please fill out this questionnaire if you are requesting...

1900 Hendon Avenue, St. Paul, MN 55108 ~ tel 612-625-7766 ~ fax 612-625-3748 ~ [email protected] ~ www.mncia.org

ORGANIC SYSTEM PLAN - DAIRY.......................................................................................................................................

Please fill out this questionnaire if you are requesting organic dairy certification. Submit farm, pasture, and livestock facility maps as well as other supporting documents (documentation for pastures owned or rented for less than three years, feed and supplement product labels, etc.) outlined in this questionnaire. Use additional sheets as necessary.

SECTION 1: General Information NOP Rule §205.401Applicant (Name/Company): FOR OFFICE USE ONLY

Applicant No: Contact Person: Check #: Address:

Amount: DR #:

City: State: Zip code: Initials: Phone: Cell: Late Fees: Fax: Email: Other: Legal Status Corporation Legal partnership Sole proprietorship

Trust or non-profit Other (specify) Year first certified organic:

List previous organic certification:

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 and state how they have been addressed.

Not applicable

Do you have access to a current copy of MCIA’s Organic Handbook? Yes NoDo you have access to a current copy of the NOP standards? Yes NoPreferred time for inspection: AM PM

Give directions to farm:

Organic System Plan - Dairy Organic Certification Print Date: 5/8/2023Controlled Version – 1/7/15 of 22 © 2015 Minnesota Crop Improvement Association

mailto:[email protected]

SECTION 2: Livestock Origin Information NOP Rule §205.236NOP §206.236 The NOP requires that organic milk and milk products come from animals under continuous organic management. This begins no later than 1 year prior to organic milk production for a one-time herd transition, and once an entire distinct herd has been converted to organic management, all animals must be under organic management from the last third of gestation. Once an organic animal is removed from an organic system, she is no longer eligible for organic production. Records must be maintained preserving the identity of all organic animals in your operation.

2.1 What type of animals do you milk? Cow Goat Sheep Other (specify) :

If you have more than one species, please contact MCIA for further instruction.

2.2 What breed(s) are in your herd?

2.3 On average, how many animals are you milking?

Please complete the breakdown for your current dairy herd. Enter numbers of animals in the table below:

CLASS REQUEST FOR ORGANIC CERTIFICATION ELIGIBLE FOR ORGANIC SLAUGHTER MANAGED CONVENTIONALLY

Mature Females: Milking

Mature Females: Dry

Young Stock: Breeding Age

Young Stock: Unbred

Young Stock: Calves/kids/lambs

Males: Breeding/Meat/Cull

Other:

Total in Herd

2.4 You must have a system for permanently identifying animals using tags, tattoos, neck chains or collars with tags, photographs, or other approved system. Non-durable systems must be backed up by a second form of identification (plastic ear tags, PLUS registrations OR neck chains PLUS photos).

How are animals identified? ear tags tattoos collars photos or drawings branding ear notches Other (specify):

2.5 Do you purchase any livestock? Yes No

List last year’s acquisitions of livestock (use additional sheet(s) if necessary).

DESCRIBE & IDENTIFY ANIMAL DATE OF ACQUISITION SOURCE/FARMCERTIFIED ORGANIC BY

WHOM?ORGANIC FOR SLAUGHTER?*


* Organic slaughter stock must be managed organically from the last third of gestation. Transitioned animals are not eligible for organic meat. Animals treated with a synthetic parasiticide are not eligible for organic meat. In order to certify dairy herd for slaughter, you will need to have records to account for these conditions.

2.6 Do you raise dairy replacement animals on-farm? Yes No

If someone is raising replacement animals for you, they must be certified organic. Please list their name(s) and address(es):

Name Address Phone Name Address Phone

2.7 Do you raise any slaughter animals on-farm? Yes No If No, how are they sold?

2.8 List the animals leaving the herd over the past year: culls, deaths, sales for replacements, slaughter, and any other reason animals left your herd (use additional sheet(s) if necessary).

DESCRIBE & IDENTIFY ANIMAL DATE OF DEPARTURE REASON FOR LEAVING SOLD AS ORGANIC?


