Schedule 4 Form of Certificate of AnalysisI1
England and Wales
| “Certificate of Analysis of Animal Feed” |
I,……………….……………,(insert name) the undersigned analyst for(1) ………………………. .…………………………………………………………certify that I received on(2)………….…… from(3)……………………………………………………………………………………………….one part of a sample of(4)……………………………………………………………...……………. ……………………………………………………………………………...for analysis, which was duly sealed and fastened up and marked(5)…………………………………………………….. ……………………………………………………………………………..and was accompanied by a label or other documentation or marking (specify as appropriate) containing the following(6)…………………………………………………………………………………………. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. and by a signed statement that the sample was taken in the manner prescribed by law. I declare that the part of the sample has been analysed by me or under my direction, and that the results of the analysis are as follows:(7)……………………………………………………..….… ………………………………………................................................................................................ ………………………………………………………………………………………………………..………………………………………………………………………………………………………..………………………………………………………………………………………………………..……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ………………………………………………………………………………………………………..………………………………………………………………………………………………………..………………………………………………………………………………………………………..……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………..………………………………………………………………………………………………………..………………………………………………………………………………………………………..…………………………………………………………………………………………………………. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………..………………………………………………………………………………………………………..………………………………………………………………………………………………………..…………………………………………………………………………………………………………. ……………………………………………………………………………………………………….. ……………………………………………………………………………………………………….. Signature of analyst………………………………………………………..Date…………………… Address:……………………………………………………………………………………………… |
| Notes for completion of certificate: | |
| 1. | Insert the name of the local authority. |
| 2. | Insert date. |
| 3. | Insert name of person submitting the sample for analysis and mode of transport. |
| 4. | Insert the name or description applied to the material. |
| 5. | Insert the distinguishing mark on the sample and the date of sampling shown. |
| 6. | Indicate the particulars marked, labelled or otherwise documented. |
| 7. | Insert the relevant results, the conclusions drawn from those results and any other relevant observations. Expand this section as necessary. |