cam pq procedure kh-eng with annex - ippc procedure for import of plant quarantine material ......

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Note: Khmer Version, but some of its 14 Annexes have been prepared in Khmer & English

MINISTERIAL DECISION

Compiled by Cambodia NPPO July, 2011

THE 14 ANNEXES OF THIS MINISTERIAL DECISION ARE:

INSPECTION PROCEDURE FOR IMPORT OF PLANT QUARANTINE MATERIAL (ARTICLE 3)

1. Application for Plant Quarantine Inspection of Import Consignment (in Khmer & English)

2. Report of plant quarantine inspection of import consignment (in Khmer & English)

PQ PROCEDURE FOR IMPORT OF HIGH- RISKED PLANT QUARANTINE MATERIAL (ARTICLE 4)

3. Plant Quarantine Material with potential of high risk of plant pest concern (in Khmer only)

4. Application for Importing of Plant Quarantine Materials (in Khmer & English)

5. Import certificate for plant quarantine material (Sample in English)

EXPORT/ RE EXPORT PLANT QUARANTINE PROCEDURE (ARTICLE 5)

6. Application for Plant Quarantine Inspection of Export Consignment (in Khmer & English)

7. Report of plant quarantine inspection of export consignment ( Form in Khmer & English)

8. Phytosanitary Certificate ( Form in English)

9. Phytosanitary Certificate for re export ( Form in English)

TRANSIT PLANT QUARANTINE PROCEDURE (ARTICLE 6)

10. Application for Plant Quarantine Inspection of Transit Consignment ( Form in Khmer & English)

11. Report of plant quarantine inspection of transit consignment ( Form in Khmer & English)

DOMESTIC PLANT QUARANTINE PROCEDURE (ARTICLE 7)

12. Phytosanitary Certificate for transport of plant quarantine material from pest epidemic area ( Domestic Form in Khmer)

13. Phytosanitary Certificate for transport of plant quarantine material across pest epidemic area ( Domestic Form in Khmer)

14. Application for Plant Quarantine Inspection of plant quarantine material for domestic transport ( Domestic Form in Khmer)

Note: this additional page have been inserted by IPPC Focal Point just for reference only

RBHraCaNacRkkm<úCa KINGDOM OF CAMBODIA

Cati sasna RBHmhakSRt Nation Religion King

3 BaküsuMkarRtYtBinitüPUtKamGnam½y elITMnijnaMcUl

(Application for Plant Quarantine Inspection of Import Consignment)

nam nigeKatþnamGñksuM ( APPLICANT'S NAME )

:................................................................................................................................ sRmab;smtßkic© P>K>G

( FOR PQ AUTHORITY )

eQμaHRkumh‘un ( COMPANY NAME)

:................................................................................................................................ • elxkUd (CODE No):……………..

• cMNat;kar (DECISION):………………………

• ………………………………………

Gas½ydæanRkumh‘un nigTUrs½BÞTMnak;TMng (COMPANY ADDRESS & CONTACT PHONE’S NUMBER)

:...................................................................................................................................

…….............................................................................................................................

sUmeKarBCUn smtßkic©PUtKamGnam½yRbcaM

TO THE PLANT QUARANTINE AUTHORITY OF

:…………………………………………………………

kmμvtßú³ (Subject)

sMukarRtYtBinitünaMcUl³ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> (APPLY FOR IMPORT INSPECTION OF)…………………………………………..........................................................................................................

ÉksarCUnP¢ab ; (ATTACHED DOCUMENTS):

1. viBaØabnbRtPUtKamGnam½y Edlecjedaysmtßkic©PUtKamGnam½yénRbeTsnaMecj (PHYTOSANITARY CERTIFICATE ISSUED BY PQ AUTHORITY OF EXPORTED COUNTRY)

1. caM)ac;RtUvEtman (NESSESSARY DOCUMENT)

2. viBaØabnbRtPUtKamGnam½ysRmab;naMecjbnþ Edlecjedaysmtßkic©PUtKamGnam½yénRbeTs naMecjbnþ (PHYTOSANITARY CERTIFICATE FOR RE EXPORT ISSUED BY PQ AUTHORITY OF RE EXPORTED COUNTRY)

2. RbsinebInaMecjBIRbeTsTI 2 (IN CASE OF EXPORT FROM 2nd COUNTRY)

3. viBaØabnbRtnaMcUlTMnijCakmμvtßúénkarRtYtBinitüPUtKamGnam½y EdlecjedayGKÁnaykdæanksikmμ (IMPORT CERTIFICATE/PERMIT FOR PLANT QUARANTINE MATERIALS, ISSUED BY GDA OF MAFF )

3. sRmab;TMnijEdlmanhaniP½yx<s; (FOR PQ HIGH RISK

GOODS) 4. ÉksarepSgeTottamkartRmUvénÉksarCUnP¢ab;TI 3 Edlecjedaysmtßkic©Bak;B½n§kñúgRbeTsnaMecj

nig¼b¤ naMecjbnþ (OTHER DOCUMENTS AS REQUIRED BY 2nd ATTACHED DOCUMENT ISSUED BY EXPORT AND/OR RE EXPORT COUNTRIES )

4. sRmab;TMnijEdlman haniP½yx<s; (FOR PQ HIGH

RISK GOODS) 5. viBaØabnbRtFUbTkmμ (FUMIGATION/DISINFESTATION CERTIFICATE) 5. RbsinebIman (IF AVAILABLE)

6. lixitGnuBaØatnaMcUlsmÖar³ksikmμ EdlecjedayRksYgksikmμ rukçaRbmaj; nigensaT (IMPORT LICENSE FOR AGRICULTURAL MATERIALS ISSUED BY MAFF)

6. sRmab;TMnijCasmÖar³ksikmμ (FOR AGRICULTURAL MATERIAL)

7. vikáybRtTMnij (INVOICE) nigbBa¢Ievcx©b; (& PACKING LIST) 7. caM)ac;RtUvEtman ¼ (NESSASSARY DOCUMENT)

8. bBa¢IpÞúkTMnij ( BILL OF LADING) 8. caM)ac;RtUvEtman(NESSASSARY DOCUMENT)

sMKal; (NOTE): sUmKUs cMeBaHÉksarCUnP¢ab;Edlman ( PLEASE MAKE A NOTE FOR AVAILABLE ATTACHED DOCUMENTS) karBiB½N’naGMBImuxTMnij (DESCRIPTION OF GOODS):

1>bMNgénkarnaMcUlTMnij (1. IMPORT PURPOSE)

:……………………………………………………. 2>pøÚvbnþdwkTMnij

(2.TRANSPORT’S WAY OF GOODS)

:…………………………………………………….

