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СЕРТИФIКАТ ЯКОG iTI/ ,'r.,

'
ДЕКЛАРАЦIЯ ВИРОБНИКА Щата: / Date:
морепродукти,
на рибу та експортуються Украiпу
що в

QUALITY CERTIFICATE/ July 24,2022

PRODUCER, S DECLARATION
сочегiпs fish апd seafood for to ukraine

KpaiHa походження l Country of origin сшдUSА

Виробник /
Astoria pacific seafoods
Рrоdчсеr
55 Pier 2 Port Docks
Astoria, OR 97103 USA FEI# 3004008971

Вiдправник /
Bornstein Seafoods, Inc.
Shtфеr
1001 Hilton Ave
Bellingham, WA 98225 USA
Одерщувач /
Солsigпее
Sc Impex SЮ,
5/3 Steet, Chisinau,
MD_2042
Container number/HoMe р конmеа не ра мЕDU9661з 18

Frоzеп Pacific Whiting HGT 23,500 Kgs

(Мg r luc cius Р r о duc tu s )
June 2022 Cases 2350

23,500 Kgs
Тоtаl/3агалом: 2350

Умови зберiгання та транспорryвання / при температурi -18 градусiв С i

Сопditiопs of storage апd transportation at tеmреrаturе -78 degrees С

TepMiH зберiгання при темпераryрi -,l8. С / 24 мiсяцiв вiд дати виготовлення /

Shelf life at temperature -18' С 24 mопths fюm the date of production
lнформацiя про продуlсг 3овнiшнiй вигляд: поверхня чиста, природного кольору, без
The iпfоrmаtiоп оп а product ушкоджень, 3апах властивий данному виду продукцiТ, без cTopo.lHix
apoMaTiB. Консистенцiя tлiльна, властива продуlfiу даного виду.
cTopoHHi присмаки та запахи вiдсутнi, Продукr не мiстить ,енетичrъ
модифiкованих органiзмiв, //
Арреаrапсе; sut'асе is рurе, with паturаl соlоur, without damages. The
smе/l,ц lhfiеrе пt iп this product, without ехtrапеоus аrоmаs. СоБsislспсе
Ь de4se, iпhеrепt iп this kiпd of product. Ехtrапеоus smacks алd sme//s
аrе absent. The product does поt сопtаiп GМО.

и стандартами США Щi

USA, Ihese goods аrе flT

, Печатка
пiдпис вiдповiдальнот особи:
Stаmр апd Ёsт, t9зa

воRNSтЕlN
Sigпаfurе of fhe responsible реrsоп:

sEAFooDý l}lC.
1001 HlLToN AVE.
BELLINGHAM, WA 98225
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W
ý]т,;ýтЕ}} F .{]}.,tЕftý сý
ýтýт,ý]ý {э

li,ý"*ýрýi{тI}ýflriз. *}" f*hýn:ýý{E,i{

Modei de certificate de sдпЁtаtс animal pentru irTportul de produse реsсёrе9ti destinate consumului uman
Model Health certificate fоr imports of fishеrу products intended for hчmап consumption

cettifi cat veterilrar с5trе certificate to Eu

united states I.2,a.
I.1. ExpeditoT/Consignot, L2, Numёrul dc rеfегiпtй al сеrtifi catuluii Сеrtfй,сlе
Numе/Nаlле rеfеrепсе ttъппlэеr lt0..1012-797,14.2:-ELI
BORNSTEIN SEAFOODS. lNC.
AdresalAddress
1001 HILTON A\ъNUE BELLINGHAM WA United Stales 98225
Nr, Тс1/Iеl Nо,
.s 360-7з4_7990

а
\ ],з, Autoritate соmреtепtё сепtrаl/СепП,аl Сопtреlепt Authority
USDCAiOAA Seafbod Inspection Progr аm
ý
Aцtoritatc competenta lосаlбl Local Compelel1l Authoriry
\ '!
,Е] 1,4.
Northwest Inspection Brarch
L6,
э
Nrrme/lYcпe
ý SC Viocris-Impex SRL
а Аdrеsа/,.1ddrass
str. Studentilor 5/3 Chisinau Moldova
Cod postal/Posta1 со,Уе
ц
ъ Iv{D-2042
Nr. Те1/Iеl No.