SECTION 3: Pasture Plan and Grazing Management NOP Rule §205.240NOP §205.240 The producer of an organic livestock operation must, for all ruminant livestock on the operation, demonstrate through auditable records in the organic system plan, a functioning plan for pasture. Pasture must be managed to comply with the requirements to supply a minimum of 30 percent of a ruminants dry matter intake (DMI) on average, over the course of the grazing season, to minimize the occurrence and spread of diseases and parasites, and refrain from putting soil or water quality at risk.

3.1 Please attach a Pasture Map, which clearly illustrates the following: Location and size of each pasture in acres Permanent fences Laneways and outdoor access areas Access to shade Location and source of drinking water Protected environment resources, if applicable

3.2(a) What cultural and management practices do you use to increase your pasture productivity, improve pasture quality, and extend the grazing season? Please check all that apply:

Pasture soil testing Fertility inputs/spreading manurepH adjustments Clipping weedsControlled access/avoiding overgrazing Stockpiling fall pastureIrrigationAnnual grazing season extension crops (warm season grasses, brassicas. Etc)Other: Other:

(b) Describe your soil fertility management and methods for pasture.

(c) Describe your approach to seeding down pasture.

3.3 What is the length of the grazing season at your farm’s location? Please describe a typical grazing season for each management group.(a) Animals milking: Grazing Season: Dates (begin), through (end)

Animals dry: Grazing Season: Dates (begin), through (end)Breeding age: Grazing Season: Dates (begin), through (end)Young stock: Grazing Season: Dates (begin), through (end)Other: Grazing Season: Dates (begin), through (end)

(b) Do you have any breaks in a typical grazing season (animals are not on pasture):Dates (begin), through (end) Reason: Dates (begin), through (end) Reason: Dates (begin), through (end) Reason:


3.4 Grazing Methods Used in Your Pasture System(a) Permanent Pasture – Please put the correct acreage for each type of management and add up your TOTAL PERMANENT

PASTURE ACREAGE at the bottom of the chart. This chart is for your land that is only used for grazing.

TYPE OF MANAGEMENT ACRES SPECIES COMPOSITION ANIMAL GROUP# HEAD/GROUP

EXAMPLE:Continuous grazing/one open pasture

38 Native grass-clover mix, brush, hardwoods

Dry cows, bred heifers 26

Management intensive grazing

Rotational grazing

Occasional grazing

Continuous grazing/one open pasture

Day & Night pastures

Strip grazing

Annual pasture season

Extension crops (basics, etc)

Other:

Other:

TOTAL ACRES:(All your permanent pasture land)

(b) How long are animals in a paddock before moving them to fresh pasture?

(c) What is the rest period for pasture between grazings? Include seasonal variations.

(d) What kinds of conventional animals share the organic pasture described here? How many head?

(e) Other comments about your pasture system:

(f) Grazing cropland. Please fill out this chart with acres you would use in a typical grazing season (not an extreme year).

TYPE OF CROP LAND NUMBER OF ACRES APPROXIMATE DATES ANIMAL GROUPS

Early season grazing hay land after 1st cut

Late season grazing hay land after 2nd or 3rd cut

Grazing crop residue Crop:

Other:


(g) How many additional acres of cropland could you potentially graze, if needed, to bring up the % DMI from pasture?

(h) Do you graze or board animals on another producer’s farm (custom boarding/grazing)? Yes NoProducer’s name: Name of Farm: Animal group grazing there: # of Head: Is this farm part of your OSP? Yes NoIf not, have you obtained an organic certificate for the pasture on that farm? Yes No

3.5(a) What drinking water sources are used during the grazing season? Check all that apply.On-site wellWater tubs in pasturesWater tubs in barn and barnyardFarm pondsOther:

(b) What is the date for last water test for coliform bacteria, salmonella and nitrates?

(c) If there are natural water bodies, wetlands, or riparian areas adjacent to grazing land, how do you prevent soil erosion, contamination or damage?

