORGANIC
SECTION 5: Soil & Crop Fertility Management
ORGANIC
IF NONORGANIC DATE
PLANTED
IF NON-ORGANIC,
EXPECTED HARVEST
DATE
NOP Rule §205.203 and §205.205
NOP Rule requires active management to build soil fertility, manage plant nutrients, protect natural resources, and prevent soil erosion.
The producer must implement a crop rotation including but not limited to sod, cover crops, green manure crops, and catch crops that
provide the following functions that are applicable to the operation: maintain or improve soil organic matter content; provide for pest
management in annual and perennial crops; manage deficient or excess plant nutrients and provide erosion control. All fertility inputs
must be approved. A "restricted" input refers to an approved material on the National List which has a specific annotation for its use
(see NOP Rule §205.601(j)(1-8), (k) and §205.602(g) and (h)). If you use a "restricted" material, you must provide evidence of how you
address the material's annotation. Under NOP Rule §205.201(a)(3), the operator must monitor fertility practices and procedures to
verify that the organic plan is effectively implemented.
Plant and animal materials (manure, compost, and uncomposted plant materials) must be managed so that they do not contribute to
contamination of crops, soil, and water by plant nutrients, pathogenic organisms, heavy metals, or residues of prohibited substances.
A. GENERAL INFORMATION
What are your soil types?
What are your soil/nutrient deficiencies?
No deficiencies
What are major components of your soil and crop fertility plan?
Biodynamic
preparations
Compost
Crop rotation
Foliar
fertilizers
Green manure
plowdown/cover crops
Incorporation of
crop residues
Interplanting
Off-farm manure
On-farm
manure
Side dressing
Soil amendments
Soil inoculants
Subsoiling
Summer fallow
Other (specify):
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Rate the effectiveness of your fertility management program:
Excellent
Satisfactory
Needs improvement
What changes do you anticipate?
How do you monitor the effectiveness of your fertility management program?
Comparison of crop yields
Crop testing
Microbiological testing
Observation of soil
Soil testing
Tissue testing
Observation of crop health
Other (specify):
(Attach copies of available test results and submit to MCIA with this questionnaire.)
How often do you conduct fertility monitoring?
List all fertility inputs, except manure (see Section C below), used or intended for use on proposed organic and transitional fields. (All
fertility inputs used during the current year and the previous three years must be listed in this table. Have all input labels
available at inspection)
Not applicable – Go to B
STATUS
PRODUCT
BRAND NAME OR SOURCE
APPROVED
RESTRICTED
APPLICATION
PROHIBITED
# PER YEAR
RATE
REASON FOR USE
If you use or plan to use restricted (R) fertility inputs, how do you comply with the “annotation”?
Not applicable
If you use fertilizers with high salt content, how do you prevent salt build up?
Not applicable
Do you burn crop residues?
If yes, please describe what materials are burned and why.
Yes
No
Do you apply sewage sludge to fields?
If yes, list fields where applied:
Yes
No
B. COMPOST USE
Not applicable – Go to C
NOP Rule §205.203(c)(2) requires that the composting process must include a C:N ratio of between 25:1 and 40:1 and
maintenance of temperatures between 131o F and 170 o F for a specific number of days, depending on the method of composting.
Keep a compost production record to verify compliance.
List all compost ingredients/additives.
What composting method do you use?
In-vessel
Static aerated pile
Windrows
Other (specify):
What is your C:N ratio?
Do you monitor temperature?
If yes, what temperature was maintained?
How long is this temperature maintained?
Yes
No
If compost is windrowed, how many times are materials turned?
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C. MANURE USE
Not applicable – Go to D
NOP Rule §205.203(c)(1) requires that raw manure must be fully composted unless applied to fields with crops not for human
consumption or incorporated into the soil 120 days prior to harvest for crops whose edible portion has direct contact with the soil, or
90 days prior to harvest for all other crops for human consumption.
What forms of manure do you use?
Fully composted
Semi-solid
Liquid
Other (specify):
Pelleted
Piled
What type of crops do you grow (check all that apply)?
Crops not used for human consumption.
Crops for human consumption whose edible portion has direct contact with the soil.