- соа 1.8. Regiunea de Codi ,9, Таrа de

с 1.7, Тата de оrigiлеlСапrq,о| оrigiп l
code
|,,so code origine/ Соrlе Cauli rу о|' desttllatioп
USA MD
Rеgiоп о| оrigiп Moldova
lUS
о
l

оri.giп ]. I2.
1.1 1,
|=
Nшле /Дrалtс Nrшlат de aprobare l Дррrоt,аl ttutпber
LINEAGE LOGISTICS PFS з01 175144i
а Adresa /,.]ddress
604 COURT MABERRY ROAD LYNDBN WA United States 98264

i,lЗ, Locul dc imbarcare/P/rrcc о| lо а liпg l. 14, Data рIесёгii l Dale of deparfure

LYNDEN, W А USA 01 l20/2022

М е а пs I.16. РСF de intraTe in UElElizil,BIP ilt EU

I. 5, Mij locul de tr ьпsроrtl o.f tr а п.ý р о гt
CHISINAU, MOLDOVA
1

Дчtоп lАirрlапе [ ] . Vароr /ýrrp [ Х ] Vagon dc cale fсгаtё /Rci/wal wоgоп [ )

Vehicul rutier /Лооd vehit,le | ] Altcle /Olicr [ ]
Identl{tcare|Т dell li|i catiotl

OCEAN VESSEL
Referinte dосumепtаrе/Dосаmаiаry rе|ёrаrcеs,,
SO: 142476

I.17

ТDТаrЦr-d,ýrt,, (Cbd SН)/Сопп|оdiу, code (HS code)

L 18, Dеsсгiеrеа m jrfuTilor/De.гcripliott of соппюdih,
l -0з0366
l_FRoZEN PACI}-IC WH]TING нGт

7.20, С antilateiQ цqп tilу

Total Net Wcight: 23500 kg
Total Gross W"ight: 2529З kg
prodttct _1Ес oR BELOW Nuпlёr de ambdiajc/Nullber ol'packages
@ oJ ].22.
Aпrbiental/,,1иbielll[ ] Refгigerat/Cllilled[ ] Congelat/ДrozcilIX] 2з50

dc
I.23, Numёrчl cle sigilii si de сопtаiпеrе//i/ел tФсаtiоп of caпtaiпer/Sectl пuпЬеr
]
I\,IEDU9661 з 1 8 S/ UL_43954з5

сегtifiсаtе ,tlr Сопsuпl саtl,sчпtрliоп |Х

I.27, Pentru sau admitet,e in iпlроrt of iпtо

ld of the
Nчmiг dc арrоьаrс а шrititilоr/дррrоvаl пumьеr of estab/lshments
Natura Tip de Nчпrёt dc Unitatc ploducaloare Numёr de ambalaje Greutate uс|ё
Specii/Species
NuпЬеr of packuges Nel y,eight
(п ume Sti intific)/(Scie ntific п а m е) mёrfuriIог tratament, аоrоьаrс al unilatii l/rалUfасturiпg plant
о[ Тrеоtпlёлtl l1lpBi -1ппrочаl t,uпlh,t|, Таrа de origine/country оr origin
Nattu,e
сопlmоdltу
'' Codul lSO/
.: /So code

Wild Cauglrt FROZEN З004008971 ASTORIA PACIFIC SEAFOODS, LLC 2з50 23500 kg
1-Pacit'] с Whiting (MERI-UсCIUS PRoDUсTUS)
uпitcd states us

рвFееfi'озч*

lxit 7, ft ilý?:il
 l l, lnfo:matii saпilare/Health lпfоrmаtiоп Il.a. NumёruI de геfеriпtЁ al rеfеrепсе пчmьеr l.b
,7
l1.1. Public fiea'tfi affestation

depozitate ýi tlanspodate in lлоd igienic 5i in сопfоrlпitаtе cu сеriп!еlе relevante ale standatdelor de s5nйtate рuьliс5 а]е statelor unite din ,.code ofFederal
Regulation'', cale аu foSt IесuпоSсutе in aceSt Sens са fiind eclriva]ente сu standartlele Соmuпitёtii Еurорепе in aplicarea Deciziei98l258lCE а Consiliului;/и,crc

