This document is a Fumigation/Disinfection Certificate issued by the China Entry-Exit Inspection and Quarantine Bureau. Below is a summary of the core contents:

1、Certificate number (No.):A blank space is left for filling in the certificate number.
2、Name and address of the consignor:Space left for filling in the specific name and address of the consignor.
3、Name and address of the consignee:The consignees address has been filled in as H LAKE AVE SUITE 535 PASADENA CA 91101 USA.
Description of Goods:Space left for filling in the specific description of the goods.
Place of Origin:Left blank for filling in the place of origin of the goods.
Declared Quantity/Weight:Left blank for filling in the quantity or weight declared for inspection.
7. Marks & Numbers (Mark & No.):Left blank for filling in the marks and numbers of the goods.
8、Number and type of packages:Left blank for filling in the type and quantity of packages.
Port of Destination:Space left for filling in the port of destination for the goods.
Means of Conveyance:Space left for filling in the means or mode of transport for the goods.
Disinfestation and/or Disinfection Treatment:Includes detailed information such as treatment date, chemicals used and their concentration, treatment method, duration, and temperature, with space left for filling in specific treatment details.
Additional Declaration:Space left for filling in additional declarations or information.
Issuance Information:
(1) Date of Issue: Space left for filling in the certificate issuance date.
(2) Place of Issue: Space left for filling in the issuing location.
(3) Official stamp: Left blank for stamping.
(4) Authorized officer: Left blank for the signature of the authorized officer.
(5) Signature: Left blank for signature.
Certificate Identification:There is a picture identifier ([pic]) at the bottom of the document, possibly for placing the logo of the Inspection and Quarantine Bureau or related graphic identifiers.

This certificate is used to certify that the goods have undergone fumigation or disinfection treatment in accordance with regulations to meet phytosanitary requirements in international trade. The information on the certificate must be completed by relevant parties and becomes valid after being signed and stamped by an authorized officer.