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.
Applicant Name *
Your answer
Contact Phone Number *
Your answer
Contact Email Address *
Your answer
Business Name
Your answer
Hemp License Number (800X-XXXXX)
Your answer
Location Address or GPS Coordinate
Your answer
Maintaining Records
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
Product Description and Total Amount of Hemp Waste (Ex: Cherry Wine Flower - 5 lbs, Tokyo/Trump Extract - 2 liters, etc) *
Your answer
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)
Your answer
Verifying Industrial Hemp
The Cannabis Program is required to review documentation to verify the origin of the Industrial Hemp.
Email Cannabis@utah.gov (Subject: Facility Name - Date - Hemp Waste)
Which verification documents will be sent? *
Required
Destination of Hemp Waste
Name of Cultivation Agent(s) to Transport Product
Your answer
Cultivation Agent(s) ID Number
Your answer
Date of Transport
MM
/
DD
/
YYYY
Estimated Time of Transport
Time
:
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