Fillable ARIZONA DEPARTMENT OF AGRICULTURE APPLICATION FOR DEPARTMENT-APPROVED QUARANTINE (Arizona)

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ARIZONA DEPARTMENT OF AGRICULTURE APPLICATION FOR DEPARTMENT-APPROVED QUARANTINE (Arizona)

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ARIZONA DEPARTMENT OF AGRICULTURE – PLANT SERVICES DIVISION – 1688 W. ADAMS ST. – PHOENIX, AZ 85007 – (602) 542-0975
ADA-PSD 0238 12-08-14 bkm http://agriculture.az.gov Page 1 of 2
ARIZONA DEPARTMENT OF AGRICULTURE
APPLICATION FOR DEPARTMENT-APPROVED QUARANTINE HOLDING AREA
(R3-4-234 AND R3-4-239)
Applicant Name and Position Title
Nursery Name
Tax Identification Number
Mailing Address
Mailing City, State and Zip Code
Mailing County
Physical Address
Physical City, State and Zip Code
Physical County
E-Mail
Telephone
Fax
List all states this location will be receiving nursery stock from
A Department-approved quarantine holding area must meet the following conditions:
1. The floor of the quarantine holding area shall be composed of a permeable surface, such as sand or
soil, and shall be free from debris, grass and weeds.
2. An outdoor quarantine holding area shall be at least 15 feet from all masonry walls, property
boundaries and non-quarantined plants.
3. The quarantine holding area shall be isolated from public access, and surrounded by a fence or other
barrier.
4. The integrity and security of the holding area shall be maintained at all times.
All regulated commodities as described in R3-4-234 and R3-4-239 shall be unloaded at destination in a
Department-approved quarantine holding area and held undisturbed until the department confirms the
regulated commodities are free of pests and a certificate of release is issued.
The applicant shall immediately notify the Department and request an inspection upon the receipt of a
regulated article as described in R3-4-234 and R3-4-239.
A receiver shall apply a pesticide or other chemical to a regulated commodity located in a quarantine holding
area only when directed or supervised by a department inspector.
Failure to meet the conditions above may result in the removal or revocation of a Department-approved
quarantine holding area.
Mail or fax the completed application to:
Arizona Department of Agriculture, Plant Services Division
1688 W. Adams St., Phoenix, AZ 85007
or fax: (602) 542-1004 Attn: Jamie Legg
For questions please call Jamie Legg at (602) 542-0992
Applicant Signature Date
Print Form
ARIZONA DEPARTMENT OF AGRICULTURE – PLANT SERVICES DIVISION – 1688 W. ADAMS ST. – PHOENIX, AZ 85007 – (602) 542-0975
ADA-PSD 0238 12-08-14 bkm http://agriculture.az.gov Page 2 of 2
ARIZONA DEPARTMENT OF AGRICULTURE
MAP FOR DEPARTMENT-APPROVED QUARANTINE HOLDING AREA
Applicant Name and Position Title
Nursery Name
Physical Address
Physical City, State and Zip Code
Physical County
E-Mail
Telephone
Fax
Contact Name
Contact Title
Contact Phone
List all states this location will be receiving nursery stock from
FOR OFFICE USE ONLY
This location meets the requirements for a Department-approved quarantine holding area.
Inspector Date
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ARIZONA DEPARTMENT OF AGRICULTURE APPLICATION FOR DEPARTMENT-APPROVED QUARANTINE (Arizona)

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Completed 20 July 2020

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