Crops for human consumption whose edible portion does not have direct contact with the soil.
If you grow crops for human consumption and use raw manure, complete the following table. If you are composting manure, please
fill out Section B above.
CROP(S)
FIELD NUMBERS
RATE
DATE APPLIED
DATE INCORPORATED
What is the source of the manure you use?
EXPECTED DATE OF
HARVEST
On-farm
Off-farm
List all sources of off-farm manure:
List all manure ingredients/additives:
If you use off-farm sources of manure, what are the potential contaminants (pit additives, feed additives, heavy metals, etc.) from
these sources?
(Attach residue analysis/additive specifications of off-farm manure.)
D. NATURAL RESOURCES
NOP Rule §205.200 and §205.203(a) require that production practices must maintain or improve the natural resources of the
operation, including soil quality. Practices must minimize erosion.
What conservation practices are used?
Conservation tillage
Contour farming
Firebreaks
Retention ponds
Riparian
management
Windbreaks
Strip cropping
Undersowing/
inter-planting
Other (specify):
Maintain wildlife
habitat
Terraces
Permanent
waterways
Tree lines
Winter cover crops
What soil erosion problems do you experience (why and on which fields)?
Not applicable
Describe your efforts to minimize soil erosion problems listed above.
Not applicable
Describe how you monitor the effectiveness of your soil conservation program.
Not applicable
How often do you conduct conservation monitoring?
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© 2014 Minnesota Crop Improvement Association
E. WATER USE
Not applicable – Go to Section 6
NOP Rule §205.200 and §205.203(c) and (d) require production practices that maintain or improve water quality. Water tests may be
required for nitrate and coliform bacteria if water is used for washing/processing organic products. Irrigation water should not
contaminate organic crops with prohibited materials. Methods to conserve water usage should be part of the irrigation plan.
Water use:
Foliar sprays
Other (specify):
Greenhouse
Irrigation
Livestock
Washing crops
Source of water:
Irrigation district
Other (specify):
Municipal/county
On-site well
River/creek/pond
Spring
(Attach current water tests for coliform bacteria and nitrates and submit to MCIA with the questionnaire)
Type of irrigation system:
None
Center pivot
Drip
Flood
What input products are applied through the irrigation system?
None
What products do you use to clean irrigation lines/nozzles?
None
Other (specify):
Is the system shared with other operators?
If yes, what products do they use?
Yes
Is the system flushed and documented between conventional and organic use?
What practices are used to protect water quality?
Drip irrigation
Fencing livestock from waterways
Micro-spray
Scheduled use of water to conserve use
Yes
No
No
Not applicable
Laser leveling/land forming
Tensiometer/monitoring
Other (specify):
List known contaminants in water supplies in your area.
(Attach residue analysis and/or salinity test results, if available.)
What water contamination problems do you experience (why and where)?
Describe your efforts to minimize water contamination problems listed above.
Describe how you monitor the effectiveness of your water quality program.
How often to you conduct water quality monitoring?
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© 2014 Minnesota Crop Improvement Association
SECTION 6: Crop Management
NOP Rule §205.205 and §205.206
NOP Rule requires a crop rotation plan that maximizes soil organic matter content, prevents weed, pest, and disease problems, and
manages deficient or excess plant nutrients. Your crop rotation may include sod, cover crops, green manure crops, and catch crops.
Producers must utilize sanitation measures to remove disease vectors, weed seeds, and habitat for pests. Cultural practices, including
selection of plant species and varieties adapted to site-specific conditions, must be used to enhance crop health.
Approved synthetic materials on the National List 205.601 may only be used when management practices are insufficient to prevent or
control problems. All weed, pest, and disease inputs must be approved. A "restricted" input has specific annotations for its use. If you
use a "restricted" material, you must provide evidence of how you address the materials' annotation.
CROP ROTATION PLANS Indicate the crop rotation plan for each field on your field history sheets.
No weed problems – Go to B
A. WEED MANAGEMENT PLAN:
What are your problem weeds?
What weed control methods do you use?
