SOP Exhibits

Title:

Exhibit 2 - Facility Inspection Report

SOP Number : BR-QM03

EXHIBIT 2

Republic of the Philippines
NATIONAL FOOD AUTHORITY
Directorate for Enforcement and Legal Affairs
Quezon City

TO : The Director, DELA
FROM : _____________________
SUBJECT : FACILITY INSPECTION REPORT OF THE WAREHOUSE AND/OR MILL OF
______________________________________________________________

Sir:

In accordance with the existing rules and regulations, I herein submit the following report:

1.a) Owner/Operator

Name _______________________________________________________________________
Residence ___________________________________________________________________
Registered Business Name _____________________________________________________
Business Address _____________________________________________________________
NFA Official Receipt No. ____________________ Date of Issue _______________________
Place of Issue ________________________________________________________________
License/Sticker No. ________________________ Control No. ________________________
Place of Issue ____________________________ Date of Issue ______________________

2. Line of Activity/ies (Per OR) Fees Paid Deficiency/ies

Application Fee P ________________ _____________
a) Retailing ________________ _____________
b) Wholesaling ________________ _____________
c) Palay Threshing ________________ _____________
d) Corn Shelling ________________ _____________
e) Regional Grains Corporation ________________ _____________
f) Processing/Manufacturing ________________ _____________
g) Exporting ________________ _____________
h) Importing ________________ _____________
i) Warehousing ________________ _____________
j) Milling ________________ _____________
k) Grains Packaging ________________ _____________
l) Others ________________ _____________
m) Surcharges ________________ _____________
Total P ________________ P _____________

3. Business Set-up

( ) Sole Proprietorship ( ) Partnership ( ) Cooperative
( ) Corporation

4. Capitalization for Grains business for 19_____ if P __________________________

a) Personal Investment P__________ Loan P ______________________
b) Creditor

5. Applicant has been engaging in the grains milling/warehousing since ______________________.
Commodities handles: ____________________________________________________________.

6. Was applicant authorized as warehouseman/miller by NARIC, RCA, or NFA before? ______________
_____________________________________________________Year ___________________________.
If so, was the applicant charged with any violation/s? ________________________________________
If so, state the nature and action taken thereon? ___________________________________________

7. Bond/s

a). Warehousing:

1. Authorized bonded capacity _________________________ Cav. at 50 kls. ________________
2. Amount of bond posted _________________________ type of bond ________________
3. Bonding company _______________________________________________________________
4. Address _______________________________________________________________________
5. Policy No. _____________________________________Date of Issue _________________
Place of Issue ____________________________________________________
6. Commodities covered_____________________________________________________________

8. Insurance/s

a). Warehousing:

1. Insurer ________________________________________________________________________
2. Address ______________________________________________________________________
3. Amount covered______________________________Policy No. __________________________
4. Period Covered_______________________________Date of Issue _______________________
5. Place of Issue __________________________________________________________________
6. Commodities Covered ___________________________________________________________

b). Milling:

1. Insurer ________________________________________________________________________
2. Address ______________________________________________________________________
3. Amount covered______________________________Policy No. __________________________
4. Period Covered_______________________________Date of Issue _______________________
5. Place of Issue __________________________________________________________________

9. Warehouse Description

a) Rodent/Insect/Bird Proof ( ) yes ( ) no
b) Exposed to fire hazard ( ) yes ( ) no
c) Fixed partition between bonded and
non-bonded stocks ( ) yes ( ) no
Description _______________________________________________________________________
d) Separate doors between bonded and
non-bonded stocks ( ) yes ( ) no
e) System of ventillation _______________________________________________________________
f) Walled partition segregating the different
commodities stored: ( ) yes ( ) no
Description _______________________________________________________________________

10. Grains Equipment and Facilities

a) Fumigating equipment ______________________________________________________________
b) Fire Fighting equipment _____________________________________________________________
c) Mechanical driers:

No. of units ___________________________ Type _______________________________
Holding Capacity ______________________ cav a50kls/load
Total Medium capacity _________________ cav/__________________ hrs.
Type fuel used ________________________
d) Solar driers:
Total Area_________________ sq. m. Capacity _____________ cavs a 50kls/cav
e) Moisutre Meter
Manufacturer _______________________ Model ____________________________________
f) Weighing Scale:
1) Platform Scale-Model______________________ Capacity __________________________
g) Transportation Facilities:
No. of units ________________________________ Total tonnage ______________________

11. Mill/s:

No. of Units _________________________________
Type of Manufacturers _________________________________
No. of compartments in
separator _________________________________
Total HP Rating ____________ HP _________________ HP
Maximum Capacity _________ cav/12 hrs. _______ cav/12 hrs.
Percentage recovery _________ cav/hr. ___________ cav/hr.
_________________________________
Are the broken grains separated from head grains? ( ) yes ( ) no
If yes, is there a mixing apparatus? ( ) yes ( ) no

12. Other mills or warehouses owned or operated by the applicant as branch/es.

___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________

13 Date of Milling Service Charge:

1) By recovery ____________________________________
2) By input ______________________________________

14. Rate of storage charge:

1) First Month _______________ 3) Third Month __________________________
2) Second Month _____________ 4) Fourth Month _________________________

15. Remarks/Observations:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

C E R T I F I C A T I O N

I hereby certify that on this _____ day of _______________ 19 ___ the above-mentioned establishment/s
was inspected by investigator/s __________________________________________ with NFA ID No. ________
in my province.


_________________________________________ ___________________________________
Witness Manager/Representative

C E R T I F I C A T I O N

I hereby certify that I have exerted all efforts to ascertain the data contained herein and that they are true
and correct to the best of my personal knowledge.

_____________________ ____________________________ ___________________________
Date of Report QGFB-Operations Officer or NFA Investigator

NOTED BY:


_______________________________________
PM/OIC