Ministry for Primary Industries
Pastoral House, 25 The Terrace
PO Box 2526, Wellington 6140
New Zealand
Email: [email protected]
Application Form DPF 502
Recommendation for Classification of Assessment Frequency of a
Recognised Dairy Laboratory

This form is required to be completed by an Accreditation or Recognition Body and a MPI Systems Auditor.

Send the completed application form, to the Ministry for Primary Industries at the above address. We prefer email files.
1.
Name of Laboratory:
Registered company name or partnership names (including the trading name) or individual name.
Full legal name:
2.
MPI Unique Identifier:
Idendifier No:
3.
Name of Contact Person:
Full Name:
4.
Title:
Business Address and Contact Details:
Physical (for service):
Phone No:
Fax No:
Postal (for communication):
E-mail:[
]
[Tick for consent to being provided
electronic information]
5.
Current Category: (please tick current category )
Reduced Verification
Standard/Entry Verification
Increased Verification
Not in Regulatory Model




Date assigned to current category: _______________________________________________________ (DD/MM/YYYY)
6.
Recommended Category: (please tick recommended category )
Reduced Verification
Standard/Entry Verification
Increased Verification



Recommended date assigned for reclassification: _______________________________________________________ (DD/MM/YYYY)
December 2016
Page 1 of 2
DPF 502
7.
Tick the appropriate boxes below:
Reduced Verification
Area
Assessment by
Accreditation /
Recognition Body:

Reporting:

Compliance with ISO
Standard 17025 and MPI
requirements demonstrated
for two years.
Regular and exception
reports complete, accurate
and on time for at least two
seasons.
Standard/Entry Verification

Compliance with ISO
Standard 17025 and MPI
requirements demonstrated
Increased Verification

a.
Regular and exceptions
reports complete, accurate
and on time for at least one
seasons; or
a.
Regular or exception reports
contain incomplete
information or factual errors
or are persistently late; or
b.
Regular reports occasionally
incomplete or late and
exception reports are
complete, accurate and on
time.
b.
Exceptions are not reported.
PLEASE CIRCLE a OR b
PLEASE CIRCLE a OR b
Management of
Critical NonCompliances:
8.

Identification and process of
elimination:

Critical non-compliances
identified;

full traceback completed to
identify root causes;

corrective actions completed
in a timely manner;

full analysis of the risk to the
operation from this type of
non-compliance completed;
and

actions taken to eliminate the
risk of potential noncompliances or monitoring
systems implemented to
identify potential noncompliance in the operation.
Failure to demonstrate
compliance with ISO
Standard 17025 and MPI
requirements.

Critical non-compliances
identified and managed in
accordance with MPI
requirements.
a.
Critical non-compliances not
identified; or
b.
critical non-compliances are
identified and inadequately
managed.
PLEASE CIRCLE a OR b
Recommendation for Reclassification:
Name of person making recommendation:
Signature of person making recommendation:
___________________________________________________
_____________________________________________________
Date:
Contact Telephone no:
___________________________________________________
_____________________________________________________
Name of Accreditation/Recognition Body:
___________________________________________________________________________________________________________
9.
Reclassification Confirmation:
This section is to be completed by the MPI Systems Auditor, who supports the recommended Classification
Name of Auditor:
Signature of Auditor:
___________________________________________________
_____________________________________________________
Date:
___________________________________________________________________________________________________________
December 2016
Page 2 of 2
DPF 502