3.6 Please describe access to shade for grazing animals (include frequency).

3.7 Outdoor access to pasture. On average how many hours per day are animals outdoors? (If it varies among different age groups, please list separately in the table below:

GROUPS OF ANIMALS SPRING SUMMER FALL WINTER


SECTION 4: Livestock Feed NOP Rule §205.237NOP §205.237 NOP Rule requires the feed ration of organic livestock be composed of agricultural products that are organically produced and if applicable, organically handled. The producer must not use a) animal drugs including hormones to promote growth, b) fee supplements or additives in amounts above those required for adequate nutrition of the species, c) plastic pellets for roughage, d) urea or manure, e) mammalian or poultry byproducts to mammals or poultry, and f) feed, feed additives, and feed supplements in violation of the Federal Food, Drug and Cosmetic Act.

The NOP requires 100% organic feed. Antibiotics and ionophores are not allowed in organic feeds. During the grazing season, you must manage your pasture as a crop that provides at least 30% of the dry matter intake (DMI) for all age groups 6 months and older. The grazing season must be typical in length for your geographic area, and must be at least 120 days. Feeding records must be available for the inspector.

If you harvest any crops in addition to the hay/grass from your pastures, you must complete a producer application. Contact MCIA for more information.4.1 Do you harvest any hay/grass from pasture? Yes No 4.2 Itemize below the total of each ORGANIC FEED PRODUCED ON YOUR OWN FARM over the past 12 months. Please attach

additional sheet(s) if necessary.

CROP(Corn silage, grain, dry hay, baleage, grass silage)

ACREAGENUMBER OF

HARVESTS

TOTAL NUMBER AND/OR WEIGHT

(i.e: 200 round bales at 500 lb each OR 276 tons, OR 5,000 lbs)

ESTIMATED DRY MATTER (DM) CONTENT

(Your forage test results, MCIA values or your own best estimate)

4.3 Do you process (mix, grind, roast, extrude, etc.) any feed on-farm? Yes No

Is the equipment also used to process conventional products? Yes NoIf yes, how is the equipment cleaned prior to processing organic feed?

4.4 List below the ORGANIC FEEDS PURCHASED over the past 12 months. Attach additional sheet(s) if necessary.

TYPE OF FORAGE OR GRAIN CROP SOURCE CERTIFIED ORGANIC BY WHOM?TOTAL NUMBER AND/OR WEIGHT

(i.e: 200 round bales at 500 lb each OR 276 tons, OR 5,000 lbs)

4.5 What is your plan for obtaining emergency feed supplies?


4.6 Describe your feed storage locations:

TYPE OF FEED TYPE OF STORAGE CAPACITY LOCATION ORG (O) TRAN (T) CONV (C)

4.7 How do you control rodents in organic feed storage?

4.8 List all feed supplement and additives, including silage inoculants and preservatives. Attach additional sheet(s) if necessary.

FEED SUPPLEMENT/ADDITIVE SOURCE SYNTHETIC (YES OR NO) REASON FOR USE

4.9(a) How much milk do you feed calves / kids / lambs? (b) Where do you obtain the milk? (c) At what age do you wean them?

Feed Rations for Ruminant Livestock


Producers of organic ruminant livestock are required to provide a full description of feed rations and calculations of how much of the ration is provided by pasture during the grazing season. The charts below can be used to provide this information. You may use an alternative method, such as the forms and resources on the NOP website, but you must specify the source.

In the reference tables below you will find 1) dry matter contents for most feeds, 2) dry matter demand for lactating cows based on size and quantity of milk produced, and 3) dry matter demand for other groups of dairy animals. Using the information in the tables below, complete the Ration and Pasture Calculation charts for each class of animals (listed in Section 2) on your farm that is fed a separate ration. If you have % DM from feed testing, or another source, use those numbers in your calculations and submit the supporting documentation. Make as many copies of the worksheets as you need.