L,сеп'"есоgпizйt.fоr this pltrposa оs eqъtivaletll lo llte ЕLп,ореоп Сопtпtччtilу sluпdltrсls as рrеsсrilэесl iп Соttпсil Decision 98/258/ЕС:
2, au tгссut cu succes cont[oalelc sanitarc 5i contl.oalc]e oгganolepticc, parazitologice, chimicc 1i micгobiologice ргсvаzutс pentru anumite саtеgогii dc рrоdusс
pescirc5ti iп сопfош]i|аtс cu ceritrlclc tclovantc аlе standaгdcIor dc sёпёtаtе рuЬliсй alc StateloI Unitc ditl,,Codc ofFcdcral Regulation", cale au fost
Ieculloscute in acest sens са fiind echivalente cu standaldele in vigoare in ComuJlitatea Еurореапi in cotrlormitate cu Decizta 98/258/СЕ а Consiliului;/йcve

as equi|,ale:ll to the ELп,opeal1 CoпlпlLlllity slalldards as prescriL,ed iп Ct]цllcil D€Lisioп 98/258/ЕС;

З. nuprovindelaspecii toxicesauspccii careconlinbiotoxine;/db notQbmefromtoxicspeclesorspeclescontaining blofoxlлS;
4. de asemenea. in cazrtl tnoltt5teloT bivalve congelate sau prelrtctatg; acestea рrочiп din zoTe de ргоduсliе supuse шпоr conditii cel pulin echivalente сеlоr

bivalvo vii./и addition,ln the case of frоzеп оr processed blyalye mol/uscs, the tater have Ьееп gathered in production areas Subje't to condlfions
at least equivaleлf lo those laid dоwп iп соuпсil Directive g1/4g2/ЕЕс of 15 Juty 1991 laying dоwп the health canditions for the
production апd
placing оп the market of live bivalve molluscs,

(2)(а)д1"51ur" cle sЁпЁtаtе atrinrali penh.u peSti Si cruStacei proveniti din асчасulturё/(2)(а)Апimаl health attestation for fish апd crustaceans of
оrrylп
|1.2,1 penfftl specii receptile la necTozi hcmatopoietici epizooticё ýНЕ), siпdrоmшi Tarrra 9i boaIa (сар galbenD/(3)ra) [Requirements for
to Epizootic haematopoietic песrоsь (EHN), Taura sупdrоmе апd Yellowhead disease
sчьsеmпаtцl, oficia1, certific с5 aninra]ele cle acvaculturi sau produsele provenite din aceStea nlerrl]ionate in partea l а рrеzепtчlчi certificate//,
иsресfоr, hereby certify that the aquaculture апimаls or products thereof referred to iп
paft l of thts certificate: 'he
Ф чпdеrSigпеd
о
iý (5)рrочiп dintr-o tcritoriu, zопё sau compaгtimotrt dcclaratc intlcmne dg
(a)Lnecroza hcmatopoieticё cpjZootic5] (a)[SindromUl Таurа] (a)[boala сар
ts gallren] ill caPitolul rdardul tеIечапt al oIE, de catre autoritatea competenta djn tаrа mеа,l(5)оrigiпаtе frоm
Ф declared
free (4)[таurа sупdrоmе] oyellowhead disease] iп ассоrdапсе with chapter vll of
а country/territory,
Directive 2006/88/ЕС оr olE Standard Ьу the competent authority of mу сочпtry,

