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SHELLSTOCK SHIPPING RECORD
Firm Name:__________________________________________________________Cert #__________________ Firm Address:________________________________________________________
Date and Time Shipped
Sold To Quantity and Species
Product Iced or in <45°F conveyance
Yes or No
Internal Temp ___°F at Shipping
OriginalHarvest Date
Original Harvest Area
Original Harvester Cert #
Signature of person performing weekly records review: _________________________________________________________ Date___________________Signature of person performing weekly records review: _________________________________________________________ Date___________________
* Indicates new record keeping requirement.
Food Safety Program - Oregon.gov/ODA/FSD 05/2014 Page 1 of 1