Permanent Preservative Treatment Certificate printable pdf download

______________________________ ______________________________

Company letterhead

(MUST be issued by the treatment provider, and MUST include the company’s name and

physical address)

PERMANENT PRESERVATIVE TREATMENT CERTIFICATE

Unique identifiable link to the consignment: ........................................................................

Description of goods/packaging treated: ……………………………………………………….

(such as pallets and crates if packaging is treated)

Quantity/volume of goods/packaging treated: …………………………………………………

Date of treatment: ………………………………..

Name of preservative formulation.....................................…………………………………….

Chemical class of preservative (active ingredients) .................................……………………..

Retention of active ingredient (loading of preservative) expressed as

................................................. % mass/mass based on the oven dried mass of the treated

wood; or mass per volume (net dry salt retention – Fenvalerate and Fenitrothion ONLY).

NOTE: %mass/mass = 100 x actual batch retention of active ingredient in penetration zone (mass/vol)

actual oven dried mass of the treated wood (mass/vol)

Plywood, LVL and veneers only:

Veneer only treatment

or glueline only treatment

or both

(please tick one)

Veneer thickness …………………………………………… mm or

inches

STATEMENT (tick one box):

This is to certify that the timber described below was treated in accordance with Department of

Agriculture and Water Resources biosecurity penetration and retention requirements with an

acceptable (listed) preservative formulation.

This is to certify that the timber described below was treated in accordance with Australian Standard

AS/NZS1604 to specific Department of Agriculture and Water Resources biosecurity penetration and

retention requirements.

Additional statements as required by the import conditions for the relevant goods/packaging (if applicable)

………………………………………………………………………………………………………………..

Printed name: ………………………..

Signature: ..........................................................

(Treatment provider company representative)

Date of issue: ..........................................

(DD/MM/YYYY)

Permanent Preservative Treatment Certificate