+. (i) pentru саrе bolile sunt сч declarare obligatorie la autoritatea competenta 5i rapoartele рriчiпd suspiciunile de iпfесtаге cu boala Televanti
Ф trobuie investigate imediat de autoritatea competent'l(i) where the relevant diseases are notifiable to the competent authority апd reports of
ц Susplcion of infection of the dbease musf Ье immediately investigated Ьу the соmреtепt authority,
Ф
(ii') orice introducetc а unor specii la boli]e tclevante se face provcnilld cljntr-o zon5 dесlагаtё iпdеmпЁ de ЬоаlЁ 1i/(ii) all introducllon ofspecles
б
о sUsceptlb/e to the relevant dlseases from ап area declared frее offhe dlsease, алd
vaccinate impotriVa botilor retevante] /(iii) species susceptible to the relevant diseases are лоl
ЕФ (iii) speciile receptive la bolile relevante
vaccinated againsl lhe rеlечалf dbeasesJ
l|,2,2 (3)(4)[Cerintcрепtru specii receptive la septicemie чirаIё, песrоzЁ herпatopoieticё infectioasi, anclnia jnfectioasЁ а somonului, virusul herpetic al
:: craplrlui koi si ЬоаJа petelor albe, dcstinate rtnrri Sau comparti]l]ent dcclarate iпdсmпе de boal5 satt care fac obiectttl чпшi prograln de suрrачеghеrе
Ф satr eradicarc pentru Ьоаlа rсlсчалil(3)Р) [Requirements fаr susceptlb/e to Viral hаеmоrrhаgiс septicaemia (V Н S), l пfе cti о u s h а еm atopoi etic
Ф (KHv) and|white spot disease lпlелdеd for а МеmЬеr State, zопе оr compartment
necrosis (IHN), lnfectious Sаlmоп апаеmiа (/SA), Koi herpes
Ф deciared dlsease free оr subject to а Sufueillance or eradication for the rеlеvапt dlsease:
L
Subscmrlafui, inspector oficia], certific сё апiпrаlеlе dc асчасulfuгd sau 1lгочсiitе din acestea mcntionate Тп раПеа l а prezentuIui certificat://, lhe
uпdеrsigпеd offiCial inspector, hereby Certify that the aquacUlture producfý thereof referred to iп Part l of this certificate:
(6)provin dintr-o tari./dintr-un teritoriu, zопё sau compartiment declarate (a)sindromul ulceros epizootic] (а) hematopoietici epizootica] (4)
[necToza
(1)
[boala сар galben] in contbmitate cu capitoluJ VII din 2006i Е8/СЕ sau standaгdul Teievant а] olE, de сЁtrе autoritalea соlпреtепtё
[sindromut Таurа] p'yyhite spof dbeaseJ ln
din tara mеа,/6)оrigiпаtе from а Country/territory, zопе or соmраrtmепt frоm (4) ун S] tl)uHN] в) [l Sд] (4)[КНЧ
ассоrdапсе with Chapter Vll of Directive 2006/88/ЕС оr the relevant olE the соmреtепt authority of mу сочпtry,
(i) irr сате bolile relevante trebllie sЁ fie declaTate 1а autolitatea competent5 iar raport5rile srrspiciuni de infectare сш о Ьоаlё rеlечапtй trebuie s5 fie
invesrigate irnecliat de сёп,с autoritatea соmреtепtё,(l) where the releyanr dlseases аrе to the Competent authority апd reporls of susрiсlол of
iпfеаtiоп of the rеlеvапt dlsease must Ье immediately investigated Ьу the competent
(ii) oricc illtr.o<lucctc а uпоr spccii reccptlvc la bolile relcvante so tacc provcnind dintr-o zоuЁ de Ьоаli si(il.) all introduction of specles

suscepfibie to the relevant diseases соле from ап area declared free of fhe dlsease, апd
(iii) Speciile receptive la bolite rеlечапtе пu Sunt vaccinate Тmроtrivа bolilor relevante]/rll' ,ýpecles to the relevant diseaýes are nof
VaCcinated against fhe releyant diseaseS/

l1.2.3 Cerinte de tгапsроrt Si etichetareЛransport апd labeling rеqчirеmепts

Subsemnatul, inspec1-or oficial, certiiic faptul сё:/l, the undersigned official inspector, hereby Certify that:

I],2,3,1 апiпrаlсlе dc асчасultuгi mcntionate mai SuS SUnt tinUte 1п conditii. iuclusiv dc calitate а apei, catc uu le аfссtсаzё sёпitаtе;/thе aquacu lture
апimаls referred to above are placed uпdеr conditions, including with а water quality, that do поt alter their heallh srafus;
ТI.2.З,2 inainte dc iпс5rсаrе, containentl de trапsроr1 (vivicгa) este clu,at(i) Si dezinfectat(ё) sarr nrr а mai fost folositй апtеriоr; si/ de асчасчltur5 men
tionate mai sus sunt tinute iп conditii, inclusiv dc calitatc а арсi, саrе nu lc afcctcazi starea dc sёпdtаtс; ithe traпsport сопlаiпеr or prior ta loadiпg is
сlеап апd disinfected оr ргеviочslу unused; апd
IL2.3,3 conlingentrrl este iclentificat рriпtr-о еtiсhеtЁ liziblIЁ atasat5 ]а exteTiorLl] containentltti sari in tlranifestшl navei, afunci cAnd transportltl se о nava ctl