3>kEnøgrkSaTukTMnij (3. PLACE TO STORE OF GOODS)

:……………………………………………………. 4>kEnøgykeTAdaMduH

(4. PLACE OF PROPAGATION)

:…………………………………………………….

esckþIEføgrbs;GñkesñIsuM (APPLICANT’S STATEMENT)

nagxJúM¼xJúM)aT¼Rkumh‘uneyIg´ sUmRbkasfa ÉksarCUnP¢ab; nigB½t’manTaMgGs;xagelI BitCaRtwmRtUvminmankarEkøgbnøM nigeKarBtamral;viFanPUtKamGnam½y.(I WOULD LIKE TO CERTIFY THAT ALL ATTACHED DOCUMENTS AND INFORMATIONS DECLARED ABOVE ARE TRUE, AND RESPECT TO ALL PHYTOSANITARY TREATMENT AS REQUIRED ).

RckTVar/ kalbriecäT (CHECK POINT, DATE)

……………………………………… htßelxa nig¼b¤RtaRkumh‘unEdlesñIsMu (SIGNATURE AND STAMP OF COMPANY) …………………...………………………………….

elx (No)>>>>>>>>>>>>>>>>>>>



3

kMNt;ehtusþIBIlT§plénkarRtYtBinitüPUtKamGnam½yelITMnijnaMcUl (REPORT OF PLANT QUARANTINE INSPECTION OF IMPORT CONSIGNMENT)

kalbriecäT nigem:agRtYtBinitü ( DATE & TIME OF INSPECTION )

:................................................................................................................................................................

nam nigeKatþnamPñak;garRtYtBinitü ( INSPECTORS'S NAMES )

:................................................................................................................................................................

nam nigeKatþnam nigmuxgarGñkcUlrYm (NAME & FUNCTION OF PARTICIPANTS )

:.......................................................................................................................................................................................................................................................................................................................................

4> lT§plénkarRtYtBinitüpÞal;enAnwgkEnøg (RESULT OF IN PLACE INSPECTION): a. karevcx©b;RtwmRtUv

(PROPER PACKAGED) b. karevcx©b;minRtwmRtUv¼briyay (UNPROPER PACKAGED/ DESCRIPTION)

c. GvtþmansmasPaBcéRgrs; (NO LIVING PEST)

d. vtþmansmasPaBcéRgrs; (DETECTION OF LIVING PEST)

e. GvtþmansmasPaBcéRggab; (NO DEAD PEST)

f. vtþmansmasPaBcéRggab;¼briyay (DETECTION OF DEAD PEST/ DESCRIPTION)

g. KμansBaØasgS½yénkarratt,at (NO SUSPECTED SYMPTOM)

h. mansBaØasgS½yénkarratt,at¼briyay ( SUSPECTED SYMPTOM/DESCRIPTION)

i. karsnñidæanelIkarRtYtBinitüpÞal; (CONCLUSION OF IN PLACE INSPECTION)

:………………………………………………...……………………………………………………………… ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………

5> lT§plénkarviPaKenAmnÞIrBiesaFn_eraKvinicä½y (RESULT OFDIAGNOSIS’S LAB TEST): a. cMnYnsMNakEdlRtUvviPaK (No. OF SAMPLES)

b. nam nigeKatþnammRnþITTYlxusRtUv (NAME OF RESPONSIBLE OFFICER)

c >kalbriecäTcab;epþIm (STARTED DATE)

d >kalbriecäTbBa©b; (COMPLETED DATE)

e >lT§pl (RESULTED)

6> karseRmcrbs;smtßkic© P>K>G (DECISION OF PQ AUTHORITY): a. GnuBaØatCRmHTMnij (CLERANCE)

b. EksRmYlkarevcx©b; (RE PACKAGE)

c. FUbTkmμ (FUMIGATION)

d. )aj;fñaMépÞxageRkA (DISINFESTATION)

e. bþÚreKaledAeRbIR)as;TMnij (CHANCE OF USE’S PURPOSE)

f. viFan P>K>G déTeTot (OTHER PQ TREATMENT)

g. esñIkemÞcTMnijecal (DESTROY OF GOODS)

h. esñIbBa¢ÚneTARbPBedIm (SEND BACK TO ORIGIN)

i. karÉkPaBBIRksYg (MAFF APPROVAL LETTER)

j. karbBa¢ak;rbs; P>K>G bnÞab;BIcMNat;viFan P>K>G (PQ CERTIFY AFTER PQ TREATENTED)

sMKal; (NOTE): karseRmcénviFan 3g nig 3h GaRs½yeday 3i ( THE DECISIONS IN POINT 3g OR 3h IS DEPEND ON 3i ) 4> karcuHhtßelxaÉkPaB (APPROVED SIGNATURES)

em:ag¼kalbriecäTbBa©b;r)aykarN_ (TIME & DATE OF REPORT COMPLETION)

………………………………… GñkeFVIkMNt;ehtu(REPORTER) ………………………………………….

m©as;TMnij b¤tMNag (GOODS OWNER/REPRESENTATIVE)

………………………………… smtßkic© P>K>G(PQ AUTHORITY) ………………………………………….

