FGIS 1001 Application for Approval to Operate as a Weight Facility

This is a fillable form; fill out, print, sign original, and mail to service area GIPSA Field Office.
FORM APPROVED: OMB NO. 0580-0013

U.S. DEPARTMENT OF AGRICULTURE
GRAIN INSPECTION, PACKERS AND STOCKYARDS ADMINISTRATION
FEDERAL GRAIN INSPECTION SERVICE
APPLICATION FOR APPROVAL TO OPERATE AS A WEIGHING FACILITY

This application form must be completed and approved before operating as a weighing facility
(7U.S.C.7A (f).) See reverse for additional instructions.

According to the Paperwork Reduction Act of 1995,
no persons are required to respond to a collection of
information unless it displays a valid OMB control
number. The valid OMB control number for this
information collection is 0580-0013. The time
required to complete this information collection is
estimated to average 8 minutes per response and 1
minute of recordkeeping, including the time for
reviewing instructions, searching existing data
sources, gathering and maintaining the data
needed, and completing and reviewing the collection
of information.

NAME OF FACILITY:

1.

ADDRESS: (Street, City, State, and Zip Code)

2.

OWNER OF FACILITY:
NAME:
ADDRESS: (Street, City, State, and Zip Code)

3.

OPERATOR OF FACILITY:
NAME:
ADDRESS: (Street, City, State, and Zip Code)

The following named persons are employed at this facility as weighers. Each individual has demonstrated the technical ability to
operate grain weighing equipment and has a reputation for honesty and integrity.

4.

All requirements and attachments are described on the reverse and must be met before signing application.

SIGNATURE OF OPERATOR AND DATE

5.

SIGNATURE OF OWNER AND DATE

6.
FORM FGIS-1001 (7/04)

(Replaces Form FGIS-1001 (10/94) which may be used.)

Clear Form

Attached to the form will be:
A. A blueprint or similar drawing (if not on file in the field office or delegated state office)
showing the location of:
1. the loading, unloading, and grain handling system;
2. the scale systems used in the weighing of grain; and,
3. the bins, interstices, and other storage arrangements.
B. The identification of each scale in the facility that will be used for weighing grain under
the Act.
C. If the facility has an automated data processing system directly related to, or indirectly
interfaced through other devices or process but related to the handling or weighing of grain
and certification of grain, the application shall show or be accompanied by the following
information:
1. System planning documents which show (1) preliminary user requirements; (2)
preliminary system design; (3) preliminary hardware/software definitions; and, (4)
development project plans; or,
2. System design documents which show: (1) general user requirements; (2) detailed
system requirements; (3) general system design; (4) detailed system design; and, (4)
development project plans; or,
3. Existing system implementation documents which show (1) the identification and
description of the existing system in terms of the location, type, and model number of
the hardware, including but not limited to the mainframe, the terminals, printers,
communications hardware, and other related components and peripheral devices; (2)
a description of the software, including but not limited to a listing of the source
language for the application and flowcharts of the programs and subroutines
(subprograms); and a description, including the formats, of the input, output, and
related records and files; (3) a documented description of the changes or modifications
made to an existing or planned system; (4) a description of the procedures for testing
the system; a description of the internal controls on accuracy and security for
safeguarding the system from the loss, misrepresentation, or manipulation of data;
and for providing audit trails; and (5) the instructions for operating the system including
but not limited to (i) an operator's manual or instructions for operating and using the
hardware and (ii) a user's guide for operating and using the application programs.
Requests to operate as a weighing facility shall also show any related information
which may be required by the Service.
D. Any other related information requested.

Form FGIS-1001 (Reverse)

INSTRUCTIONS FOR FILLING OUT FORM FGIS-1001, “APPLICATION FOR
APPROVAL TO OPERATE AS A WEIGHING FACILITY”
The U.S. Grain Standards Act and regulations require facilities to submit information
showing that the weighing facility and the elevator personnel operating weighing
equipment at that facility meet the conditions necessary to have official weighing.
Facilities are required to provide this information when service is first established, and
annually afterwards.1 Facilities fill out the Form FGIS-1001, “Application For
Approval To Operate As A Weighing Facility”, to document that their facility complies
with these conditions.
Field offices, delegated, and designated agencies are responsible to see that this
information is submitted annually. Agencies may obtain this form from their
supervising field office, or direct applicants to this website. After agency managers
receive and review the form FGIS-1001 and supporting attachments from the facility,
they should send two copies of the form FGIS-1001 and supporting attachments to their
supervising field office.
Field offices can use this form's annual completion as a cue to evaluate if the office's
and agency's facility handbook(s) is in need of updating. The information required on
this form is similar to the information required to compile facility handbooks. After
field office managers know the information on the FGIS-1001 is accurate, send a copy
of each FGIS-1001, for each facility in the field office's jurisdiction, to the Policies and
Procedures Branch.
Instructions for Use.
(1)

Name of the facility, mailing and street address.

(2)

Owner's name and address.

(3)

Name of person or company who actually operates the facility.

(4)

Names of persons employed at the facility that operate the facility's scales
as weighers. By listing employees here, the facility is stating that these
individuals can demonstrate a technical ability to operate grain weighing
equipment and have a reputation for honesty and integrity. If the facility's
personnel fluctuates because personnel are hired from employment pools,
such as longshore personnel, the individuals who directly supervise these
individuals (facility) or "key" longshore personnel can be listed. These
blanks do not require the signature of the individual.

1 The agency or field office may already have all the information shown on the back of the FGIS-1001, especially if the
facility has been prompt in notifying official personnel of conditions affecting official weighing (official personnel should
always be notified of changes affecting weighing). If this is the case, it is not necessary to submit the attachments with the
FGIS-1001 again.

(5)

Operator's signature with date (usually the plant superintendent or
manager).

(6)

Owner's or corporate officer's signature with date.

Attached to the form will be the information shown on the back of the form.
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
The signed form should also be mailed to this location.
For further information on the “Application For Approval To Operate As A Weighing
Facility”.
Martin A. Begley
Policies and Procedures Branch
Field Management Division
1400 Independence Avenue, SW, Room 2409 N
Washington, DC 20250-3630
Telephone 202-720-0277
[email protected]