FACILITY NAME FACILITY ADDRESS State: Postcode: POSTAL ADDRESS (Leave blank if same as above) State: Postcode: CONTACT DETAILS Name: Email address: Phone number: ( ) REGISTERED ESTABLISHMENT NUMBER: DECLARATION By applying for protocol export listing, I/we,...... agree to the following: Meet the conditions and requirements that apply to conditions for import of fruit fly host commodities to Thailand Read the Department of Agriculture and Water Resources Privacy Notice (attached). Provide all information and associated documentation listed on the following pages Read the relevant protocols and work plans for the nominated market and agree to meet the conditions and requirements contained therein.
Please select which commodities you intend to export: Apples Cherries Kiwifruit Pears
Apricots Citrus Nectarines Persimmons
Avocadoes Grapes Peaches Plums
Failure to comply with the aforementioned conditions and restrictions, including but not limited to providing access to properties and documents required under the above agreements, may lead to importing country requirements not being met or not being verified, which will prevent certification being issued.
FACILITY REPRESENTATIVE SIGNATURE DATE
...... /...... /...... (print name) WITNESS SIGNATURE DATE
...... /...... /...... (print name) Export approval application for onshore cold treatment facilities for export of fruit fly host commodities to Thailand
Export listing application for on-shore cold treatment facilities for export of fruit fly host commodities to Thailand Page 1 of 4 Requirements for onshore cold treatment facilities
The following information must be provided to the department as part of the application process:
1. Layout of treatment rooms, inspections areas and load out areas. Please attach plans, maps and images.
2. Description of how product security will be maintained for each treatment and loading.
3. Dimensions of the facility.
4. Capacity of each cold room used for treatment.
Export listing application for on-shore cold treatment facilities for export of fruit fly host commodities to Thailand Page 2 of 4 5. Specifications and details of temperature-recording equipment including serial numbers of the fruit pulp temperature probes and air sensors.
6. The type of insulation used in the cold rooms.
7. The make, model, type, and capacity of the refrigeration condenser and evaporator air circulation.
8. The temperature range of the equipment, defrost cycle control and specifications and details of any temperature-recording equipment.
9. Detailed Standard Operation Procedures (SOPs) for product security, movement and treatment. Please attach relevant SOPs.
Export listing application for on-shore cold treatment facilities for export of fruit fly host commodities to Thailand Page 3 of 4 Privacy Notice Horticulture Exports Program
‘Personal information’ means any information or opinion about an identified, or reasonably identifiable, individual.
The collection of personal information by the Department of Agriculture and water resources (the department) in relation to this application is for the purpose of export listing, meeting requirements under nominated importing country protocols, to assist in the collection of industry levies, and related purposes. If the relevant personal information requested in this application form is not provided by you, the department will be unable to assess your eligibility to export your commodity to importing countries.
Personal information may be disclosed to Australian Diplomatic Posts, and relevant Industry Peak Bodies, persons or organisations where necessary for these purposes, provided the disclosure is consistent with relevant laws, in particular the Privacy Act 1988. Your personal information will be used and stored in accordance with the Privacy Principles.
By completing and submitting this form you consent to the disclosure of all personal information contained in this form to the National Plant Protection Organisation (NPPO) of the nominated importing countries. The department has not taken steps to ensure that the NPPO of importing countries does not breach the Privacy Principles. This means that:
the NPPO will not be accountable under the Privacy Act you will not be able to seek redress under the Privacy Act you may not be able to seek redress in the overseas jurisdiction. NPPO of importing countries may not be subject to any privacy obligations or to any principles similar to the Privacy Principles.
The department’s Privacy Policy, including information about access to and correction of your personal information, can be found at: http://www.agriculture.gov.au/about/privacy
To contact the department about your personal information or to make a complaint: Telephone: Switchboard +61 2 6272 3933 Email: [email protected] Post: Privacy Contact Officer, Department of Agriculture and Water Resources, GPO Box 858, Canberra ACT 2601.
Export listing application for on-shore cold treatment facilities for export of fruit fly host commodities to Thailand Page 4 of 4