RksYgksikmμ rukçaRbmaj; nigensaT MINISTRY OF AGRICULTURE FORESTRY AND FISHERIES

smtßkic©PUtKamGnam½y énGKÁnaykdæanksikm μ PLANT QUARANTINE AUTHORITY OF

GENERAL DIRECTORATE OF AGRICULTURE

RbcaM (AT) :……………………………

elx (No) :…………………………… elxkUdesñIsuM (APPYING CODE No) :…………………………

:…………… :……………

:…………

:……………………………………………

:………………………………. :………………………………

:………………………………

:…………………………………………………………………………………

:………………………………………………..

:………………………………………………..

:………………………………………………..

:………………………………………………..

:……………………………………………………………………



3

TMnijCakmμvtßúénkarRtYtBinitüPUtKamGnam½y EdlmanskþanuBlhaniP½ysmasPaBcéRgx<s;rYmman³

- BUC nigbMENkBUCrukçCati sRmab;daMduHbnþ BUCdMNaMCalikavb,kmμ (Tissue culture) RbePTrukçCatieFVIetsþ dkykecjBIem)aedIm CalikabNþúHsarBagÁkayEdl)anEksMrYlEhSn

- stVl¥itrs; GtisuxumR)aN Pñak;garCIvsaRsþ pSit - Gal;hÁa dI b¤ CIkMb:usþ× EdlekIteLIgBIkMeTckMTIrukçCatiBukpuyeRbIsRmab;bNþúHb¤daM b¤ begáInCICatidI - plitpl bEnø EpøeQIRss; nig emIm b¤ BnøkekþógRss; nigBBYkEsø EdlmanbMNgnaMcUlBIRbeTsCaRbPB

EdlminFøab;naMcUlmkkm<úCa - bNþaTMnijdéTeTotEdlcat;kñúgkRmithaniP½yénsþg;darPUtKamGnam½yGnþrCatielx 32 man TI 3 nig TI

4 sþIBIcMNat;fñak;TMnijGaRs½yelIkRmithaniP½ybgáeLIgedaysmasPaBcéRg.



3 BaküsuMnaMcUlTMnijCakmμvtßúénkarRtYtBinitüPUtKamGnam½y (Application for Importing of Plant Quarantine Materials)

nam nig eKatþnamGñksuM ( APPLICANT'S NAME )




:................................................................................................................................ elxkUdesñIsuM ³……………

cMNat;kar³ ……………………… …… …………………………… ……………………………


:..................................................................................................................................................................................................................................................................................................................................................................................................

sUmeKarBCUn Ék]tþmGKÁnayk énGKÁnaykdæanksikmμ


sMueKalkarN_GnuBaØatnaMcUl³ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> (APPLY FOR IMPORT OF)……………………………………………………………………............................................................................................................


bBa¢IeQμaHsmasPaBcéRgEdlmanvtþmanratt,atkñúgplitkmμ nigkarkSaTukTMnijkMBugesñIsMu kñúgRbeTs kMeNIténTMnij (THE LIST OF ENDEMIC AND STORED PEST OF APPLYING GOODS IN THE PLACE OF

ORIGIN)

¬caM)ac;RtUvEtman ¦ (NESSASSARY DOCUMENT)

bBa¢IeQμaHsmasPaBcéRgEdlmanvtþmanratt,atkñúgplitkmμ nigkarkSaTukTMnijkMBugesñIsuM kñúgRbeTs dwkCBa¢Únqøgkat; (THE LIST OF ENDEMIC AND STORED PEST OF APPLYING GOODS IN THE PLACE OF

TRANSIT)

¬RbsinebIRtUvdwkCBa¢Únqøgkat;¦(IN CASE OF TRANSIT IN OTHER COUNTRIES)

Éksarbec©keTsRbRBwtþkmμnanaelITMnijkMBugesñIsuM EdlmanGMeBIkm©at;smasPaBcéRg (TECHNICAL/TREATMENT DOCUMENTS SUPPORTED IN PEST DISINFESTATION OF APPLYING GOODS)

¬RbsinebIman¦ (IF AVAILAIBLE)


1>eQ μaHTUeTAénTMnij (1. COMMON NAME OF GOODS)

:……………………………………………………. 2>eQμaHviTüasaRsþénTMnij

(2.BOTANICAL NAME OF GOODS)

:…………………………………………………….

3>brimaNTMnij (3. GOODS’S QUANTITY)

:……………………………………………………. 4>kaevcx©b;TMnij

(4. DESCRIPTION OF PACKAGE)

:…………………………………………………….

5>bMNgénkarnaMcUlTMnij (5. IMPORT PURPOSE)

:……………………………………………………. 6>RckTVarnaMcUlTMnij

(6. POINT OF ENTRY)

:…………………………………………………….

7>RbeTsRbPBTMnij (7. PLACE OF ORIGIN)

:……………………………………………………. 8>RbeTsqøgkat;

(8. CONTRY’S TRANSIT)

:…………………………………………………….


nagxJúM¼xJúM)aT¼Rkumh‘uneyIg´ sUmRbkasfa ÉksarCUnP¢ab; nigB½t’manTaMgGs;xagelI BitCaRtwmRtUvminmankarEkøgbnøM nigsnüafa nwgpþl;bEnßmnUvbNþa B½t’manBak;B½n§eTAnwgTMnijesñIsuM edIm,IsRmbsRmYldl;dMeNIrkarviPaKhaniP½ysmasPaBcéRg EdlGacbgáeLIgedaykarnaMcUlTMnijEdlesñIsuM nig eKarBtamral;viFankarPUtKamGnam½y. (I WOULD LIKE TO CERTIFY THAT ALL ATTACHED DOCUMENTS AND INFORMATIONS DECLARED ABOVE ARE TRUE AND PROMISE THAT WILL SUBMIT OTHER RELATED DOCUMENTS AS REQUIRED FOR FILLFULL THE PROCESS OF PEST RISK ANALYSIS AND RESPECT TO ALL PHYTOSANITARY TREATMENT AS REQUIRED).

raCFanIPñMeBj/éf¶TI (PHNOM PENH, DATE)

…………………………… htßelxa nigRtaRkumh‘unEdlesñIsMu (SIGNATURE AND STAMP OF COMPANY) ……………………………………..…………….

elx (No)>>>>>>>>>>>>>>>>>>>

KINGDOM OF CAMBODIA Nation Religion King

3 GENERAL DIRECTORATE OF AGRICULTURE

PLANT PROTECTION SANITARY AND PHYTOSANITARY DEPARTMENT

IMPORT CERTIFICATE FOR PLANT QUARANTINE MATERIAL

Permission is hereby granted to Import Plant Quarantine Material in accordance with: the Sub-Degree on Phytosanitary Inspection, No. 15 Or. Nor.Kro dated 13 March 2003 and Law on the Management of Quality and Safety of Products and Services dated 21 June 2000.

