Application with a View to Registration Or Approval Under The

Application with a view to Registration or Approval under the

EC Feed Hygiene Regulation

(EC Regulation 183/2005)

To:Hampshire County Council, Trading Standards Service,

Montgomery House, Monarch Way, Winchester, Hampshire SO22 5PW

Data Protection Act 1998

We are collecting this information for the purposes of animal feed hygiene registration.

This information will be used to make a record on our database of the feed business.

This information may be shared with other Food and Feed Law enforcement bodies

It is stored on our departmental database and a paper copy may also be retained.

The data will be retained for 6 years after it ceases to be current (e.g. close of business)

1. Name or business name of the feed business to which this application relates:

Name:
Business Name:

1. Address and associated details of the premises where the activity requiring registration or approval is undertaken or to be undertaken:

Address:
Post code:
E – mail address:
Telephone No: / Fax No:

3. Activity or activities carried out on the premises (please use the code

and activity description shown in below.

Approval Activities (tick all those that apply)

Code / Activity / Code / Activity
A1 / Manufacture/market nutritional additives / A5 / Manufacture/market bio-proteins
A2 / Manufacture/market zootechnical additives / A6 / Manufacture/market products of amino acid fermentation
A3 / Manufacture/market antioxidants with maximum levels / A7 / Manufacture/market premixture containing vitamins A and D
A4 / Manufacture/market xanthophylls & carotenoids / A8 / Manufacture/market premixtures containing copper or selenium

Registration Activities (tick all those that apply)

Code / Activity / Code / Activity
R1 / Manufacture/market feed additives (other than approved) / R8 / Transport feed and/or feed products
R2 / Manufacture/market premixtures other than those approved / R9 / Store feeds and /or feed products
R3 / Manufacture/market bioproteins other than those req approval / R10 / Mixing feed on farm using premixture/additives
R4 / Manufacture Compound Feeds / R11 / Mixing feed on farm using compounds/concentrates
R5 / Market Compound Feeds / R12 / Food businesses supplying co-products destined for feed
R6 / Manufacture Pet Foods / R13 / Livestock farms feeding but not mixing
R7 / Manufacture/Market Feed Materials (including former foodstuffs) / R14 / Arable Farms growing feed materials

4. Name of Applicant:

5. Address of Applicant (if different to the address indicated in 2. above):

Address:
Post code:
E – mail address:
Telephone No: / Fax No:

Name:

Signature:Date:

Position in Business

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