fr
(4)[Peýte]
vivier5. саrе contine toate informatiile relevante mentionate iп rubricite 1,7-1.1 1 din раПеа l а prezentului certificat Si рriп rtппitоагеа
(a)[cruStacei] deStinat (d eStinali) сопSUmU lui Umап ре teritoriul U niunii .lthe сопsi9пmепf lý ideпtified Ьу а legible label оп the exterior of'the
or whеп transpo,"fed Ьу well boat, iп fhе shipb manirest, With the rеlечапt iпfоrmаtiоп referred fo lп boxes l. 7 to of Part оf thls certificate,
folloWing stаlеrпелf., Чl) [F i sh]{a) [Cru sta се ап s] i пtе п ded for h ч m а п сопsumрtiоп lп the Uпiоп",

, l.i:i
*ýotL
ф ;i 1{

G-Ф

е пt tl't
 Numiru] de rеfЪriпti al ccrtificatu]ui,/Certificate rеfеrепсе пumЬеr
I1.a. Il.b
/vofes R0.3012,79744,22-EU
Par|ea |/Part l:
- RU brica 1.8: Regiunea de origine: Pentru molustc bivalve congelaie sаu рrеluсrаtс. sc iпdiсЁ zопа dc productie/.8ox rеfе rепсе .1.8: Rеgiоп of origin:
Fоr products оfЪquасulturе origin and if appropriate, indicate zопеs as /lsted iп commlsslon Declsloлs 2002/з08/Ес апd 200З1634/ЕС,
Fоr frоzеп or processed ЬlиаlVе mollusCs, lndicate the production area,
- Ru brica l, 1 1 : Locul de provenientti: пштсlс si adTesa rrnititji de expediere,lBo х rеfеrепсе 1.1 1 : Place of origin: паmе апd address of the
disр atch esfab/lsh,Tlenl,
- Rulэrica L l5: Nruпirul ile irrregistraTe (чаgоапе dc tren Sаu conia;nere si callioane), пuпliпr] zborului (aeronave) sаu dепшпitеа (vapor). in cazul
dеsсёгсirii si incёrc;rii. se adrtc inlbrtlatii supIimentare./Bo х rеfеrепсе /. 15: RеgЫrаtlоп пumЬеr (railway wagons оr сопtаiпеr апd
lоrriеs), flight пumЬеr (аirсrаft) оr паmе (shlp), Separafe iпfоrmаtiоп is to Ье provided iп the event of unloading апd reloading,
- RUЬriса1,19:аSеutilizасоtjuliIеSНсоrеsрuпzitоаге:0301,ОЗ02,0з03,0304,0з05,0з06,0307,0308,05.11,1504,1516,1518,1603,1604,
1 605, 2 1 06,/8ох rеfеrепсе l,1 9: lJse the appropriate HS codes: ОЗ01 , 0302, озо3,
о304, 0з05. 0306, 0307, 0308, 05.1 1 , 1 504, 1 51 6, 1 51 8,

1 60з, 1 604, 1 605, 21 06.

- RuЫica I.2З: IdontiГlcarea cotltaitletTlui/rrumirul si.цiliului:Daci sigilrul атс utr trumёг de sегiс, accsta trebuic si 1ic indicat./Box rеfеrепсе 1.2З:
ldепtifiсаtiоп of сопtаiпеr/sеаI пumЬеr: опlу where applicable,
- Rubrica 1.28: Natura produsului: Specificati dасЁ este vorba despre асчасullurё sau origine sёlbati сё.lВох rеfеrепсе 1.28: Nature of commodity:
specifyif aquacultureorWildorigin,Treatmenttype: live,chilted,frazen,processed. lvlaпufacturingplant:includesfacforyyessel,
freezer vessel, cold Store, proceSsиg р/апr.
Раrlеа ll/Рап ll:
/2) Рагtса II.2 а prezentului certjficat nrr se арliсЁ pcntru:/PatI l1.2 of this cerlificate does nol арр|у to:

