FGIS 921-2 Inspection Report - Insects in Grain

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OMB No. 0580-0025
1. Name and Address of Shipper

U.S. Department of Agriculture
Grain Inspection, Packers and
Stockyards Administration
Animal and Plant Health Inspection Service
INSPECTION REPORT – INSECTS IN GRAIN

2. Location of Elevator
Page

4. Quantity

of

5. Country of Destination
8. Sublot Number/
Carrier Identification

3. Grain/Commodity

6. Name of Carrier/Vessel
9. Date
Inspected

10. Stowage
(Hold Nos.)

11. Quantity

15. Remarks (Use reverse for additional space)

12. No. of
Live Insects

7. Loading Date Start/Date Finished
13. Lot
Infested

14. Name of Insect

16. Name of Inspector

Fumigation Information
17. Date of Fumigation

18. Treatment

19. Hold Nos.

20. Type of Chemical

21. Concentration Level

22. Duration of Exposure

23. Temperature at Time of Fumigation

24. Quantity (metric tons)

25. Name of Inspector

Form FGIS-921-2 (01-07) Previous editions are obsolete.
FORM APPROVED OMB NO. 0580-0025: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid
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Additional Remarks: (Additional information from boxes 8 - 15 may be continued on this page, or agency
letterhead may be attached)

_________________________________________________________________________________________________________
Form FGIS-921-2 (Reverse)
Page
of

Instructions for Completing Form FGIS 921-2
“INSPECTION REPORT – INSECTS IN GRAIN.”
1.

Name and address of the shipper.

2.

Location of elevator where the barge, vessel or carriers (railcars, containers) were
loaded.

3.

Type of grain/commodity examined for insects.

4.

Total quantity (pounds or metric tons) of the grain/commodity that was loaded on
the barge or vessel, or the number of containers and/or hopper cars.

5.

Destination country for the grain/commodity.

6.

Name of the vessel or barge identification number/name.

7.

Dates the loading of the barge/vessel, unit train, container booking started and
completed.

8.

Sublot Number or Carrier Identification (e.g., container, railcar, or truck). For
unit trains, where individual carrier IDs are required, list separately or note, “see
reverse or attached for listing of car numbers.”

9.

Applicable for containers only. Date the grain/commodity was loaded and
examined for insects.

10.

Stowage (Hold Nos.), location where the grain/commodity for that particular
sublot is stowed.

11.

Enter the approximate quantity (pounds) of the grain/commodity in the bargelot
or sublot. For railcars and containers, use the actual weight of the lot or use the
appropriate carrier terms (e.g., hopper, carlot, unit train, and container).

12.

Number of live insects found in the corresponding sublot or carrier (if any).

13.

Check the box if the grain/commodity examined meets the FGIS criteria for
“Infested” or “Sample Grade” (SG) because of live insect infestation. Mark this
column only as it applies to insects, not any other SG condition.

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Note: The FGIS designation “Sample Grade” is applicable to beans, lentils, peas,
and rice when infested with live weevils or other live insects injurious to stored
grain. Sample Grade is also applicable to lots of milled rice that contain dead
insects. Do not report milled rice lots that are “Sample Grade” due to dead
insects. The FGIS designation of “Infested” is applied to the grains, barley,
canola, corn, flaxseed, mixed grain, oats, rye sorghum, soybeans, sunflower seed,
triticale, and wheat when they are infested with live weevils or other live insects
injurious to stored grain.
14.

Name of any insect found in the corresponding sublot or carrier. Identify by
using the insect’s common name (e.g., Rice Weevil, Red Flour Beetle). DO NOT
USE TERMS THE TERMS “BRAN BUG” OR “OLI.”

15.

Place any remarks, if needed, in this section. The reverse of the form may be
used if additional space is needed.

16.

Name of inspector completing this form.

Note Section 17 - 25: Complete these sections for fumigation of vessels where official
personnel are present to witness the application of the fumigant. For containers or
railcars that are fumigated when official personnel are not physically present to witness
the fumigation, the required fumigation documentation may be attached to the form.
17.

Date that the grain/commodity in the noted sublot/barge/railcar/container was
fumigated.

18.

Fumigation method used to treat the grain/commodity. (Leave this space blank)

19.

The stowage space (e.g., hold numbers, container number, rail car number) that
was fumigated.

20.

Type of chemical used to fumigate the grain/commodity.

21.

The concentration level of the fumigant used.

22.

Length of time the stowage area (e.g., vessel holds, railcar, container, and barge)
needs to be secured for a proper treatment of the grain/commodity.

23.

The air temperature at the time of fumigation.

24.

Total quantity of grain/commodity fumigated expressed in metric tons, if known.
For railcars and containers, use the actual weight or use the appropriate carrier
terms (e.g., hopper, carlot, unit train, and container).

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25.

Name of the inspector who verified the fumigation process. Complete this block
only if official personnel were present to observe the fumigation.

CONTACT INFORMATION:
Contact the field office responsible for the geographic area in which the service will be provided.
Details for these locations can be found at:
http://www.gipsa.usda.gov/GIPSA/webapp?area=home&subject=fc&topic=fsp
For further information on the Inspection Report - Insects in Grain:
Robert S. Lijewski
Policies and Procedures Branch
Field Management Division
1400 Independence Avenue, SW, Room 2409 N
Washington, DC 20250-3630
Telephone:
Fax:
Email:

(202) 720-0224
(202) 720-1015
[email protected]

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