P-42, r. 10 - Regulation respecting medicinal premixes and medicinal foods for animals

Schedule Disposition versions

2023-01-01

SCHEDULE IV

(Revoked)

O.C. 1633-92, s. 21; O.C. 1829-93, s. 5; O.C. 1443-2022, s. 27.

2012-09-01

SCHEDULE IV

(ss. 30.1 and 30.6)

SAMPLING MINUTES

	SAMPLING MINUTES
	pursuant to:		* Animal Health Protection Act (chapter P-42, s. 55.15)
		* Marine Products Processing Act (chapter T-11.01, s. 45, par. 5)
	*	Other Act

Name and address of person in charge	Report No.

	A- REASONS FOR ACTIONS TAKEN	
 Considering the reasons mentioned in offence report No.	respecting  	
                         	(name and address of person concerned)
dated	, I took the samples described in the document attached hereto, to be shipped or delivered, at room temperature *, refrigerated * or frozen *, on  		 at _________o’clock by 	
	 to the * Laboratoires d’expertise et d’analyses alimentaires or * Laboratoire de 
               (means of transport)
pathologie animale.  Seals are affixed to the sample containers. Project  No.		 At the time of the swabbing, the surface used was 	cm2.	
	B- SAMPLING (Method and procedures used - representativeness of the sample, etc.)	
	
	
	
	
	
		
		
		
		
		
	C- DESCRIPTION AND CHARACTERISTICS OF THE SAMPLE	
In addition to the record number and the name and address of the person concerned, I indicated, on the document attached hereto, the data and characteristics that I have personally observed in respect of each sample, particularly the place where the sample was taken, its number, the seal number, nature of the product, trademark, number of the lot to which it belongs, quantity taken, temperature of the sample when it was taken and, where applicable, the date on which the sample product was packaged, its "best before" expiry date or any other information likely to prove the authenticity of the sample.	
Made in triplicate at 		* Document(s) attached	
	(place)		


SIGNATURES	
I have personally observed the facts and taken the actions mentioned in *A *B *C	I have personally observed the facts and actions mentioned in *A *B *C
Authorized person	Authorized person
Surname and given names (in block letters)	Surname and given names (in block letters)
Authorized person’s No. or position	Authorized person’s No. or position
Signature	Signature
(Form prescribed by regulation to be used as documentary evidence)	

O.C. 1633-92, s. 21; O.C. 1829-93, s. 5.