Name and Address of Importer Name and Address of Exporter

Country of Origin Entry point

Botanical Name

Common Name/Variety Quantity (Wt/No.)

GW : NW :

General Entry Conditions The Consignment of plants/seeds should be:

(I) Free from soil and weed seeds (II) Accompanies by and official Phytosanitary Certificate by the authorized officer at the country of origin (iii) …………………………………

Special Entry Conditions

PEQ Requirements For a period of………. Days.

Date of Issue: ……/…..…/…….. Place of Issue: PHNOM PENH Validity Date: ……/…..…/……..

(Signature & Stamp of GDA Director General)

GENERAL DIRECTOETAE OF AGRICALTURE

(Signature of PP-SPSD Director)


PLANT PROTECTION SANITARY AND PHYTOSANITARY DEPARTMENT, NO. 54B, St 656, Sangkat Toeuk Laak 3, Khan Toul Kok, P-Penh, Cambodia Tel: (855) 23 885 482, Fax: (023) 883 267. EMAIL: [email protected]

No:….......…



3

BaküsuMkarRtYtBinitüPUtKamGnam½y elITMnijnaMecj (Application for Plant Quarantine Inspection of Export Consignment)





:................................................................................................................................ elxkUdesñIsuM ³……………

cMNat;kar³ ……………………… …… ……………………………


:................................................................................................................................. ..................................................................................................................................

sUmeKarBCUn Ék]tþmGKÁnayk énGKÁnaykdæanksikmμ

(TO H.E DIRECTOR GENERAL OF GENERAL DIRECTORATE OF AGRICULTURE)


sMukarRtYtBinitünaMecj ¼naMecjbnþ ³ ………………………………………………………………………………………………………………….. (APPLY FOR EXPORT /RE EXPORT INSPECTION OF)…………………………………………...........................................................................


1. viBaØabnbRtPUtKamGnam½y Edlecjedaysmtßkic©PUtKamGnam½ykñúgRbeTsCaRbPBedIménTMnij (PHYTOSANITARY CERTIFICATE ISSUED BY PQ AUTHORITY OF COUNTRY’S ORIGIN)

1. cMeBaHkarnaMecjbnþ (FOR RE EXPORT)

2. lixitGnuBaØatnaMcUlTMnijCakmμvtßúénkarRtYtBinitüPUtKamGnam½y Edlecjedaysmtßkic©PUtKamGnam½y énRbeTsnaMcUl (IMPORT CERTIFICATE/PERMIT FOR PLANT QUARANTINE MATERIALS, ISSUED

BY PQ AUTHORITY OF IMPORTING COUNTRY)

2. sRmab;TMnijEdlmanhaniP½yx<s ;(FOR PQ HIGH RISK GOODS)

3. bNþalkçxNÐPUtKamGnam½yénRbeTsnaMcUl (OTHER DOCUMENTS RELATED TO PQ REQUIEMENT OF IMPORTING COUNTRY)

3. RbsinebIman (IF AVAILABLE)

4. viBaØabnbRtFUbTkmμ (FUMIGATION/DISINFESTATION CERTIFICATE) 4. RbsinebIman (IF AVAILABLE)

5. vikáybRtTMnij (INVOICE) 5. caM)ac;RtUvEtman (NESSASSARY DOCUMENT)

6. bBa¢Ievcx©b; (PACKING LIST) 6. caM)ac;RtUvEtman (NESSASSARY DOCUMENT)


1>bMNgénkarnaMecj (1 .EXPORT PURPOSE)

:……………………………………………… 2>meFüa)aydwkCBa¢Ún

(2 .MEAN OF CONVEYANCE )

:…………………………………………………….

3>RckTVarecj (3. EXIT POINT)

:……………………………………………… 4>Rck nigRbeTseKaledA

(4. ENTRY AND COUNTRY DESTINATION)

:……………………………………………………. ……………………………………………………..

eQμaH nigGas½ydæanRkumh‘un EdlTTYlTMnij (NAME & ADDRESS OF CONSIGNEE)

:…………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………….……………


nagxJúM¼xJúM)aT¼Rkumh‘uneyIg´ sUmRbkasfa ÉksarCUnP¢ab; nigB½t’manTaMgGs;xagelI BitCaRtwmRtUvminmankarEkøgbnøM nigeKarBtamral;viFanPUtKam Gnam½y. (I WOULD LIKE TO CERTIFY THAT ALL ATTACHED DOCUMENTS AND INFORMATIONS DECLARED ABOVE ARE TRUE, AND RESPECT TO ALL PHYTOSANITARY

TREATMENT AS REQUIRED ) raCFanIPñMeBj/ kalbriecäT (PHNOM PENH, DATE)

……………………………………. htßelxa nigRtaRkumh‘unEdlesñIsMu (SIGNATURE AND STAMP OF COMPANY) ……………...…………………………………

…

elx (No)>>>>>>>>>>>>>>>>>>>



3

kMNt;ehtusþIBIlT§plénkarRtYtBinitüPUtKamGnam½yelITMnijnaMecj (REPORT OF PLANT QUARANTINE INSPECTION OF EXPORT CONSIGNMENT)


:................................................................................................................................................................