Black fallow
Corn gluten
Crop rotation
Delayed Seeding
Electrical
Fast emerging
varieties
Mechanical
cultivation
Smother crops
Field preparation
Flame weeding
Hand weeding
Livestock grazing
Monitoring soil
temperature
Soap-based
herbicides
Other (specify):
Mowing
Non-synthetic
mulch
Steam weeding
Prevention of weed
seed set
Synthetic mulch
Use of hand tools
Soil sterilization
Do you keep a record of how often you utilize these weed control methods, i.e., dates and fields when you cultivate or flame weed a
specific field?
Yes
No
List all weed control product inputs used or intended for use on organic and transitional fields. (All inputs used or intended for use
during the current year and used in the previous three years must be listed in this table. Have all input labels available at
inspection.)
STATUS
WEED PROBLEM
CONTROL PRODUCT
APPROVED
RESTRICTED
IF RESTRICTED, DESCRIBE COMPLIANCE WITH
NOP RULE ANNOTATION
PROHIBITED
If you use plastic or other synthetic mulches, is the mulch removed at the end of the growing season or harvest season?
Yes
No If no, why not?
If you use newspaper or other recycled paper for mulch, do you use paper with glossy or colored inks?
Rate the effectiveness of your weed management program:
Excellent
Satisfactory
Yes
No
Needs improvement
What changes do you anticipate?
How do you monitor the effectiveness of your weed management program?
Comparison of crop yields
Observation of crop health
Records kept of observation/counts
Weed counts
Observation of weed types
Other (specify):
How often do you conduct weed monitoring?
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No pest problems – Go to C
B. PEST MANAGEMENT PLAN
What are your problem pests?
Insects (List):
Birds
Gophers
Rodents
Other animals
Do you work with a pest control advisor?
If yes, give name and contract information:
Yes
What strategies do you use to control pest damage to crops?
None
No
Animal repellents
Bat houses
Bird houses
Companion planting
Crop rotation
Development of
habitats for natural
enemies
Frog ponds
Hand picking
Insect repellents
IPM
Limited use of
prohibited products
Lures
Monitoring
Physical barriers
Physical removal
Release of predators/
parasites of pest
species
Selection of plant
species/varieties
Timing of planting
Trap crops
Traps
Use of approved
products
Use of restricted
products
Other (specify):
Do you keep a record of how often you utilize these pest control methods, i.e., dates when you scout or apply inputs to a specific
field or crop?
Yes
No
List all pest control products used or intended for use on organic and transitional fields. (All inputs used or intended for use during
the current year and in the previous three years must be listed in this table. Have all input labels available at inspection)
Not applicable
STATUS
PEST PROBLEM
CONTROL PRODUCT
APPROVED
IF RESTRICTED, DESCRIBE COMPLIANCE WITH
NOP RULE ANNOTATION
RESTRICTED
Rate the effectiveness of your pest management program:
What changes do you anticipate?
PROHIBITED
Excellent
How do you monitor the effectiveness of your pest management program?
Comparison of crop yields
Crop quality testing
Monitoring records kept
Observation of crop health
Satisfactory
Needs improvement
Insect monitoring with traps
Other (specify):
(Attach copies of your test results.)
How often to you conduct pest monitoring?
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No disease problems – Go to Section 7
C. DISEASE MANAGEMENT PLAN
What are your problem crop diseases?
What disease prevention strategies do you use?
Companion planting
Limited use of prohibited
materials
Solarization
Vector management
None
Compost/tea use
Plant spacing
Timing of planting/cultivating
Other (specify):
Crop rotation
Selection of plant species/
varieties
Use of approved materials
Field Sanitation
Soil balancing
Use of restricted materials
List all disease management inputs used or intended for use on your organic and transitional fields/crops. (All inputs used or
intended for use during the current year and used in the previous three years must be listed in this table. Have all input
labels available at inspection)
Not applicable
STATUS
DISEASE PROBLEM
CONTROL PRODUCT
APPROVED
RESTRICTED
Rate the effectiveness of your disease management program:
What changes do you anticipate?
PROHIBITED
Excellent
How do you monitor the effectiveness of your disease management program?
Crop quality testing
Observation of soil
Microbiological testing
Soil testing
Monitoring records kept
Tissue testing
IF RESTRICTED, DESCRIBE COMPLIANCE WITH
NOP RULE ANNOTATION
Satisfactory
Needs improvement
Comparison of crop yields
Observation of crop health
Other (specify):
(Attach copies of any test results.)
