ÐÏà¡±á>þÿ =Aþÿÿÿ:;<ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿì¥Áo ø¿°bjbjZóZó £t8™zf8™zfà0Þÿÿÿÿÿÿ·Ê Ê ÿÿÿÿ###8[ä?¼#%làû *"/*/*/*q,q,q,|j~j~j~j~j~j~j$o¶»qT¢jq,O,O,"q,q,¢j/*/* ¿k*Í1Í1Í1q,F/*/*|jÍ1q,|jÍ1Í12d”’h/*ÿÿÿÿà:#ãgÖÿÿÿÿ·,‚®e.hjék<%lÜe¶t9-\t\’h’h&t¸h°q,q,Í1q,q,q,q,q,¢j¢j•/8q,q,q,%lq,q,q,q,ÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿÿtq,q,q,q,q,q,q,q,q,Ê Õ: Instructions: Thank you for choosing Quality Certification Services as your organic certifier! Use this form to add non-pasture location(s) used for organic livestock production to your Organic Grower Plan outside of your annual renewal. This form may be used for locations that are on land that does not require an organic grower plan such as poultry barns with adjacent outside access areas and feeding yards or pads used during the non-grazing season for ruminant livestock that are not associated with organic pasture. Submit the completed application along with the Fee Payment Form and applicable fees to QCS by e-mail to HYPERLINK "mailto:apply@qcsinfo.org" apply@qcsinfo.org or by mail to the address listed above. Maintain a copy of the completed application for your own records to ensure that the submitted plan is consistent with practices on your operation. ALLA 1: BASIC INFORMATIONName of certified operation: FORMTEXT FORMTEXT QCS Entity #: FORMTEXT FORMTEXT Name and position of person completing this form (must be an authorized contact): FORMTEXT FORMTEXT Date: FORMTEXT FORMTEXT ALLA 2: ADDITIONAL LIVESTOCK LOCATION(S)A. PARCEL MANAGEMENT (CHECK ONE) FORMCHECKBOX The management of the new location is consistent with the Organic Livestock Plan (OLP) currently on file with and approved by QCS. FORMCHECKBOX The management of this location is/will be different than the Organic Livestock Plan (OLP) currently on file with and approved by QCS. The Organic Livestock Plan (OLP) needs to be updated. Briefly describe changes below. Complete and attach the applicable sections of the Organic Livestock Plan application. FORMTEXT B. TYPE(S) OF PRODUCTION This form may only be used for livestock locations that do not require an Organic Grower Plan for certification of the land. FORMCHECKBOX Penned poultry (in permanent shelter with outside access area) FORMCHECKBOX Non-ruminant livestock production FORMCHECKBOX Yard, feeding pad or feedlot used for ruminant livestock during the non-grazing season FORMCHECKBOX Other (specify): FORMTEXT C. DRIVING DIRECTIONS Please provide driving directions to the new livestock location(s) FORMTEXT D. LIVESTOCK MAPS Provide a map for each livestock production unit depicting all livestock production areas. Include buildings, roads, adjoining land uses, buffers, feed storage areas, and natural water sources. Please show the dimensions of all permanent housing (e.g. barns), outside access areas, yards/feeding pads, and buffer zones. ALLA 2: ADDITIONAL LIVESTOCK LOCATION(S)E. LIVESTOCK PRODUCTION LOCATIONS 1. Please provide the name and locations of all parcels on which organic livestock will be raised. Livestock Production Unit Name or Number Physical Location (Physical address, GPS coordinates, legal description, etc.) Number of Permanent Housing Units (e.g. barns) FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT F. HOUSING/SHELTER FORMCHECKBOX Not applicable (No housing provided) 1. Describe the types of housing/shelter in use: FORMTEXT 2. List the dimensions for each structure. Attach additional pages if necessary Barn/Shelter Name/# Dimensions Maximum number of animals housed at one time FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT 3. Are the same units ever used for conventional livestock? FORMCHECKBOX Yes FORMCHECKBOX No If yes, explain. FORMTEXT ALLA 3: OUTSIDE ACCESS AREA MANAGMENT1. Complete this table for non-ruminant livestock FORMCHECKBOX N/A Production Unit Outside access area dimensions # Livestock using outside access area FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT 2. Describe finish feeding yard, feeding pad or feedlot used for ruminant livestock FORMCHECKBOX N/A Yard/Feeding Pad Name/# Dimensions Maximum stocking rate Is yard/feeding pad large enough to allow all livestock to feed without competition FORMTEXT FORMTEXT FORMTEXT FORMCHECKBOX Yes FORMCHECKBOX No FORMTEXT FORMTEXT FORMTEXT FORMCHECKBOX Yes FORMCHECKBOX No Check all applicable uses of yards, feeding pads or feedlots: FORMCHECKBOX Access to the outdoors during the non-grazing season FORMCHECKBOX Supplemental feeding during the grazing season FORMCHECKBOX Finish feeding of slaughter stock 3. Describe the cover vegetation of the outdoor access area or feeding yard/pad/feedlot. FORMTEXT 4. List specific adjoining land uses and buffer zones on your operation that correspond with parcel maps. Attach additional pages if necessary. FORMCHECKBOX Not applicable, no prohibited materials used nearby. Parcel/Field Adjoining Land Use Width of Buffer Type of Buffer (i.e. cropland, treeline, hedgerows, grass strip) If buffer is cropland, describe how crops are used. FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT 5. What safeguards are used to prevent accidental contamination from non-organic practices on adjoining land? (Show adjoining land uses and buffer zones on maps): FORMTEXT ALLA 4: LAND USE AFFIDAVITELIGIBILITY: To be eligible for organic certification under 7 CFR 205.202(b), the land must be free of material prohibited by the USDA Organic Regulations for at least 36 months (3 years) prior to use for livestock to be represented as organic. INSTRUCTIONS: Complete a separate Land Use Affidavit for each livestock production unit (or acreage being added to an existing livestock production unit) that is not already certified organic. If you have multiple new livestock production units, make copies or request extra forms from QCS. 