New Mexico Department of Agriculture, Organic Program

2604 Aztec NE, Albuquerque, NM 87107

(505) 841-9422

NMDA certifies organic farms, livestock and processing facilities. NMDA does NOT certify material input products (fertilizer, pest control, etc) but determines which products are either ALLOWED or PROHIBITED for use by the organic operationsthat we certify.

MATERIAL REVIEW Application

Name(s) of applicant:
Business Name:
Mailing address:
Physical address:
City: / State: / Zip:
Telephone(s):
Fax:
Email:
Website:

NMDA POLICIES:MATERIAL REVIEW

1)NMDA accepts --at its discretion --requests for review of input materials products from the product manufacturer.

2)In-state requests are given priority. Acceptance of requests is not guaranteed by NMDA.

3)No fees are charged for this service but NMDA reserves the right to change this policy in the future.

4)The review process is instituted at the request of the manufacturer and must be renewed annually, also by request.

5)The NMDA makes the determination of allowance (or prohibition) by reviewing the process & ingredients used in the formulation of the product. Full disclosure of the entire process, of all ingredients, of the specific formulation of EACH ingredient & the entire product and of other information deemed pertinent must be reviewedbefore final determination is made.

6)Formulas and other proprietary information will be kept confidential.

7)Literature such as sales brochures are inadequate and will not be considered unless accompanied by the information required above.

8)Changes in the product including but not limited to formulations, ingredients, brand name and manufacturing process must be reported to NMDA by the manufacturer or risk loss of approval of the product.

9)When a product is approved, a letter will be issued to the manufacturer stating product name(s) and approval(s). Such letters are only in effect during any given calendar year.

10)Copies of these letters may be provided by the manufacturer to their customers.

11)NMDA’s name, seal or implied endorsement must NOT appear in any form on any product label, brochure or literature.

12)Willful violation of NMDApolicies may result in revocation of product approval.

13)Product approval in no way implies granting of organic certification of the product by the NMDA.

14) Product approval is for use by operations certified organic by NMDA. The product’s use by operations not certified by NMDA must be approved by their certification agency.

15) Incomplete applications will be returned.

AFFIRMATION OF APPLICANT

As the responsible party/parties for the product & operation:

1)I have read and acknowledge the above NMDA policies.

2)I have read and am familiar with USDA/National Organic Program 7CFR.205 and the pertinent materials regulations, particularly §205.105, §205.203 and §205.600 through 607.

3) If my product is approved, I affirm that during the period of approval, I will abide by these conditions in order to retain my product’s approval.

4) I affirm that all the information provided in this application is accurate and complete, and fully describes my production practices.

5) I affirm that I will promptly report all changes in my product formula/ production operation to the NMDA.

6) I agree to verification procedures deemed necessary and appropriate to ensure compliance of my product. These include:

a)Mandatory annual review of records & documents pertaining and relevant to the materials production operation.

b)At the discretion of NMDA, on-site inspections of all facilities, materials, storage and equipment relevant to the operation.

c)Cooperation with the NMDA inspector during the above.

d)Requests for additional records and documentation throughout the year as appropriate to verify continuing compliance with organic rules and regulations.

e)Unannounced spot inspections during normal business hours.

f)Sample collection of materials by NMDA for residue tests if deemednecessary.

PRINT NAME
SIGNATURE DATE

PRODUCT INFORMATION

1)Type of product:

Fertilizer

Soil Amendment

Mineral Supplement

Trace Element

Active Biological

Pesticide

Herbicide

Processing Aid

Packaging Aid

Other______

2)Product Brand Name, exactly as it appears on the label:

3)Attach Product Label. If there are variations, attach ALL versions.

4)Do you manufacture this product? Yes No

5)Do you buy and repackage this product? Yes No

6)If yes to #5, do you have authority for full disclosure of the product’s ingredients and production methods? Yes No

7)If no to #6, list manufacturer/supplier.

Company name
Contact person
Address
City State Zip
Phone Email
Website

8)Each ingredient will be reviewed for compliance.Attach:

(a)Product label of each ingredient.

(b)Material Safety Data Sheet (MSDS) for each ingredient

(c)Contact information for your ingredient supplier(s).

9)Is this product derived from or does it contain manure? Yes No

10)If yes to #9:

(a)Source of manure (be specific)

(b)Is manure composted? Yes No

(c) If yes, describe how the composting process meets National Organic Program rule § 7CFR 205.203 (2). Attach additional information if necessary.

(d) If no, how is the manure treated?

11) Are any of the ingredients considered “living” i.e. micro-organisms, yeasts, enzymes, cultures ?

Yes No

12) If yes,

(a)specify and describe ingredient in detail

(b)attach independent verification of non-GMO origin

(c)Contact information for your supplier of “living” ingredients:

13)Attach DETAILED description of the product’s manufacture/ production process here or on a separate sheet.

14)Draw or attach a DETAILED map /diagram of your production facility thatcorresponds with #13 above. Include all equipment; storage; manufacturing/ processing areas.

15)Do you process, package, store, transport or otherwise handle materials and products that are Prohibited for use by organic operations?

Yes No

16) If yes to #15, do you use the same equipment for processing, packaging, storing, transporting or otherwise handling Prohibited materials that you use with materials intended for use by organic operations?

Yes No

17) If yes to #15, describe in DETAIL how you prevent commingling and contamination during incoming transport, storage, manufacturing, processing, packaging, and outgoing transport.

18)Complete the PRODUCT FORMULA SHEET on next page

PRODUCT FORMULA SHEET

Name of product as it appears on label:
INGREDIENT / % BY WEIGHT / SOURCE/ SUPPLIER / PURPOSE