How often do you conduct disease monitoring?
SECTION 7: Maintenance of Organic Integrity, Crop Storage
NOP Rule §205.201(a) and §205.202(c)
A. ADJOINING LAND USE:
NOP RULE requires that organic production areas have distinct boundaries and buffer zones to prevent the unintended application
of a prohibited substance or contact with a prohibited substance that is applied to adjoining land not under organic management.
Adjoining land includes cropland, pastures, residential property, fallow land, etc. Buffer areas may change annually, depending on
contamination potential from adjoining land uses. The recommended buffer zone is 25' per MCIA guideline. This number may
change on specific sites. The NOP Rule requires that the buffer must be sufficient in size or other features (windbreaks, diversion
ditches) to prevent the unintended contact by prohibited substances applied to adjacent land areas. Crops within the required buffer
must be left unharvested or harvested, stored, and disposed of as non-certified crop, with records kept of crop disposition. Indicate
specific buffer zones you maintain and show all adjoining land uses on your attached field maps.
If crops are harvested from the buffer zones with equipment used for harvesting organic crops, what safeguards do you use to
protect organic crops from contact with buffer crops?
What additional safeguards do you use to prevent accidental contamination?
Written notification to:
Electrical companies
Adjoining landowners
Farm service office
Aerial spray companies/airports
Highway departments
Have you posted signs along roadsides that adjoin organic fields?
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None
Organic
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Drainage commissions
Other (specify):
Yes
No
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© 2014 Minnesota Crop Improvement Association
Do any fields or portions of fields flood frequently (more than once every ten years)?
If yes, list field numbers:
How do you monitor for crop contamination?
GMO testing
Wind direction/speed data
Other (specify):
Yes
Photographs
Residue analysis
No
Visual observation
How often do you conduct crop contamination monitoring?
B. SPLIT AND PARALLEL PRODUCTION
Not applicable – Go to C
To prevent contamination by non-organic products, organic standards have additional rules for farm operations that include both
conventional and organic production. The farm operator must demonstrate the ability to keep crops separate throughout the
operation. Specific records must be kept to document these practices.
Do you grow the same crop under both organic and transitional or conventional production practices?
If yes, list specific crop varieties in the following table for both organic and transition/conventional crops.
SPECIFIC
CROPS/VARIETIES
FIELD NUMBERS
TRANSITIONAL
CONVENTIONAL
CHECK
IF GMO
TOTAL
ACREAGE
Yes
PLANNED USE OF CROP (SALE, SEED,
NON-ORGANIC LIVESTOCK FEED, ETC.)
No
STORAGE
SITE ID
Prohibited soil amendments, herbicides, pesticides, other chemicals used on conventional crops:
WHO APPLIES?
SELF OR CUSTOM
PRODUCT NAME/TYPE
NEXT TO WHICH ORGANIC
FIELDS?
WHERE ARE THEY STORED?
(ON-FARM OR OFF-FARM & W HERE)
C. EQUIPMENT
To prevent commingling and contamination, all equipment used in organic crop production must be free of non-organic crops and
prohibited materials. Equipment used for both organic and non-organic farming must be cleaned/flushed prior to use on organic
fields or crops. Keep records of equipment clean and flush activities.
List equipment used for planting, tillage, cultivation, spraying, and harvesting.
EQUIPMENT NAME
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OWNED
RENTED
CUSTOM
USED ON ORGANIC
& CONVENTIONAL
Organic
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Not applicable – Go to D
HOW IS EQUIPMENT CLEANED
BEFORE USE ON ORGANIC FIELDS?
PURGE
USED
QUANTITY OF
PURGE
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© 2014 Minnesota Crop Improvement Association
Is your equipment maintained so that fuel, oil and hydraulic fluid do not leak?
If you use a sprayer, what type?
Purchased
Other equipment: could any equipment you use have been contaminated by previous use?
If yes, describe:
Yes
No
New
Used
Yes
No
D. HARVEST
NOP §205.272(b)(1) and (2) requires that containers, bins and packaging materials must not contain synthetic fungicides,
preservatives or fumigants. All reusable containers must be thoroughly cleaned and pose no risk of contamination prior to use.