RATIONS AND PASTURE CALCULATIONS FOR LACTATING COWS

I. DRY MATTER DEMAND (DMD)Number of Cows in

this Group Average Weight Per Cow Average Milk Per Day Per Cow in Pounds

DMD From Dairy Cows Dry Matter Demand Chart

(A)

II. WINTER NON-GRAZING SEASON FEED RATION III. SUMMER GRAZING SEASON FEED RATION

Feed Types – List All % DM Lbs fed DMI fed Feed Types – List All % DM Lbs fed DMI fed

Example: Corn silage 35% (.35) x 10 # = 3.5# Example: Dry corn 89% (.89) x 15 # = 13.35#

x = x =

x = x =

x = x =

x = x =

x = x =

x = x =

TOTAL DM FED (B) TOTAL DM FED (C)

IV. PASTURE CALCULATION

minus = divided by = x 100 = %DMD Total DM Fed Pasture DM DMD DM % from

(from A) (from C) Fed (from A) pasture


Dairy Cows Dry Matter Demand (DMD)

Average Milk Per

Day

Small Breed (<900-

1200#) DMD

Large Breed (1200-1400#+)

DMD10# 21# 27#15# 23# 28#20# 24# 30#25# 26# 31#30# 28# 33#35# 30# 34#40# 31# 36#45# 33# 37#50# 35# 39#55# 36# 40#60# 38# 42#65# 40# 43#70# 42# 45#75# 43# 46#80# 45# 48#

RATIONS AND PASTURE CALCULATION FOR ADDITIONAL GROUP

I. DRY MATTER DEMAND (DMD)Find the DMD as % of average body weight. Average weight x % (move decimal to the left two digits) = Dry Matter Demand

Which Group? Number of Animals in this Group

Average Weight Per Animal

DMD as % of Body Weight From Ruminant Groups Chart

Dry Matter Demand

(A)



Example: Corn silage 35% (.35) x 10 # = 3.5# Example: Dry corn 89% (.89) x 15 # = 13.35#

x = x =

x = x =

x = x =

x = x =

x = x =

x = x =





RATIONS AND PASTURE CALCULATION FOR ADDITIONAL GROUP

I. DRY MATTER DEMAND (DMD)Find the DMD as % of average body weight. Average weight x % (move decimal to the left two digits) = Dry Matter Demand

Which Group? Number of Animals in this Group

Average Weight Per Animal

DMD as % of Body Weight From Ruminant Groups Chart

Dry Matter Demand

(A)



x = x =

x = x =

x = x =

x = x =

x = x =

x = x =






Transitional or Split Operation NOP Rule §205.236(a)(2), §205.272 NOP §205.236(a)(2) Crops and forage from land, included in an Organic System Plan of a dairy farm that is in its third year of transition, may be consumed by the dairy animals of the farm during the 12-month period immediately prior to the sale of organic milk and milk products.NOP §205.272 You must prevent the commingling or organic and nonorganic product and protect organic products form contact with prohibited substances.

Transitional Operation

4.12 Will livestock be fed third year transitional crops/forage included in the organic system plan of a dairy during the 12 months of management prior to milk and milk products being sold as organic? Yes NoIf yes, when did you begin feeding third year transitional feed?

What dates did you begin (or plan to begin) feeding 100% organic feed?

What dates did you begin (or plan to begin) selling milk as organic?

Split Operation

4.13 If there are non-organic animals on the farm, explain what measures are taken to ensure segregation.

4.14 Please explain how organic and non-organic feeds are kept separate?

4.15 How is equipment cleaned that is used for both organic and non-organic animals or animal products?


SECTION 5: Health Care Practices NOP Rule §205.238NOP §205.238 The NOP rule requires that producers must establish and maintain preventative livestock health care practices. When preventative and veterinary biologics are inadequate synthetic medications may be administered provided they are allowed under 205.603. The producers of an organic livestock operation must not withhold medical treatment from a sick animal in an effort to preserve its organic status. All appropriate medications must be used to restore an animal to health when methods acceptable to organic production fail. Livestock treated with a prohibited substance must be clearly identified and shall not be sold, labeled, or represented as organic. All medical records and vet records (dosages, dates, etc.) must be available for inspection.

5.1 Many practices contribute to the health, wellbeing and productivity of your herd. Check all that apply to your operation and add any other practices that you use but are not listed. Add additional comments about your approach to herd management below.