:................................................................................................................................................................


:.......................................................................................................................................................................................................................................................................................................................................

1> lT§plénkarRtYtBinitüpÞal;enAnwgkEnøg (RESULT OF IN PLACE INSPECTION): a. karevcx©b;RtwmRtUv

(PROPER PACKAGED) b. karevcx©b;minRtwmRtUv¼briyay

(UNPROPER PACKAGED/ DESCRIPTION)




f. vtþmansmasPaBcéRggab;¼briyay(DETECTION OF DEAD PEST/ DESCRIPTION)




:…………………………………… ………………………………………….…………………………….. ……………………………………………………………………………………….……………………… …………………………………………………………………………………….…………………………



:…………………………………………………………………………….










g. karbBa¢ak;rbs; P>K>G bnÞab;BIcMNat;viFan P>K>G (PQ CERTIFY AFTER PQ TREATENTED)

4> karcuHhtßelxaÉkPaB nigbBa©b;r)aykarN_ (APPROVED AND COMPLETED SIGNATURES)

em:ag¼kalbriecäTbBa©b;r)aykarN_ (TIME & DATE OF COMPLETION REPORT)

………………………………… GñkeFVIkMNt;ehtu (REPORTER) ………………………………………….

m©as;TMnij b¤ tMNag (GOODS OWNER/REPRESENTATIVE)

………………………………… karseRmcrbs;smtßkic© P>K>G (DECISION OF PQ AUTHORITY)

:………………………………………… ……………………………………………………………………………………………………………………………………………………………………………………




RbcaM (AT) :……………………………

elx (No) :…………………………… elxkUdesñIsuM (APPYING CODE No) :…………………………

:…………… :……………

:…………

:……………………………………………

:………………………………. :……………………………

:…………………………………………………………………………………

:………………………………………………..

:………………………………………………..

:………………………………………………..

:………………………………………………..

ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL


3

GENERAL DIRECTORATE OF AGRICULTURE PLANT PROTECTION SANITARY AND PHYTOSANITARY DEPARTMENT

PHYTOSANITARY CERTIFICATE No.NNN/YY

From: Plant Protection Organization of Cambodia To: Plant Protection Organization(s) of……………………

I. DESCRIPTION OF CONSIGNMENT

Name and address of exporter

Declared name and address of consignee

…………………………………………………………………………………..

…………………………………………………………………………………..

Number and description of packages

Distinguishing marks

…………………………………………………………………………………..

…………………………………………………………………………………..

Place of Origin Declared means of conveyance Declared point of entry

…………………………………… ……………………………………

……………………………………

Name of produce and quantity

Botanical name of plants

…………………………………………………………………………………..

…………………………………………………………………………………..

This is to certify that the plant and plant products or other regulated articles described herein have been inspected and /or tested according to appropriate official procedures and are considered to be free from the quarantine pests specified by the importing contracting party and to conform with the current phytosanitary requirements of the importing contracting party, including those for regulated non-quarantine pests.

II. ADDITIONAL DECLARATION

………………………………………………………………………………………………………

III. DISINFESTATION AND / OR DISINFECTION TREATMENT

Treatment Date: ………………………………………………………………………………..

Treatment: …………………………………………………………………………………

Chemical (Active ingredients): …………………………………………………..………

Duration & Temperature :…………………………………….………………………

Concentration: ………………………………………………………………………………….

Additional Information: ………………………………………….……………………

Date Inspected :…………………….. Place of Issue: Phnom Penh Date Issued :……………….






ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL NNN/YY ORIGINAL


3

GENERAL DIRECTORATE OF AGRICULTURE PLANT PROTECTION SANITARY AND PHYTOSANITARY DEPARTMENT

PHYTOSANITARY CERTIFICATE FOR RE EXPORT No.NNN/YY

From: Plant Protection Organization of Cambodia To: Plant Protection Organization(s) of……………………

I. DESCRIPTION OF CONSIGNMENT

Name and address of exporter

Declared name and address of consignee

…………………………………………………………………………………..

…………………………………………………………………………………..

Number and description of packages

Distinguishing marks

…………………………………………………………………………………..

…………………………………………………………………………………..

Place of Origin Declared means of conveyance Declared point of entry

…………………………………… ……………………………………

……………………………………

Name of produce and quantity

Botanical name of plants

…………………………………………………………………………………..

…………………………………………………………………………………..

This is to certify that the plants, plant products or other regulated articles described above were imported into Cambodia from ______________ covered by Phytosanitary certificate No. ________,*original certified true copy of which is attached to this certificate; that they are packed repacked in original *new containers, that based on the original phytosanitary certificate

and additional inspection , they are considered to conform with the current phytosanitary requirements of the importing contracting party, and that during storage in Cambodia, the consignment has not been subjected to the risk of infestation or infection.

II. ADDITIONAL DECLARATION

………………………………………………………………………………………………………

III. DISINFESTATION AND / OR DISINFECTION TREATMENT

Treatment Date: ………………………………………………………………………………..

Treatment: …………………………………………………………………………………

Chemical (Active ingredients): …………………………………………………..………

Duration & Temperature:…………………………………….………………………

Concentration: ………………………………………………………………………………….

Additional Information: ………………………………………….……………………

Date Inspected:…………………….. Place of Issue: Phnom Penh Date Issued :……………….








3 BaküsuMkarRtYtBinitüPUtKamGnam½y elITMnijqøgkat;

(Application for Plant Quarantine Inspection of Transit Consignment)


:................................................................................................................................

sRmab;smtßkic© P>K>G ( FOR PQ AUTHORITY )


:.............................................................................................................................. elxkUdesñIsuM ³……………

cMNat;kar³ ……………………… …… …………………………… ……………………………


:...........................................................................................................................................................................................................................................................................................................................................................................................

sUmeKarBCUn smtßkic©PUtKamGnam½yRbcaM

TO THE PLANT QUARANTINE AUTHORITY OF

:…………………………………………………………


sMukarRtYtBinitüqøgkat;³ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> (APPLY FOR TRANSIT INSPECTION OF)…………………………………………..........................................................................................................