How are your organic crops harvested?
Mechanical
By hand
Are any organic crops custom harvested?
If yes, provide name and address of custom harvester.
Yes
No
Who is responsible for cleaning the custom harvest equipment?
Describe steps taken to protect organic crops from commingling and contamination during harvest.
What containers are used for moving product from harvest to storage?
Plastic containers
Truck boxes
Wooden totes
Cardboard/waxed boxes
Other (specify):
Gravity wagons/boxes
Are containers new or used?
If used, what did they contain prior to organic use?
New
Used
Are the containers used for organic crops only?
Yes
No
Describe potential contamination or commingling problems you have with harvest of organic crops.
None
E. POST HARVEST HANDLING
NOP Rule §205.201(a)(5) requires that post-harvest handling procedures do not contaminate organic products with non-organic
crops or prohibited materials.
(For on-farm processing, you need to complete an Organic Processor Handling Plan Questionnaire.)
Describe your post-harvest handling procedures and equipment.
Is the processing area and equipment used for both organic and non-organic products?
If yes, describe steps taken to prevent commingling and contamination.
Yes
No
Does packaging present any contamination problems for your organic products?
If yes, what are they?
Yes
No
Check types of packaging material used:
Natural fiber
Paper
Plastic
In what form are finished products shipped?
Liquid bulk
Mesh bags
Metal drums
Other (specify):
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Aseptic
Bulk
Synthetic fiber
Cardboard cases
Paper bags
Organic
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Cardboard
Foil
Waxed paper
Glass
Metal
Other (specify):
Cardboard drums
Plastic crates
Dry bulk
Tote bags
Foil bags
Tote boxes
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© 2014 Minnesota Crop Improvement Association
F. CROP STORAGE
No Organic Crop Storage – Go to G
Operators must keep organic and non-organic crops in separate storage areas and prevent commingling and contamination.
Storage records must be maintained. (Attach storage site map.)
Describe your storage locations:
STORAGE
ID NO.
TYPE OF CROPS
STORED
TYPE OF STORAGE
FILL
DATE
CAPACITY
EMPTY
DATE
ORGANIC
TRANSITION
BUFFER
Do you use the same storage areas for organic, transitional, buffer and/or conventional crops?
If yes, how do you segregate organic crops from non-organic crops?
CONVENTIONAL
Yes
No
How do you clean storage units prior to storage of organic crops?
How do you prevent/control insect pests in crop storage areas?
No insect problems
How do you control rodents in crop storage areas?
No rodent problems
What stored crop inputs have you used in the last three years?
Coloring agents
Growth regulators
Oils
Sprouting inhibitors
Synthetic fumigants
Waxes
Preservatives
Other (specify):
Ripeners
None
Rodenticides
Are any stored crop inputs used or planned for use on organic crops?
If yes, specify input.
(Retain labels and submit to MCIA with this questionnaire.)
Yes
No
List all pest control products used or intended for use in the current season in your storage areas.
(Have all input labels available at inspection.)
STATUS
PEST PROBLEM
CONTROL PRODUCT
Approved
Restricted
IF RESTRICTED, DESCRIBE COMPLIANCE WITH
NOP RULE ANNOTATION
Prohibited
Not applicable – Go to Section 8
G. Transportation
Who is responsible for arranging transportation of organic products?
Buyer
Self
Other (specify):
Describe how organic products are transported.
What potential contamination or commingling problems do you have with the transport of organic crops?
What steps are taken to protect the integrity of organic products during transport?
Dedicated organic only
Inspecting transport units prior to loading
Letter/contract with transport company stating organic requirements
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None
Cleaning transport units prior to loading
Use of Clean Truck Affidavits
Other (specify):
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© 2014 Minnesota Crop Improvement Association
SECTION 8: Record-Keeping System
NOP Rule §205.201(a) and §205.202(c)
NOP Rule requires that records disclose all activities and transactions of the operation, be maintained for 5 years, and demonstrate
compliance with the NOP Rule. Organic products must be tracked back to the field/location where they were produced/harvested. All
records must be accessible to the inspector.
