CFIA Facility Questionnaire for Export of Rendered Products to Canada

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TAHD-DSAT-IE-2002-10-10 Annex 3

This facility questionnaire must be completed by any facility that wishes to export to Canada animal products and by-products defined as rendered products by CFIA. The purpose of the Questionnaire is to identify ruminant and/or SRM cross contamination risks. An annual on-site inspection by the endorsing Central Competent veterinary authority is required to verify that the information provided within this questionnaire is complete and accurate as presented.

Note: no questionnaire is required for fish oil. A completed questionnaire is required for all other commodities listed as "rendered products" within the import policy: TAHD-DSAT-IE-2002-10-10 Animal Health Import Requirements for Raw Inedible Products and Rendered products.

Facility Information

Name of Facility Being Inspected:
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Physical Address of Facility:
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Mailing address of Facility if different than physical address:
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List activities that the facility performs (i.e.: thermal processing/manufacture, chemical extraction, packaging, storage, etc.):
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Facility Representative Information

Name of Facility Representative completing questionnaire: space

Person present during annual inspection (if same person then indicate "same"): space

Title: space

Contact information: space

telephone number: space

email Address: space

Competent Authority Veterinarian or Inspector Information

Name and title of CCVA Veterinarian or CCVA Inspector Performing Annual Inspection:
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Name of Central Competent Veterinary Authority and individual CCVA Veterinarian (that endorses the questionnaire and annual inspection):
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Attach Additional Documentation, As Required

1. List all the animal origin ingredients, species of origin and country of origin and industry source in the table below for all animal origin materials received, stored, processed or otherwise handled in this facility, and all animal origin ingredients for all products produced in the facility. For tallow, indicate the % of insoluble impurities as greater than 0.15% or less than or equal to 0.15%.

Animal Origin Ingredient Species of Origin and Tissue type (if relevant) Country of Origin Source of product: Central Competent Veterinary Authority (CCVA) inspected Abattoir; Dead stock yard; Other

2. The following questions pertain to ruminant ingredients received, stored, handled, or processed in the facility. They deal with risk of cross-contamination with ruminant-origin material (which is a prohibited material to feed to ruminants) as well as with Specified Risk Material (SRM). SRM is bovine tissues which may not be used as feed material for any animal in Canada, consisting of the skull, brain, eyes, trigeminal ganglia, tonsils, spinal cord, vertebral column (excluding the vertebrae of the tail, the transverse processes of the thoracic and lumbar vertebrae, and the wings of the sacrum), and dorsal root ganglia of bovines 30 months of age and over sourced from countries of controlled BSE Risk Status, or of bovines 12 months of age and over sourced from countries of undetermined risk for BSE, as well as the distal ileum of bovines of all ages.

2.1. Does the facility receive, store, handle or process any ruminant - origin ingredients? Yes checkbox No checkbox

If the answer is No, please proceed to question #3.

2.2. If yes, please describe what ruminant tissues are received, handled, processed or stored:
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2.3. Does the facility maintain dedicated processing rooms for ruminant and non-ruminant product? Yes checkbox No checkbox

2.4. Does the facility maintain dedicated processing equipment (i.e.: lines, machinery, and tools) for ruminant and non-ruminant product? Yes checkbox No checkbox

2.5. Does the facility maintain dedicated storage rooms for ruminant and non-ruminant product? Yes checkbox No checkbox

2.6. Does the facility maintain dedicated employees for ruminant and non-ruminant product? Yes checkbox No checkbox

2.7. Does the facility maintain appropriate documentation (i.e.: signs and labels) and employee training to ensure non-ruminant product does not come in contact with ruminant product? Yes checkbox No checkbox

2.8. Does the facility use dedicated trucks/containers (e.g. bulk tank) for incoming material? Yes checkbox No checkbox

2.9. Does the facility use dedicated trucks/containers for out-going material? Yes checkbox No checkbox

2.9.1. If yes, what is the basis for the dedication? (Species of origin? Type of supplier? Other?)
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2.9.2. If no, does the facility clean non-dedicated trucks and containers using a cleaning and disinfection protocol approved by the CCVA? Yes checkbox No checkbox