1. viBaØabnbRtPUtKamGnam½y Edlecjedaysmtßkic©PUtKamGnam½yénRbeTsnaMecj (PHYTOSANITARY CERTIFICATE ISSUED BY PQ AUTHORITY OF EXPORT COUNTRY)

1. caM)ac;RtUvEtman (NESSESSARY DOCUMENT)

2.viBaØabnbRtPUtKamGnam½ysRmab;naMecjbnþ Edlecjedaysmtßkic©PUtKamGnam½yénRbeTs naMecjbnþ (PHYTOSANITARY CERTIFICATE FOR RE EXPORT ISSUED BY PQ AUTHORITY OF RE EXPORT COUNTRY)

2. RbsinebInaMecjBIRbeTsTI 2 (IN CASE OF EXPORT FROM 2nd COUNTRY)

3. lixitGnuBaØatnaMcUlTMnijCakmμvtßúénkarRtYtBinitüPUtKamGnam½yEdlecjeday RbeTsnaMcUl(IMPORT CERTIFICATE/PERMIT FOR PLANT QUARANTINE MATERIALS, ISSUED BY IMPORTING COUNTRY )

3. sRmab;TMnijEdlmanhaniP½yx<s; (FOR PQ HIGH RISK GOODS)

4. ÉksarepSgeTottamkartRmUvénÉksarCUnP¢ab;TI 3 Edlecjedaysmtßkic©Bak;B½n§kñúgRbeTsnaMecj nig¼b¤ naMecjbnþ (OTHER DOCUMENTS AS REQUIRED BY 2nd ATTACHED DOCUMENT ISSUED BY EXPORT

AND/OR RE EXPORT COUNTRIES )

4. sRmab;TMnijEdlmanhaniP½yx<s; (FOR PQ HIGH RISK GOODS)

5. viBaØabnbRtFUbTkmμ (FUMIGATION/DISINFESTATION CERTIFICATE) 5. RbsinebIman (IF AVAILABLE)

6. vikáybRtTMnij (INVOICE) nigbBa¢Ievcx©b; (& PACKING LIST) 6. caM)ac;RtUvEtman (NESSASSARY DOCUMENT)

7. bBa¢IpÞúkTMnij ( BILL OF LADING) 7. caM)ac;RtUvEtman (NESSASSARY DOCUMENT)


1>RckcUl nigRckecj (1 .ENTRY AND EXIT POINT)

:……………………………………………… 2>pøÚvbnþdwkTMnij

(2.TRANSPORT’S WAY OF GOODS)

:…………………………………………………….

3>ry³eBlqøgkat;RbmaNCa (3.ESTIMATED OF TRANSIT PERIOD)

:………………………………………………… 4>Rck nigRbeTseKaledA

(4. ENTRY AND COUNTRY DESTINATION)

:…………………………………………...…

esckþIEføgrbs;GñkesñIsuM (APPLICANT”S STATEMENT)

nagxJúM¼xJúM)aT¼Rkumh‘uneyIg´ sUmRbkasfa ÉksarCUnP¢ab; nigB½t’manTaMgGs;xagelI BitCaRtwmRtUvminmankarEkøgbnøM nigeKarBtamral;viFanPUtKam Gnam½y. (I WOULD LIKE TO CERTIFY THAT ALL ATTACHED DOCUMENTS AND INFORMATIONS DECLARED ABOVE ARE TRUE, AND RESPECT TO ALL PHYTOSANITARY

TREATMENT AS REQUIRED ) RckTVar/ kalbriecäT (CHECK POINT, DATE)

……………………………………..

htßelxa nig¼b¤RtaRkumh‘unEdlesñIsMu (SIGNATURE AND/OR STAMP OF COMPANY) …………………...………………………………….

elx (No)>>>>>>>>>>>>>>>>>>>



3

kMNt;ehtusþIBIlT§plénkarRtYtBinitüPUtKamGnam½yelITMnijqøgkat; (REPORT OF PLANT QUARANTINE INSPECTION OF TRANSIT CONSIGNMENT)

3 I. karRtYtBinitüpÞal;enARckTVarcUl (THE ENTRY PQ INSPECTION): …………………………………………………..


:................................................................................................................................................................


:................................................................................................................................................................


:.......................................................................................................................................................................................................................................................................................................................................

kmμvtßúRtYtBinitü (INSPECTION SUBJECT ) RbePT nigbrimaNTMnij

(NAME & QUANTITY OF GOODS )

meFüa)aydwkCBa¢Ún (MEAN OF CONVEYANCE )

1> lT§plénkarRtYtBinitüpÞal;enAnwgkEnøgelIépÞxageRkAénbnÞúkTMnij (RESULT OF IN PLACE INSPECTION): a. bnÞúkTMnijmanPaBmaM

(GARGO IN GOOD CONDITION ) b. bnÞúkTMnijminmanPaBmaM

(GARGO IN BAD CONDITION)




f. vtþmansmasPaBcéRggab;¼briyay(DETECTION OF DEAD PEST/ DESCRIPTION)




:………………………………………………………………………… …………………………………………………………………………



:…………………………………………………………………………….










g. karbBa¢ak;rbs; P>K>G bnÞab;BIcMNat;viFan P>K>G (PQ CERTIFY AFTER PQ TREATENTED)




RbcaM (AT) :……………………………

elx (No):……………………………………………………………

elxkUdesñIsuM (APPYING CODE No) :…………………………

:…………… :……………

:…………

:……………………………………………

:………………………………. :……………………………………..

:…………………………………………………………………………………

:………………………………………………..

:………………………………………………..

:………………………………………………..

:………………………………………………..

:………………………………………………………….………………..……..

:…………………………………………………………….…………………...

