CDAC-8 CA Dates--Rept. of Disposition of Product Grade Dates

--------------------------------------------CDAC form no. 8

Califomia Date AdministrativeCommittee
P.O.Box 1736,Indlo, CA92202-1736
(760) 347-4510

OMS no. 0581-0178

1616

REPORT OF DISPOSITION OF PRODUCT GRADE DATES
(Section 987.64, 987.164, 987.151)
This report must be completed

GRADE

,

for each disposition of product grade dates and filed with CDAC within 24 hours.

The following quantities of dates were disposed of as indicated below on
ITEM
NO. VARIETY

~

INSPECTION
CERT. NO.

LOT NUMBER

,19

OUTLET(Manufacturer)
or country of export)

NUMBEROF
CONTAINERS

NETWEIGHT

1
2
3
4
5
6
7
8
9
10

The undersigned HANDLERcertifies that these dates are being disposed of in accordance with regulations of the
California Date Administrative Committee.
Handler

Signature
(authorized agent)

Date

Title

.Ii.

The undersigned MANUFACTURERacknowledges receipt of and certifies that the above dates will be disposed of in
accordance with the regulations of the California Date Administrative Committee.

Manufacturer

Signature
(authorized agent)

Date
Title

Net pounds received at plant

ORIGINAL(white copy) must be mailed to the Calif. Date Admin. Committee, P.O. Box1736,lndio,CA 92202-1736.
DUPLICATE (canary copy) and TRIPLICATE(pink copy) must be given to the party receiving the fruit. Upon arrival at
destination the party transporting the fruit must turn both copies overto the party actually receiving the fruit, whereupon said
party shall complete the Manufacturer section and mail the pink copy to the CDAC. The canary copy is to be retained by the

Manufacturerfor record keeping.
QUADRUPLICATE
(goldenrod copy) to be retained by Handlerauthorizingmovementof the fruitfrom its source forrecord
keeping.
,

The making of any false statemenl3 or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation
of title 18, Section 1001, United States Code, which provides for a penalty of a fine of $10,000 or imprisonment of not more than five Y8B13or both.
This report Is required by law (7 USC B08(d), 7 CFR 987.64, 7 CFR 987. 151). Failure to report can result in a fine of not less than $50 or more than $5,000 for each
such violation and each.~
d!!ring whi,?h_su,?h"i0/ation continues shall be deemed a separate violation. This form is to insure proper disposition of product grade dates.
AccorrJing to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMS control number. The valid OMS control number for this informaoon collection is 0581-0178. The orne required to complete this information
collection is eslimated to average 30 minutes per response, including the orne for reviewing instructions. searching existing data sources, gathering and maintaining the date
needed, and completing and reviewing the collection of infotmation.
The U.S, Department of Agriculture (USDA) prohibits discrimination
in all its programs and activities on the basis d race, color, national origin, age, disability, and \i\oi1ereapplicable, sex, marital status, familial status.
parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part d an individuars Income is derived from any public assistance program (Not all prohibited bases apply to
all programs.) Persons with disabilities \i\oi1orequire alternative means for communication
of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice
and TDD).
To file a complaint of discrimination,
write to USDA, DirectDr, Office of Civil Rights,
an equal opportunity provider and employer.

1400 Independence

Avenue,

SW"

Washing1Dn,

D,C. 20250-9410,

or caH (600) 795-3272

(voice) or (202) 720-a382

(TOO), USDA is