Fillable Form 5.: STATE ESTABLISHMENT HOURS OF OPERATION N.C. (Information Technology Services)

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Form 5.: STATE ESTABLISHMENT HOURS OF OPERATION N.C. (Information Technology Services)

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The Form 5.: STATE ESTABLISHMENT HOURS OF OPERATION N.C. (Information Technology Services) form is 1 page long and contains:

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  • 11 check-boxes
  • 55 other fields

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File type: PDF

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N.C. DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
MEAT AND POULTRY INSPECTION DIVISION
STATE ESTABLISHMENT
HOURS OF OPERATION
This approval is valid until a request for change is approved.
3. DATE:
4.
PLANT ADDRESS AND E-MAIL ADDRESS:
2. AREA:
SCHEDULE OF OPERATIONS
6. TYPES OF INSPECTION: (check all that apply)
MEAT POULTRY
YES NO
CUSTOM SLAUGHTER
YES NO
CUSTOM EXEMPT PROCESSING
RETAIL EXEMPT
NO YES
DUAL JURISDICTION ESTABLISHMENT
with FDA
NO YES
JURISDICTION
COMMENTS:
SILURIFORMES - FISH
FIRST SHIFT
SECOND SHIFT
DAYS START TIME LUNCH END TIME DAYS START TIME LUNCH END TIME
SUN. SUN.
MON. MON.
TUES. TUES.
WED. WED.
THURS. THURS.
FRI. FRI.
SAT. SAT.
EXEMPT ACTIVITIES
1. ESTABLISHMENT NO.:
PLANT NAME:
5.
Note: Specify daily clock hours of operation (first eight (8) hours) and lunch periods for all shifts. Overtime is to be arranged locally with your Inspector in Charge.
MPID Director
Date Approved
Effective Date
TA Coordinator's Signature
Date
Area Supervisor Signature- has confirmed these hours are reasonably within the scope of Inspector's tour of duty.
Date
Plant Owner's or Manager's Signature
Date
Your Hours of Operation, when approved as requested, are done so with the understanding that any work performed outside of these hours is
subject to overtime charges, in accordance with CFR Title 9 Sections 307.4 and 381.37.
MPIS Form 1d
Scheduled Pre-Op
SHIFT #1
SHIFT #2
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Form 5.: STATE ESTABLISHMENT HOURS OF OPERATION N.C. (Information Technology Services)

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Completed 8 June 2022

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