Selective breeding Access to outdoors Herbal remedies Raise own replacements Pasture rotation Preventative strategies Isolation for sick or new animals Clean bedding Periodic fecal examinations Vaccinations Ventilation Dusting wallows Homeopathic remedies Culling Other: Nutritional supplements Probiotics Other: Good sanitation Regular veterinary care

5.2 Describe internal and external parasite control on your farm. Include methods used both to prevent and reduce infestations.

5.3 Synthetic parasiticides are for emergency use only, and only certain ones are permitted. If you use these products, please complete the table below.

TYPE OF PARASITICIDE PROTOCOL FOR USE

Example:Ivermectin Calves under 6 months, showing symptoms of infestation, confirmed by veterinary fecal egg count.

5.4 List all routinely performed medical treatments and physical alterations (including vaccines, dehorning, castration and hoof trimming, tail docking, ear tagging, branding, etc).

CLASS OF ANIMAL TREATEDPROTOCOL AND PRODUCTS OR

IMPLEMENTS USEDREASON FOR TREATMENT

5.5 If alterations are made, what methods are used to minimize suffering (e.g. anesthetics)?

5.6(a) What tools and techniques do you use for treating mastitis?

(b) What tools and techniques do you use for treating respiratory issues?

(c) What tools and techniques do you use for treating calf scours?


(d) What tools and techniques do you use for dehorning?

5.7 Do your animals have any recurring health problems? Please describe your full management protocol, including medical and environmental management strategies.

PROBLEM CLASS OF ANIMAL MANAGEMENT PROTOCOLMEDICAL CULTURAL/ENVIRONMENTAL

Example:Scours Calves (0-2 mo) Electrolytes, slippery elm, yogurt

Change bedding more often, spilt bottle feeding into 3x/day

5.8 List any hormones given over the past year, animals treated, and reason for use.

ANIMAL TREATED HORMONE(S) USEDDATE(S) USED OVER LAST 12 MONTHS

REASON FOR USE LOCATION OF ANIMAL

5.9 List any antibiotics, and restricted or prohibited synthetic medications given over the past year, animals treated, and reason for use.

ANIMAL TREATED ANTIBIOTIC(S) USEDDATE(S) USED OVER LAST 12 MONTHS

REASON FOR USE LOCATION OF ANIMAL

5.10 If individuals are treated with prohibited or restricted materials, how are they identified, segregated, and/or removed from the

organic system?

HEALTH PROBLEM/DISEASE

ANIMAL I.D. PREVENTION/MANAGEMENT PRACTICE

PRODUCTS USEDAPPROVED (A)RESTRICTED (R)PROHIBITED (P)


5.11 How do you prevent the use of prohibited medications in your livestock operation?

5.12 Please describe any biosecurity program for your farm.

5.13 Please provide the name, phone, and address of your regular veterinarian.

Name: Phone:

Address:

City/State: Zip:

5.14 Which livestock pests affect your operation? Flies Internal parasites External parasites Predators Other:

5.15 How do you prevent or control livestock pests?

5.16 How do you monitor for presence of livestock pests?


SECTION 6: Living Conditions NOP Rule §205.239NOP §205.239 The NOP rule requires that a producer must establish and maintain living conditions which accommodate health and the natural behavior of the species. A producer may provide temporary confinement due to inclement weather, animals’ stage of production, conditions in which health and safety of the animals may be in jeopardy, or risk to soil and water quality. The producer must also manage manure in a manner that does not contaminate the environment.

6.1 What type of shelter is used for each animal group in summer and winter? List more than one if necessary. Include the type of housing (Stanchion barn, tie stall barn, free stall, bedded pack housing, run-in shed, trees, hutches, etc.), a description of the floor type (concrete, ½ slatted, fully slatted, etc.), and the size of the shelter (length X width).

GROUP(S) OF ANIMALS SUMMER SHELTER WINTER SHELTERWINTER OUTDOOR

ACCESS?Mature females: Milking

Mature females: Dry

Young Stock: Breeding Age

Young Stock: Calves/lambs/kids

Males: Breeding/Meat/Cull

Other:

6.2 What type of bedding material is used? If it is an agricultural product and edible (i.e. not sawdust or sand), it must be certified organic.