Page 1

4> kic©snüarbs;m©as;TMnij b¤tMNagkñúgkardwkCBa¢Únqøgkat;RbeTskm<úCa (CONDITIONS SHOULD BE FOLLOWED BY GOODS’S OWNER OR REPRESENTATIVE, WHEN TRANSPORT IN CAMBODIA):

a. EfrkSasPaBedIménbnÞúkTMnijmin[Ebk)ak; b¤rebIk Edlbgá[mankarkMBb; b¤RCuHTMnijtampøÚv (TO MAINTAIN A CARGO IN ORIGINAL FORM TO AVOID A SPREAD OR LEAKAGE OF GOODS ALONG THE WAY )

sRmab;smtßkic© P>K>G ( FOR PQ AUTHORITY )

b. minebIkbnÞúkTMnijedayK μankaresñIsuM nigcUlrYmBIsmtßkic© P>K>G nig smtßkic©Bak;B½n§ ( DO NOT OPEN A CARGO WITHOUT PERMISION AND JOINING BY PQ AUTHORITY AND OTHER RELATED AGENCIES )

elxkUdcMNat;kar ³………… cMNat;kar³ ……………………… ……

…………………………… ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………..……………………………

c. minrMElk b¤ dak;bEnßmsmÖar³NamYyeTAkñúgbnÞúkTMnij edayK μankaresñIsuM nigcUlrYmBIsmtßkic© P>K>G nig smtßkic©Bak;B½n§ (DO NOT TAKE OUT OR ADD ANY THING FROM A CARGO WITHOUT PERMISION AND JOINING BY PQ

AUTHORITY AND OTHER RELATED AGENCIES ) d. RtUvraykarN_CabnÞan; nigsuMkarcUlrYmGnþraKmn_BIsmtßkic© P>K>G tamry³TUrs½BÞelx³ 023 885 482

TUrsarelx³ 023 883 267 kñúgkrNI EdlmankarrebIkFøúHFøaybnÞúkTMnijedayRbkarNamYytampøÚv kñúgRbeTskm<úCa. (MUST URGENTLY REPORT AND ASK FOR INTERVENTION TO PQ AUTHORITY BY PHONE

NO. 023 885 482/ FAX: 023 883 267 IN CASE OF BREAKING A CARGO ALONG THE WAY IN CAMBODIA )

5> karcuHhtßelxaÉkPaB nigbBa©b;kMNt;ehtuenARckTVarcUl (APPROVED SIGNATURES AND COMPLETION OF PQ INSPECTION REPORT AT THE ENTRY POINT OF CAMBODIA)




………………………………… smtßkic© P>K>G (PQ AUTHORITY) ………………………………………….

kMNt;sMKal; (NOTICE) : m©as;TMnij b¤tMNagRtUvrkSar)aykarN_enH edayP¢ab;sMNuMÉksarBak;B½n§nwgkarRtYtBinitü P>K>G edIm,I bgðaj smtßkic©P>K>G enARckTVarecjBIRBHraCaNacRkkm<úCa (GOODS OWNER OR REPRESENTATIVE SHOULD KEEP THIS REPORT AND OTHER RELATED PQ

INSPECTION DOCUMENTS TO SHOW TO THE PLANT QUARANTINE AUTHORITY AT THE EXIT POINT OF CAMBODIA)

II. karRtYtBinitüpÞal;enARckTVarecj (THE EXIT PQ INSPECTION):


:................................................................................................................................................................


:................................................................................................................................................................


:.......................................................................................................................................................................................................................................................................................................................................

1> lT§plénkarRtYtBinitüpÞal;enAnwgkEnøgelIépÞxageRkAénbnÞúkTMnij (RESULT OF IN PLACE INSPECTION): a. bnÞúkTMnijmanPaBmaM

(GARGO IN GOOD CONDITION ) b. bnÞúkTMnijminmanPaBmaM

(GARGO IN BAD CONDITION)




f. vtþmansmasPaBcéRggab;¼briyay (DETECTION OF DEAD PEST/ DESCRIPTION)

g. karsnñidæanelIkarRtYtBinitüpÞal; (CONCLUSION OF IN PLACE INSPECTION)

:………………………………………………………………………………… …………………………………………………………………………………

2> karcuHhtßelxaÉkPaB nigbBa©b;kMNt;ehtuenARckTVarecj (APPROVED SIGNATURES AND COMPLETION PQ INSPECTION REPORT AT THE EXIT POINT OF CAMBODIA)




………………………………… smtßkic© P>K>G (PQ AUTHORITY) ………………………………………….

:………………………………………………..

:………………………………………………..

:………………………………………………..

:……………………………………………

Page 2

RBHraCaNacRkkm<úCa Cati sasna RBHmhakSRt

3

viBaØabnbRtPUtKamGnam½y sMrab;dwkCBa¢ÚnecjBItMbn;raldalqøg

sñak;karRtYtBinitüPUtKamGnam½ybeNþaHGasnñRbcaMRck………………………………………………………………….. seRmcpþl;viBaØabnbRtPUtKamGnam½yCUnelak

:......................................................... ePT......................... Gayu........................ qñaM Gas½ydæanbc©úb,nñ nigTUrs½BÞTMnak;TMng

:...................................................................................................................................................................................................................................................................................................................................

dwkCBa¢ÚnecjBItMbn;raldalqøgnUv : 1>eQ μaHTMnij

:………………………………………… 2> brimaN nigkarevcx©b;

:……………………………………………...……………………………

3>RbPBTMnij

PUmi……………………………………………………………….. 4>eKaledA :……………………………………………………………………

5>TisedAeRbIR)as;

:…………………………………..……………………… 6>meFüa)aydwkCBa¢¢n

:……………………….…………………………………

TIkEnøg/ kalbriecäT

………………………………… RbFansñak;karRtYtBinitüPUtKamGnam½y

………………………………………….

lT§plénkarRtYtBinitü nigkarseRmcrbs;smtßkic©PUtKamGnam½y 1. K μansmasPaBcéRgEdlkMBug

manvtþmankñgtMbn;ratt,at 2. mansmasPaBcéRgEdlkMBug

manvtþmankñgtMbn;ratt,at 3. GvtþmansmasPaBcéRgrs; 4. vtþmansmasPaBcéRgrs; 5. karBinitüeXIjepSgeTot 6. karseRmcrbs;smtßkic© P>K>G :………………………………………….………………………………………..…

:……………………………………………………..

