Hemp Harvest Report Sample Request Form

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Fill out a separate request for each strain or product to be sampled; this will assist both UDAF inspectors and the UDAF lab to coordinate and track samples.

Allow 5 days for an inspector to coordinate a sampling time.

Starting July 1st, 2020, Official Sample Tests will be billed at $65 per test and $65 per hour to sample.

R68-24-5(3) Thirty (30) days prior to harvest the licensee shall submit a Harvest Report

Industrial Hemp Cultivation R68-24: https://rules.utah.gov/publicat/code/r068/r068-024.htm

Email *

Contact Name *

To be present at sampling

Contact Phone Number *

Format: XXX-XXX-XXXX

Sampling Date Request *

YYYY

Hemp License Name *

Hemp License Number: *

Format: 8001-XXXXX

Look-up a Utah Industrial Hemp license: ag.utah.gov -> Online Services -> License Look-up -> Industrial Hemp -> 8001 Growers, 8002 Processors

https://ag.utah.gov/

Sampling Location: Address or GPS Coordinates *

County

Strain Name (or Grower Lot ID) *

Harvest Quantity (approximate number of plants) *

Is this Hemp Lot under Contract?

Yes

Other:

Clear selection

Storage Location: Address or GPS Coordinates *

Tests Requested *

Official State Hemp Verification Test ($65.00) Potency THC % and CBD %

Full Panel Test ($800.00) Foreign Matter, Water Activity, Moisture, Cannabinoids, Pesticides, Heavy Metals, Microbial, Mycotoxin, Residual Solvent

Pesticides Test ($160.00)

Heavy Metals Test ($110.00)

Required

A copy of your responses will be emailed to the address you provided.

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