TYPE OF BEDDING CERTIFIED ORGANIC BY WHOM?

6.3 How often is the barn cleaned out? Describe the process and any products used (i.e. bedding lime, disinfectants, sanitizers, cleaning products, etc.)

6.4 Please describe ventilation system:

6.5 Temporary Confinement is defined as denying access to the outdoors, “occurring for a limited time only, (e.g. overnight, throughout a storm, during a period of illness), not permanent or lasting. NOP 205.239.(a) Describe why and how long animals are confined.


SECTION 7: Manure Management NOP Rule §205.203(d)NOP §205.203(d) The NOP rule requires that manure be managed so that it does not contribute to the contamination of crops, soil, and water.

7.1 What forms of manure do you use: Liquid Semi-solid/piled Fully composted

7.2 If manure from your farm is used on your fields, describe how it is used: Not used

7.3 List any additives/ingredients (example: bedding, barn lime, inoculants, preservatives):

7.4 During what months do you apply manure/compost?

7.5 Describe your composting method:

7.6 Estimated quantity of manure generated per year:


SECTION 8: Milk Handling NOP Rule §205.201, §205.272NOP §205.201, §205.272 Organic dairy operation must meet all applicable state and federal regulatory sanitation requirements. Equipment sanitizer must present no risk of contamination.

8.1(a) What is your estimated herd average for milk production? lbs/yr/animal

(b) What was your total annual milk production last year? lbs/yr

(c) What is the annual average somatic cell count (SCC) and bacteria count?

8.2 What type of milk handling system do you use? Pipeline Automated/Robotic Step saver Hand milking Parlor Tie stalls Stanchions Bulk tank Milk cans Other:

8.3 Describe the cleaning process for all milk handling equipment (water temperature, number of rinses, etc.)

Please fill out the table below and list all cleansers and sanitizers used:

CLEANSERS, SANITIZERS, ACID CLEANERS, ETC. BRAND

ON NATIONAL LIST

IF NO, STATE REASONOMRI

APPROVED

Yes No Yes No

Yes No Yes No

Yes No Yes No

Yes No Yes No

8.4 Describe milking/udder preparation.

Please fill out the table below and list all:

CLEANSERS, SANITIZERS, AND/OR TEAT DIP

BRANDON NATIONAL

LISTIF NO, STATE REASON

OMRI APPROVED

Yes No Yes No

Yes No Yes No

Yes No Yes No

Yes No Yes No

8.5 How often do you change inflations?

8.6 How many animals do you currently milk?


8.7 Report product for the last six milkings:

DATE POUNDS PRODUCED DATE POUNDS PRODUCE

8.8 How are you licensed? grade A Grade B Other:

8.9 How is your milk sold? Direct to buyer Direct to retailer Contract to buyer Direct to wholesaler Other:

Name of milk buyer:


SECTION 9: Transportation and Slaughter NOP Rule §205.201NOP §205.201 NOP standards require that humane methods of handling be used for loading, unloading, holding at slaughter. Slaughter facilities must be certified.

9.1 Product Transportation Not ApplicableHow is milk transported?

Do you arrange product transportation? Yes No

How are organic and non-organic products kept separate during transportation?

Is clean transportation provided? Yes No

Are transport units used to carry any prohibited materials? Yes No

How do you ensure that outgoing transport units are clean prior to loading products?

9.2 Livestock Transportation Not Applicable

How are livestock transported?

What form of transportation is used?

Do you arrange livestock transportation? Yes No

Is there at least one person responsible for the well being of livestock at each step of the transport process? Yes NoIf yes, who? Buyer Self Other (specify)

Do you have an animal identification method in place during transportation? Yes NoIf yes, please describe

How are organic and non-organic animals kept separate before slaughter?

Is clean transportation provided? Yes No

Are transport units used to carry prohibited materials? Yes No

How do you ensure that outgoing transport units are clean prior to loading livestock?

Is an inspection/cleaning process documented? Yes No


Have transport companies been notified of organic handling requirements? Yes NoHow are animals loaded?

