PFI QAQC Program – Pellet Fuel Manufacturer Registration Form

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PELLET FUELS INSTITUTE ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ IN ALLIANCE WITH THE HEARTH, PATIO & BARBECUE ASSOCIATION 1901 North Moore Street Suite 600 Arlington, VA 22209 (703) 522-6778 fax:(703) 522-0548 PFI QA/QC Program – Pellet Fuel Manufacturer Registration Form The following information will be required of any pellet fuel production facility intending to participate in PFI’s QA/QC program with the intent of manufacturing a PFI Registered Pellet Fuel and use PFI’s QA/QC program Certification Mark. Company Name: _______________________________________________________________ Mailing address: _______________________________________________________________ Physical Address: ______________________________________________________________ Company Contact: Contact name: _________________________________ Contact phone: ___________________ Contact Fax: __________________________ Contact E-mail: ___________________________ How many production facilities does your company operate?_____________________________ What are the names of each of your production facilities and where are they located (city and State/Province)? If your company has more than one production facility, do separate production facilities sell product under the same brand name? Yes No If yes, how do you differentiate the product produced by each production facility? Please select one of the production facilities listed above to be registered with this form. Note: You must register each production facility separately. Production Facility Name:________________________________________________________ Mailing Address:_______________________________________________________________ Physical Address:_______________________________________________________________ Production Facility Contact: Contact name: _________________________________ Contact phone: ___________________ Contact Fax: __________________________ Contact E-mail: ___________________________ Production Facility Internal QA/QC Contact: Contact name: _________________________________ Contact phone: ___________________ Contact Fax: __________________________ Contact E-mail: ___________________________ Which PFI Registered Laboratory is this production facility using? Product(s) (list all): Fuel Brand Name(s): Grade of Brand(s): Raw Feed source(s) of Brand(s): Do you use chemically treated feedstock materials?: If yes, identify all and explain. Yes No Do you use additives? If yes, list all: Yes No Approximate annual tonnage per grade: ______________ Super-Premium ______________ Premium ______________ Standard ______________ Utility What is the estimated tonnage per grade that is destined for the North American residential/commercial market? ______________ Super-Premium ______________ Premium ______________ Standard ______________ Utility PFI Program Compliance: Production facility has a copy of the PFI QA/QC Program for Residential/Commercial Densified Fuel? Yes No Production facility has a copy of the PFI Standard Specification for Residential/Commercial Densified Fuel: Yes No All production facilities are required to establish and implement their own written QA/QC program for evaluating their finished product(s). Written QA/QC programs must follow PFI’s standardized format and include all of the parameters outlined in the PFI QA/QC Program for Residential/Commercial Densified Fuel. PFI’s standardized QA/QC documents can be obtained through the PFI website. To purchase these documents please go to the following weblink: http://www.pelletheat.org/2/quality.html Please include a copy of your written QA/QC program with your registration packet submittal. Production facility has written and implemented their written QA/QC program? Date of implementation: ___________ Yes No Producer has initiated third party QA testing with a PFI registered laboratory at a frequency of one sample per 1000 tons of product produced? Yes No Date of Initiation_____________ For a list of PFI registered laboratories please consult our website at the following link: http://www.pelletheat.org/2/quality.html The drafting and implementation of a QA/QC program as well as the initiation of third party testing is required for a production facility to become registered with the PFI. Registration can be completed at any time. Grade verification, however, is tracked on a quarterly basis. Production facilities that register prior to January 1, 2009 will initiate grade verification starting January 1, 2009. Production facilities that register after January 1, 2009, but prior to April 1, 2009 will initiate grade verification on April 1, 2009. All future registrants will initiate grade verification on the first day of the subsequent quarter to which they have registered. Official grade verification is based on one year of third party test data as well as fines testing conducted at the mill. Grade verification is required to use PFI’s QA/QC program Certification Mark. Producer has signed and submitted a Certificate of Compliance to PFI? Yes No

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