Soil Testing for PCN Application Form - SASA

Application for Potato Cyst Nematode Soil Test:Seed Potatoes including Farm Saved SeedApplication must be submitted on, or before, the 31 st August in the year before planting, to SASAHeadquarters, SPCS Administration, Room A14, Roddinglaw Road, Edinburgh EH12 9FJ.APPLICANT / OCCUPIER DETAILSName of Applicant:Full postal address:Name of Occupier:If different from ApplicantFull postal address:Postcode: Tel: Postcode: Tel:Having read the Soil Testing for Potato Cyst Nematode (PCN) Leaflet, I apply for the areas detailed overleaf to betested for PCN. I declare that I am the occupier of the land (or his authorised agent) and to the best of myknowledge and belief all the information supplied is full and correct in every aspect.I agree to pay the necessary fees in respect of this application.Signature of Applicant:Date:Signature of Occupier:If different from ApplicantDate:INSTRUCTIONS FOR COMPLETING THE FORMAll applicants must provide a sketch map overleaf in respect of all fields to be tested. The sketch must clearlyshow the location of the field, the total area, the division into sampled units, if required, and any areas not to besampled. The drill direction must be indicated.If you wish the whole field area to be sampled and for SASA to divide the field equally into the maximum numberof sampled units, please tick the box. Otherwise please indicate the number of sampled units on the form and thearea of each sampled unit on a sketch map (see example below).If a post planting test for the export of ware potatoes is required, please provide a sketch map of the croplocation in the field and the measurements of the area to be sampled. Check the “Test Type” box for ware andenter the country of destination.EXAMPLE OF COMPLETED FIELD AREA DETAILS AND SKETCH MAPField IdentificationFID No. (LPID)Area of Field(Ha)Divide into maximum allowablenumber of equal partsIf notNumber of Sampled UnitsPresent CropWinter or Spring SownYear last Cropped with Potatoes(Ware or Seed)NJ 76411 / 5552619.52Spring2002Intended Year of Planting 2011Test typeIf crop to be grown for export pleasestate country of destinationSeed Export wareExport Ware PPT-

LOCATION OF FIELDS TO BE SAMPLEDFarm Code No:A separate form must be completed for each farm code number.Name of Farm:FIELD AREA DETAILS AND SKETCH MAPSField IdentificationFID No. (LPID)Area of Field(Ha)Divide into maximum allowablenumber of equal partsIf notNumber of Sampled UnitsPresent CropWinter or Spring SownYear last Cropped with Potatoes(Ware or Seed)NIntended Year of PlantingTest typeIf crop to be grown for export pleasestate country of destinationSeed Export wareExport Ware PPTField IdentificationFID No. (LPID)Area of Field(Ha)Divide into maximum allowablenumber of equal partsIf notNumber of Sampled UnitsPresent CropWinter or Spring SownYear last Cropped with Potatoes(Ware or Seed)NIntended Year of PlantingTest typeIf crop to be grown for export pleasestate country of destinationSeed Export wareExport Ware PPTField IdentificationFID No. (LPID)Area of Field(Ha)Divide into maximum allowablenumber of equal partsIf notNumber of Sampled UnitsPresent CropWinter or Spring SownYear last Cropped with Potatoes(Ware or Seed)NIntended Year of PlantingTest typeIf crop to be grown for export pleasestate country of destinationSeed Export wareExport Ware PPTField IdentificationFID No. (LPID)Area of Field(Ha)Divide into maximum allowablenumber of equal partsIf notNumber of Sampled UnitsPresent CropWinter or Spring SownYear last Cropped with Potatoes(Ware or Seed)NIntended Year of PlantingTest typeIf crop to be grown for export pleasestate country of destinationSeed Export wareExport Ware PPT