2.10. Does the facility use unidirectional product flow? Yes checkbox No checkbox

2.11. Does the facility have a preventative control plan (PCP)(for example HACCP, GMP)? Yes checkbox No checkbox

If yes:

2.11.1. What are the hazards named in the PCP? List them by category type: chemical, biological and physical:
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2.11.2. What are the mitigation measures used to control these hazards?
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2.11.3. Does the facility have a traceability program and recall plan in place? Yes checkbox No checkbox

2.11.3.1 If yes, does the facility carry out a test of their traceability/recall program? Yes checkbox No checkbox

2.11.3.2 If yes, how? When was the last test? What were the results?

3. Does the facility maintain sanitation and prevent adulteration or contamination of finished products with incoming raw materials? This may occur by proper use of chemicals, product direction flow protocols, cleaning & disinfection procedures, using signs and labels, cleaning and sanitizing procedures for processing equipment, conveyances storage areas, other equipment and trucks, etc. Yes checkbox No checkbox

4. Does the facility have a written separation protocol on file that outlines separation of material that is eligible for export to Canada from material that is not eligible? Yes checkbox No checkbox

4.1 If "Yes", does the facility demonstrate effective implementation of this protocol? Yes checkbox No checkbox

5. For dry rendered products only:

Is the moisture content of the rendered meals manufactured, stored, processed, or otherwise handled in this facility less than 10%?

Yes checkbox No checkbox
If "No," indicate moisture content: space.

6. For liquid products (i.e. poultry digest or fish protein hydrolysate):

Is the product for further processing in Canada?

Yes checkbox No checkbox

If "No," please indicate the processing time and temperature, or pH or other processing that the product has undergone.
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7. For fats and oils of animal origin (including yellow grease or used fats or oils from commercial enterprises):

Is the oil or fat a single species origin product?

Yes checkbox If "Yes," which species? space.
No checkbox If "No," describe: space.

8. For mixed product or for bovine origin oil or fat (sole source):

8.1. Does the product contain less than or equal to 0.15% insoluble impurities? Yes checkbox No checkbox

8.2 If "Yes," does the facility obtain testing from an independent third party laboratory accredited by the equivalent of the Standards Council of Canada (SCA)? Yes checkbox No checkbox

Specify the name of the independent third party laboratory used:
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and the national standards council equivalent to the SCA in the country of origin. space

9. What is the name of the central competent veterinary authority (CCVA) which oversees (inspects and approves) the production of your product and which has the authority to provide government certification for materials being exported to Canada? space

Signatures/endorsements:

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Signature of Facility Official

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Date (yyyy/mm/dd)

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Name of Facility Official

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Title of Facility Official

Contact information (telephone and email): space

I, the salaried veterinary inspector of (insert name of CCVA) do hereby certify that the questionnaire above is complete and accurate as submitted and that:
(Insert appropriate clause below)
Either
the facility does not receive any ruminant material;
or
the facility receives ruminant material.

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Signature of Veterinary Inspector

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Date (yyyy/mm/dd)

Official Seal of CCVA

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Name of Veterinary Inspector

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Title of Veterinary Inspector

Date of annual inspection: space

The section below should only be completed for facilities if they were inspected by a non-veterinary inspector (such as a USA National Oceanic Atmospheric Agency (NOAA) inspector). The questionnaire must be endorsed by a full-time, salaried veterinarian of the CCVA.

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Signature of Inspector

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Date (yyyy/mm/dd)

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Name of Inspector

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Title of Inspector

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Signature of full-time, salaried veterinarian of the CCVA

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Title of full-time, salaried veterinarian of the CCVA

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Name of full-time, salaried veterinarian of the CCVA

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Date (yyyy/mm/dd)

Official Seal of CCVA

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