:………………………………………………………

:………………………………………………………………………………………………………

sRmab;smtßkic©PUtKamGnam½y

GKÁnaykdæanksikmμnaykdæankarBardMNaM Gnam½y nigPUtKamGnam½y sñak;karRtYtBinitüPUtKamGnam½ybeNþaHGasnñ elx³____________________________PKG>bs


3

viBaØabnbRtPUtKamGnam½y sMrab;dwkCBa¢Únqøgkat;tMbn;raldalqøg

sñak;karRtYtBinitüPUtKamGnam½ybeNþaHGasnñRbcaMRck………………………………………………………………….. seRmcpþl;viBaØabnbRtPUtKamGnam½yCUnelak

:......................................................... ePT......................... Gayu........................ qñaM Gas½ydæanbc©úb,nñ nigTUrs½BÞTMnak;TMng

:...................................................................................................................................................................................................................................................................................................................................

dwkCBa¢Únqøgkat;tMbn;raldalqøgnUv : 1>eQ μaHTMnij

:………………………………………… 2> brimaN nigkarevcx©b;

:……………………………………………...……………………………

3>RbPBTMnij

PUmi……………………………………………………………….. 4>eKaledA :……………………………………………………………………

5>TisedAeRbIR)as;

:…………………………………..……………………… 6>meFüa)aydwkCBa¢¢n

:……………………….…………………………………

7>lkçx½NtRmUvkñúgkardwkCBa¢¢n :…………………………………..…………………………………………………………..………………………………..……………… …………………………………..…………………………………………………………..…………………………………………………………..…………………………………………………………..…………………………………………………………..………………………..…………………………………………………………..…………………………………………………………..………………

TIkEnøg/ kalbriecäT

………………………………… RbFansñak;karRtYtBinitüPUtKamGnam½y

………………………………………….

lT§plénkarRtYtBinitü nigkarseRmcrbs;smtßkic©PUtKamGnam½y 7. K μansmasPaBcéRgEdlkMBug

manvtþmankñgtMbn;ratt,at 8. mansmasPaBcéRgEdlkMBug

manvtþmankñgtMbn;ratt,at 9. GvtþmansmasPaBcéRgrs; 10. vtþmansmasPaBcéRgrs; 11. karBinitüeXIjepSgeTot 12. karseRmcrbs;smtßkic© P>K>G :………………………………………….………………………………………..…

:……………………………………………………..

:………………………………………………………

:………………………………………………………………………………………………………


GKÁnaykdæanksikmμnaykdæankarBardMNaM Gnam½y nigPUtKamGnam½y sñak;karRtYtBinitüPUtKamGnam½ybeNþaHGasnñ elx³____________________________PKG>bs


3 BaküsuMkarRtYtBinitüPUtKamGnam½y elIkardwkCBa¢ÚnTMnijCakm μvtßúRtYtBinitüPUtKamGnam½ykñúgRbeTs

nam nigeKatþnamGñksuM

:.................................................................................................................................................................

Gas½ydæan nigTUrs½BÞTMnak;TMng

:.......................................................................................................................................................................................................................................................................................................................................

sUmeKarBCUn smtßkic©PUtKamGnam½yRbcaMtMbn;raldalqøg

:…………………………………………………………

kmμvtßú³ sMukarRtYtBinitüdwkCBa¢Ún³ >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> …………………………………………..................................................................................................................................................................................

ÉksarCUnP¢ab ; : 15. lixitbBa¢ak;rbs;GaCJaFrXuM¼sgáat; elIRbPBTMnijEdlesñIsuM 16. vikáybRtTMnij nigbBa¢Ievcx©b;

karBiB½N’naGMBImuxTMnij : 1>eQ μaHTMnij nigbrimaN

:………………………………………… 2>briyayBIkarevcx©b;

:……………………………………………

3>RbPBTMnij

:………………………………………… 4>eKaledAénkardwkCBa¢Ún

:……………………………………………

5>TisedAeRbIR)as;

:………………………………………… 6>meFüa)aydwkCBa¢¢n

:…………………………………………

esckþIEføgrbs;GñkesñIsuM nagxJúM¼xJúM)aT¼Rkumh‘uneyIg´ sUmRbkasfa ÉksarCUnP¢ab; nigB½t’manTaMgGs;xagelI BitCaRtwmRtUvminmankarEkøgbnøM nigeKarBtamral;viFanPUtKam Gnam½y. TIkEnøg/ kalbriecäT

………………………………… htßelxa nig¼b¤RtaRkumh‘unEdlesñIsMu

………………………………………….

lT§plénkarRtYtBinitü nigkarseRmcrbs;smtßkic©PUtKamGnam½y

1. K μansmasPaBcéRgEdlkMBug manvtþmankñgtMbn;ratt,at

2. mansmasPaBcéRgEdlkMBug manvtþmankñgtMbn;ratt,at

3. K μanvtþmansmasPaBcéRgrs; 4. manvtþmansmasPaBcéRgrs; 5. karBinitüeXIjepSgeTot 6. karseRmcrbs;smtßkic© P>K>G :………………………………………….………………………………………..…

karcuHhtßelxabBa¢ak;BIkarGnuBaØatdwkCBa¢Ún TIkEnøg¼em:ag¼kalbriecäT

………………………………

[

smtßkic© P>K>G

……………………………… ……………………………………..

:……………………………………………………..

:………………………………………………………

:………………………………………………………………………………………………………


nam nigeKatþnam htßelxa

kUdsmÁal; :………………………….……. :……………………………… ……………………………………..

cam pq procedure kh-eng with annex - ippc procedure for import of plant quarantine material ......

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