(

Enclosure 2

Subeection 207.1
1. OF PAGER
REQUEST FOR AND RESULTS OF TESTS 2 1
SECTION A-REQUEST FOR TeaT _ : |

1 VO: Clanine BIP Codey [ 2, PRCA: (metus SIP Coed

USDA, FGIS Gecrge Sadth, orc

Coamodity Testing Laboratory eet

pldg. 205) Rm. - Bolton, 1 60419-8419

Agricultural Research Center - Bast 217-855-1212

(6. MASRUFACTURING PLANT AGGE 21) DEMERS Charade SAP Coty
Allatar Packing . .
Dee Platnens 200i Nertniaber If GOs :
ry mL 1s Northlake, IL 4
DLA-130-88-C-0001 .
ut WEALOM FOR BUMAEITT AL. (®. Gate

‘& END TEM OR PRQUECT 7. L0THO. Je

Yellow cake Mix “abe Verification Testing | ==*TM
‘ype It, Class 1, Style 8B 1 10 (Reliable) 6 Oct, 89
10. Mar IMAL TO BE f-yy Pa cy Sry Py Four SSMERO ANO7OR ORAWANG HO. & RE.

End Item 1 1b. Composite FP800 ibs, - MIL-p~44275
12 PURCHASED FROM OR SOURCE 1d SHIPMENT METHOD ‘13, BATE SAMPLED AND SUBMITTED BY .

urs 6 Oct 89/3. S. Hearns, or., 1LT

18 RDMARKS 4ND/OR SPECUL INSTRUCTIONS ANG/ OR WAIVERS.
Moisture testing.

17 SENG MEPORT OF TEST TO

DPSC-HOS(T)
Block 2 and 2500 §. 20th St. Phila. PA 19101-8419

SECTION B- RESULTS OF TEST (Cynimus on plain whue paper mare spect ie rayuired)

¥ GATE SAMPLE RECEVED 2 DATE RESULTS REPORTED

‘9. CAR REPORT MUMGER

ry TEST PERFORMED RES TE OF VEST

SAMPLE ROT

ACQUIREMENTE

TYPED MAME AND TITLE OF PERSON CONDUCTING TEST

GMATURE

DD.1222

MEPLACES OD FORM 1222. 4 JUL SH, WHICH IS OBSOLETE.


4155.6
mT NO OF PeerS
[ REQUEST FOR AND RESULTS OF TESTS 1 1
( SECTION A. REQUEST FOR TEST :
(laatele SIP Cota) 2 FROM: Cinetate ZIP Cute
Commander, DPSC John Jones, OIC
ATTN: USDA, AMS, PY Div., PPS :
2800 So. 20th St. 32 We Sed. Sto, Rm. 212 |
Phila.,s PA 19101-8419 Yakima, WA 96901-8999
206-555-1212
(3, ORME CONTRACTOR AND ADOREM fnatude ZIP Code) « PLANT SAME 6000) SCIORERS (Besdnthe ZIP Contint
Green River Fooda, Inc. Green River Foods, Inc.
P.O. Box 338 Loat Creek, Rd.
Green River, WA 98942 Westover, WA 96931
DLA-138-88-C-0210
SEER - PO sane
3 EMD ITD and/On PROECT © samece |? LOTMO |. REALGM COM SUmeAT OM, e.
fume SaerreD
Tomato Catsup 2 8081 | coc (Reliable) 6 Oct 89
10. Taste Type W Bee 12. SC / OA DRAWINGS WO, & REY
ini eS rs ale
rapping, no sections (8,000 cases) | PPP+S-760B
' 14 SHIPMENT M6ETHOO 13. GATE SAMPLED AND SUBMITTED BY
Star Strapping
Yakima, WA Parcel Post. 6 Oct_89/V. S$, Florence, CPT

(© REMARKS AND7 OW BPECIAL INETRUCTIONS ANO/OR WAIVERS,

17 SEND WEPORT OF TEST TO
Block 2 and DPSC-HOS(T) 2800 S. 20th St. Phila., PA 19101-9419

SECTION B-RESULTS OF TEST ‘Commas an plasm white paper W more anmar wo ree vired)

1. GATE SAUOLE RECEWED ® GATE AtSuLts REPORTED 3, CAN REPORT MOMse ER
a ‘TERT PERFORMED MEATS OF TEET AMPLE ROT REQUIACHETS
ore TYPED MAME AND TITLE OF PERSON CONDUCTING TEST SCHATURE

DD. nuleee REPLACES BO FORM 1222.1 14 58, WHICH 8b OBSOLETE.



Onclesure 4 © .o
Subsection 207.3, DPSCH 4155.6

ee ey

REQUEST FOR AND RESULTS OF TESTS

SECTION A. REQUEST FO8 TEST :
Regional Veterinary | 2 FROM: intasr 217 Gran
Veterinary

Casta £1? Colt Chief ,
Laboratory Div,

Services
William Beaumont Army Medical Center ts Arey peelth Clinic (Chicago Section) $
Bldg.
Yt. Sheridan, IL 60037-5570

- 0.0. meer
Es Orr }®. eave
1252-10 | 0016 COC Verification 6 Oct £9
(8 TTD “o z Az 5 Batt EGRO7OR DRAWERS . a
1lb. Composite [1043 lbs. (23 ca) 21 CFR 133.158
. PURCHASED Filed OF SOURCE 44 SHIPMENT METHCO 1% DATE SAMPLED AND SUBMITTED BY
Air Express 6 Oct 89/E. Hernandez, WO

V0. RDAARKE ANO7GR SPECIAL HARTRUCTIONS AND/ON WAIVERS,

Request telephonic notification of results (see block 2).
Please return sample box to addrese an block 2,

Block 2 and DPSC-HQS(T), 2800 So. 20th St. Phila., PA 19101-8419
SECTION B- RESULTS OF TEST (Contre on plan hus papar U more apace & resin)
(. GATE Saurce RECoWED

J stock ? and Year to *

‘&. DATE REBULTS REPORTED ‘2. LAe werOnT NUSEER

ry TERT PERT OMMED OCMCTS OF TEST ‘SAMPLE REULT i. MOURCMOTS

|" THPED MAME AND TITLE OF PEREOW CONOUCTING TERT RCNATURE
D

D1 222 PLACES 00 FORM HEE, 1 21 98, WHRCH Wb OBSOLETE