Documentation Of Sample Selection, Shipping, And Disposal By Manufacturer/vendor Form

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Documentation of Sample Selection, Shipping, and Disposal by
Manufacturer/Vendor Form
The manufacturer/vendor shall provide the laboratory with a representative sample of the product or packaging
to be tested in accordance with the Operations Manual for Biobased Product Certification Program.
This form must be completed and submitted to the laboratory with the sample to be tested with a copy to
ASTM International.
1. Information on Manufacturer/Vendor
Name:
Date (dd/mm/yyyy):
Title:
Company:
Address:
Address:
City:
State/Province:
Country:
Postal code:
Phone:
E-mail:
USDA Application #:
Product Name:
Brand Name:
2. Retail Products
A retail product is defined as a finished article of commerce which is not for resale but for use and
consumption by the consumer.
2.1
I am submitting a retail container of the product which is labeled, sealed, and secured for retail
purchase. I have provided the smallest retail size.
2.2 Provide information on the selected retail container including the date selected, lot number, and name and
location of the manufacturing facility:
3. Non-Retail Products
3.1
The product is not available in a retail container and I am providing a representative sample of the
product.
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02/28/11

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