which mеапs crusfaceans по lопgеr able to sчrуlие as living апimаls if returned to the епvirопmепt frоm which they were obtained,
(Ь) pesti Sacrificati Si eviscerati iпЪiпtе de eХpediere;/rbl fish which are Slaughtered апd eviscerated before dispatch,
(о) anirTale clc асчасulturё Si produse provenite din acestea, introduse ре piata pcntru сопsчmtil umalr fiтi ргосеsаrс ultсriоаrЁ, cu conditia sё
fc ambalate in ambalaje
pentru r'inzarca cu am;nuntul саrе rеsрссtё ргсЧссiеrilе pctrttT astfeJ dc ambalaje din Rcgularncnful (СЕ) ш'. 85З/2004;/(с) aquaculture апimаls апd
products thereof,
packages which Comply With the
which аrе placed оП t1-Ie rпаrkеt for humiп сопsumРtiоп Without further processing, provided that they аrе packed iп retail-sale
рrочlslолs fоr such packages И Rеgu/аtlол (ЕС) No 85З/20а4,
(d) crstacee destiпate unitatilor de рrосеsаrе autorizate тп conformitate cu articolul 4 alineatul (2) al Directivei 2006/88/сЕ, SaU centrelor de expediere,
сепtrеlоr
de purificare sau uпоr Tntreprinderi de aceeasi саtеgоriе ecbipaTe cu un sistetl de trаtаге а rеziduurilоr care sЁ neutralizeze agentii patogenl respectivi sau iп саrе

processing esfab/lshг,ents auihorized iп ассоrdапсе with дlliсlе 4(2) of Directive 20о6/88/Ес, оr for dispatch ceпters, purificatlon cenfers or slmliar businesses
'whichar.e-equippecl js ýubjecllo othertypesof treatmentreducing
withaneffluenttreatmenf system inactivating ihераlhоgелsiпquеstlоп, orwheretheeffluent
the risk of trалsmltflпg dlseases to the natural waters to ап acceptable level,

iespectiv, iп conformitate cu Regu|abentul (СЕ) пr, S5Зl2ОО4.Це) crus/aceans which аrе iпtепdеd for fulther processlлg before humап сопSumрtiоп without
ЬЙроrаry storage at the place оiрrосеsslлg ап d packed апd labeled for that purpose iп ассоrdапсе with Regulation (ЕС) No 853/2004,

to iп the
in anexa lV lа Directiva 2ОО6/88/СЕ. /Ра гls l1.2,1 апd lt,2.2 of this ceftificate опlу apply to Specles susбepilb/e to оле ог mоrе of the dlseases rеfеrrеd
headiпg of the роiпt сопсеrпеd, Susceptlb/e specles are listed iп дппех lV to Directive 2006/88/Ес,
рЁstrа mепtiuпеа согеsрuпzЁtоаrе./Кеер as аррrорпаtе,
(?) А se

autotizaLca contingentului itl oricare parlc а Uniunii./For сопslgлп?епrs of ýpecies suscepllb/e to EHN, Таurа Sупdrоmе апd/оr Yellowhead dlsease lhis stаtеmелf
must Ье kept for the сопsigпmепt to Ье authorized inta апу раft оF the Uпiоп.

sin5tate а fесirеi fetme si

contine specii receptive la Ьоаlа (bolile) pentr care se aplicd jndcmnitatea sau progTanlul (ptogramele), Accesul 1а date сч pliviTe la starea de
а

Ье
Гtocircj zollc de счltiчагс а rllolustelor din comunitate se poate face la асlrеsа http://ec.europa.eu/food/animal/liveanimalS/aquacUlture/index_en.htm/Гo
authorized iпtо а МеmЬеr State, zопе оr соmраrtmелt (boxes 1,9 апd t,10 of Parl l of the ceПificate) declared free from VнS, /нN, /sд, KHV or
Whitespot
dlseaseorйth asurveillancёoreradicationprogramestablishedln ассоrdапсеwithдrliсlеа4O)оr(2)оf Directive2o06/88/Ec, oneofrheýeslafemenlsmusl
bekeptiftheconsignmentcon1alлspeciessascЪpflb/etothedbease(s)forwhichdbeasefreedomorprogram(S)apply(ies) Dataoпthediseasestafusofeacfl
fаrm Ьпd mollusc lБrmiпg area iп the Соmmuпitу are acoessible at http://ec,europa,eu/food/animal/liveanimals/aquaculture/index_en,htm

parliculars iп the ceПiflcate,

lnspector official official iлsресfоr

Nume (cu majuscule)/ FUnctia Si titlul/

Nаmе (iп capitals) MARV|N MCELROY, lD:3012 Qualification алd tlt/e cso

SеmпЁttrга;"/
DatalDate Jul 2о, 2о22 Signature

Stampila/Starnp

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