Is the loading area and means of transportation free of protrusions that could cause bruising and/or injury? Yes No

Do the methods of transportation provide adequate ventilation and comfortable head space so that the animal is able to stand in a natural position? Yes No

Do you use any tranquilizers or stimulants during loading, transport or unloading? Yes No

How long does transport take?

9.3 Organic Slaughter: If you are selling organic meat from animals within the dairy herd please complete this section. If you are selling organic meat from animals that are under separate management than dairy animals (finishing, pasture

rule exemptions), then please contact MCIA. You may need to complete the general Livestock Questionnaire. If you butcher and process meat on your farm, you need to complete a Processor/Handler Questionnaire.

If you are certifying meat from dairy animals, please list the number of each below:

TYPE OF ANIMAL NUMBER OF ANIMALS SLAUGHTERED PER YEAR NUMBER OF LBS. OF MEAT SOLD PER YEAR

Dairy Culls

Steers/wethers

Calves/kids/lambs

Bulls/bucks/rams

Other:

Provide us with the name, address and phone number of facility where your animals are slaughtered.

Name: Phone: Address

Do you let the slaughterhouse know that your livestock is certified organic? Yes No

How do you sell your livestock products? Type of Marketing:

Direct to Retail Farmers Market On Farm Retail Wholesale Breeding Stock Feeder Stock Other (specify)

If you sell individual packages retail, please attach your organic label for us to review.


SECTION 10: Record-Keeping System NOP Rule §205.103NOP §205.103 The 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. All records must be accessible to the inspector.

What type of records do you keep for organic production?

Documentation of sources of livestock Certification of purchased animals Breeding and calving records Animal Identification Records DHI Individual Health Records, including all treatments Vet Slips Labels for Health Inputs Purchase records for off-farm feed & feed supplements Feed and Feed supplement Labels Feed Ration Records Feed Storage Records Records for Manure Management Monitoring Records Organic Complaint File Milk production records Somatic cell/plate counts Documentation of Previous Land Use for Rented and/or Newly Purchased Land Livestock sales records Slaughter records Proof of Certification for Slaughter/Processing Facilities Outdoor access / temporary confinement records Pasture / Grazing records Equipment Cleaning Records Activity Logs Production Records Clean Transport Records Sales Records (purchase order, contract, invoice, cash receipts, cash receipt journal, sales journal, etc.) Shipping Records (bill of lading) Records to show separation of non-organic livestock Other:

Do you maintain your records for at least five years? Yes No

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? Yes No(Attach copies of all organic product labels and submit to MCIA with this questionnaire)


SECTION 11: AffirmationI affirm that all statements made in this application are true, correct, and complete. No prohibited products have been applied to any of my organically managed grazing areas and/or used in the production of my organic livestock. I understand that the operation may be subject to unannounced inspection and/or sampling for residues at any time as deemed appropriate. I understand that acceptance of this questionnaire in no way implies granting of certification by MCIA. I agree to abide by MCIA Guidelines and the certification standards and/or certification requirements applicable to my operation. I agree to notify MCIA in writing of changes in any of the following: farm contact information, applicant contact information, legal status, ownership or control of operation. I agree to pay all fees assessed by MCIA.

Signature _____________________________________________________________ Date ____________________________

I have attached the following documents: * REQUIRED DOCUMENTATION

*Maps of all pastures and livestock facilities (showing adjoining land use and field identification)*Annual Organic Livestock Agreement*Payment of Base Fee (See the Fee Schedule and Scale of Sanctions)Documentation for pastures owned or rented for less than three years (if applicable)Water test (if applicable)Feed and supplement product labels (must include ingredient lists) (*required for all off-farm inputs)Ingredient lists for any health treatment materials used (*if applicable)Organic product labels (*applicable when packaging organic product)

I have made copes of this questionnaire and other supporting documents for my own records: Yes No

Submit completed form, supporting documents, Annual Organic Livestock Agreement, and fees to:

Minnesota Crop Improvement Association1900 Hendon AvenueSt. Paul, MN 55108


please fill out this questionnaire if you are requesting...

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