2020 Industrial Hemp Waste Transfer Form
Submit at least 10 Days before transfer.
In the State of Utah, the sale and transfer of Industrial Hemp Waste to Medical Cannabis Cultivators is authorized by Rule 68-32.
All Parties involved in a transaction between the Industrial Hemp Program and Medical Cannabis Program must understand that it is a violation to sell or transfer hemp BIOMASS that is above 0.3%.
All transfers of hemp biomass and hemp extract must be documented with UDAF transportation permit.
DO NOT BEGIN THIS FORM UNTIL A MEDICAL CANNABIS FACILITY HAS AGREED TO BUY INDUSTRIAL HEMP WASTE.
Accurate and Complete Reporting
This form is to be filled out with the most current and accurate information available. Applicant is to be a custodian of the hot hemp. Discrepancies found between this report and inspector observations during an audit may result in regulatory action.
Contact Phone Number
Contact Email Address
Hemp License Number (800X-XXXXX)
Location Address or GPS Coordinate
Industrial Hemp Growers and Processors are responsible to maintain complete records of products and must be able to complete mass balance on all inventory, including hemp biomass, hemp oil, hot hemp oil, hot hemp waste, and biomass.
Type of Industrial Hemp Waste
Hemp Extract greater than 0.3% THC
Hemp Extract less than 0.3% THC
Hemp biomass containing 0.3% THC or less by dry weight
Product Description and Total Amount of Hemp Waste (Ex: Cherry Wine Flower - 5 lbs, Tokyo/Trump Extract - 2 liters, etc)
Reporting Lots or Batches
"Lots" are defined as biomass of the same strain harvested at the same time and "Batches" are crude oil extracted on the same date using identical lots of biomass.
Number of Lots or Batches
Origin of Hemp Waste (Business Name and License # or State of Origin)
Verifying Industrial Hemp
The Cannabis Program is required to review documentation to verify the origin of the Industrial Hemp.
(Subject: Facility Name - Date - Hemp Waste)
Which verification documents will be sent?
Official State of Utah Sample Results
Independent Lab - Certificate of Analysis (Out of State Hemp)
Transportation Permits (Out of State Hemp)
Destination of Hemp Waste
7001-20173 Standard Wellness LLC
7001-20174 Tryke Companies Utah LLC
7001-20175 Dragonfly Greenhouse
7001-20176 Zion Cultivators LLC
7001-20177 Medical Cannabis LLC
7001-20178 True North of Utah LLC
7001-20179 Wholesome AG
7001-20180 Harvest of Utah LLC
Name of Cultivation Agent(s) to Transport Product
Cultivation Agent(s) ID Number
Date of Transport
Estimated Time of Transport
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This form was created inside of State of Utah.