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Make copies as needed. I have had full management control of this land during the time period from FORMTEXT ____________________________ through FORMTEXT ____________________________ FORMCHECKBOX Present. (Use exact dates). Last known prohibited substance application. To the best of my knowledge, (Check one): FORMCHECKBOX no substances prohibited by the USDA organic regulations were applied to this parcel during my ownership/management. FORMCHECKBOX the last substance prohibited by the USDA organic regulations applied during my management of this parcel was (name of substance) FORMTEXT ___________________ on (date) FORMTEXT ___________________. Using the table below, list ALL inputs that have been applied to the land or crops during the time of your management in the last three years/36 months including fertilizers, pest/weed/disease control products, treated seeds, inoculants, treated seeds, etc. FORMCHECKBOX Additional pages attached FORMCHECKBOX NONE Product Name as it Appears On LabelManufacturerLast Application DateFields where applied FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT FORMTEXT I affirm that the answers given in this affidavit are true and correct and acknowledge that making a false statement in this affidavit is a violation of the NOP regulations and may lead to civil or criminal penalties. FORMTEXT ____________________________________________ (Signature) FORMTEXT _____________________ (Date) ADDITIONAL LIVESTOCK LOCATION APPLICATION AFFIRMATIONThis affirmation is submitted as part of the additional livestock location application to allow QCS to assess the compliance of the new parcel(s) with the National Organic Program Final Rule contained in 7 CFR 205. I have reviewed the Organic System Plan previously submitted to QCS and updated any and all sections in which the Organic System Plan has changed. I understand that failure to notify QCS of new management practices on additional livestock production locations constitutes a false statement under §205.100 of the NOP Final Rule and §1001 of Title 18 of the United States Code, and may subject me and/or the certified operation to criminal and civil penalties. Further, I understand that certification under the NOP Final Rule and QCS policies creates a continuing obligation to inform QCS of all changes, additions, and deletions to the Organic System Plan. A failure to provide complete and truthful disclosure of changes to the OSP may lead to initiation of the noncompliance procedures in §205.662, and may culminate in the suspension or revocation of the operation s organic certification and all persons responsibly connected with the operation. If subsequent inspection of the operation reveals that this application was incomplete or inaccurate, I understand that a Notice of Noncompliance will be issued. I also agree that any updated forms submitted by the operation to resolve the noncompliance will be reviewed by QCS staff at a charge to the operation of up to $100 per form. In addition, any subsequent inspection conducted by QCS to verify the accuracy of such forms will be borne by the certified operation, even if the inspection is in addition to the regular annual inspection required by the NOP Final Rule. I agree that QCS has the right to request that the operation submit a complete OSP in any given year, or in all years, as QCS deems appropriate to assess compliance with the NOP Final Rule and QCS policies and procedures. I affirm that I am either the principal or an agent of the operation, and am authorized to make representations, enter into contracts and otherwise conduct business on behalf of the operation for the purposes of organic certification. I consent and agree to the foregoing, and further affirm under penalty of law that the responses provided by me are true, correct, and complete: ___________________________________________ _______________________ Signature Date ___________________________ Name and Title (NOTE: The name of the signing party must be the same as the Certification Contact listed in form OLP1 on file in the QCS office or as updated and attached to this affidavit.) Quality Certification Services (QCS) 5700 SW 34th Street, Suite 349, Gainesville FL 32608 phone 352.377.0133 / fax 352.377.8363 www.qcsinfo.org PAGE PAGE 1 1C3E02, V1, R4, 3/26/2020 ØèÚèèéêé°ê²êNîâðäðæðöæöööÔÇöUqkdÛS$$If–l4Ö”°Öòþä*ò+Ö0ÿÿÿÿÿÿöò+6ööÖÿÖÿÖÿÖÿ4Ö4Ö laö^ÿf4gÖ¨T'yt‰#" &F$Ifgd‰#" &Fdh¤x$Ifgd˜|i"$ &F$Ifa$gd‰# $Ifgdg - Pêlênêpêrê°ê²ê ëbëdë€ë‚ë„ë†ëúëììrìtìì’ì”ì–ìœíží²í´í¶íï×ÂÂïïµ©™©†™™©}}}™©j™™©]}M]jRh&ßh˜|iUaJjh&ßh˜|iUaJ%j“Qh&ßh˜|iU\]aJh&ßh˜|iaJ%jQh&ßh˜|iU\]aJjh&ßh˜|iU\]aJh&ßh˜|i\]aJh&ßh˜|i5\]aJ)jh‰#h‰#CJOJQJU^JaJ/j«Ph‰#h‰#CJOJQJU^JaJ h‰#h‰#CJOJQJ^JaJ¶í¸íºí¼í¾íÀíÂíèíêíþíîîîîîîîî î"î$îLîNîððVðXðtðvðxðzð²ð´ðÐðÒðÔðÖðâðäðíííííà×Ë×à××»àíííííà×Ë°°°¡°‘¡¡°¡°¡¡°p h‰#h‰#CJOJQJ^JaJjgSh‰#h‰#UaJjóRh‰#h‰#UaJjh‰#h‰#U^JaJh‰#h‰#^JaJj}Rh&ßh˜|iUaJh&ßh˜|i\]aJh&ßh˜|iaJjh&ßh˜|iUaJ$jh&ßh˜|iUaJmHnHu&äðæð.ñ0ñHñJñtñvñ 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