Which of the following records do you keep for organic production?
Organic complaint file
Field maps
Field activity log(s)
Field history sheets (previous three years)
Documentation of previous land use for rented and/or newly purchased land
Input records for soil amendments, seeds, manure, foliar sprays and pest control products (keep all labels)
Documentation of attempts to source organic seeds and/or planting stock
Documentation of organic seedlings
Residue analyses of inputs (i.e., manure sourced off-farm)
Compost production records
Monitoring records (soil tests, tissue tests, water tests, quality tests, observational)
Equipment cleaning records
Harvest records that show field numbers, date of harvest and harvest amounts (including custom harvest records)
Labor records
Storage records that show storage location, storage identification, field numbers, amounts stored, and cleaning activities
Clean transport records
Sales records (purchase order, contract, invoice, cash receipts, cash receipt journal, sales journal, etc.)
Shipping records (scale ticket, dump station ticket, bill of lading)
Transaction Certificates
Audit control summary
Other (specify):
(Please have these records available for the inspector.)
How long do you keep your records?
Which of the following records do you keep for conventional production?
Field maps
Field history sheets
Harvest records
Labor records
Sales records
Shipping records
Other (specify):
Not applicable
Input records
Storage records
Type of Marketing
Bulk commodities to processor
Contract to buyer
CSA/Subscription service
Direct to retail
Farmers market
On-farm retail
Wholesale
Other (specify):
Do you use or plan to use the USDA organic seal on product labels or market information?
Yes
No
Do you use or plan to use the MCIA logo on product labels or market information?
(Attach copies of all organic product labels and submit to MCIA with this questionnaire)
Yes
No
The following substance is not allowed in production or handling of organic products which will be exported to Canada. Indicate if all
inputs are free of:
Sodium or Chilean Nitrate
The following inputs are not allowed in production or handling of organic apples and pears which will be exported to Europe.
Indicate if all inputs are free of:
Streptomycin
Tetracycline
Organic System Plan - Producer
Controlled Version – 4/2/14
Organic
Page 13 of 14
Print Date: 02/08/16
© 2014 Minnesota Crop Improvement Association
SECTION 9: Final Fees
NOP Rule §205.406
To continue certification, a certified operation must annually submit Final Fees due to Minnesota Crop Improvement
Association. See the Fee Schedule and Scale of Sanctions for applicable final fees.
The Final Fee submission forms and instructions are available in electronic format on the MCIA website at www.mciaorganic.org.
Submit a Submission Form - Producer/Livestock/Wild Crop Final Fees and payment along with this application.
SECTION 10: Affirmation
I affirm that all statements made in this questionnaire are true and correct. No prohibited products have been applied to any of my
organically managed production during the three-year period prior to projected harvest. I understand that the operation may be subject
to unannounced inspection and/or sampling for residues at any time as deemed appropriate to ensure compliance with the NOP Rule. I
understand that acceptance of this questionnaire in no way implies granting of certification by MCIA. I agree to follow the NOP Rule.
Applicant Signature
Date
I have attached the following documents:
Annual Organic Producer Agreement*
Documentation for fields owned or rented for less than three years, if applicable
Field History Sheets and Maps of all parcels/fields (showing adjoining land use and field identification)*
Greenhouse and Seedling Information Sheet
Input product labels, if applicable
Map - Storage Site
Organic product labels, if applicable
Payment (see the Organic Fee Schedule and Scale of Sanctions for information on fees)*
Residue analyses, if applicable
Soil and/or plant tissue tests, if applicable
Storage History Record
Submission Form - Producer/Livestock/Wild Crop Final Fees
Water test, if applicable
Other (specify):
* Indicates required submissions.
I have made copies of this questionnaire and other supporting documents for my own records:
Yes
No
Submit completed form, supporting documents, Annual Agreement - Crop/Livestock Producer, and fees to:
Minnesota Crop Improvement Association
1900 Hendon Avenue
St. Paul MN 55108
Organic System Plan - Producer
Controlled Version – 4/2/14
Organic
Page 14 of 14
Print Date: 02/08/16
© 2014 Minnesota Crop Improvement Association