ACP-2 Failed Lot Notification

Administrative Committee for Pistachios OMB No. 0581-0215

1318 E. Shaw Avenue, Suite 420

Fresno, CA 93710-7912

Ph (559) 221-8294 Fax (559) 221-8044

Email: [email protected]

ACP Form 2 - Failed Lot Notification

Section A: Complete the following information for the failed lot and send the original to the ACP office within 10 days of test completion. Provide a copy to the Handler for their records.

L ot description: Lot Id marks:

W eight: Lbs. Container size/description:

H andler of the product:

A ddress: City: State: Zip code:

S ampled by: Date: Of (Agency)

Section B: To be completed by the Handler. Record if lot passed minimum quality (yes or no) and the certificate number.

D id lot fail Minimum Quality Standard? Yes: No: Certificate #:

Section C: To be completed by the Aflatoxin Testing Laboratory. Record if lot passed aflatoxin (yes or no) and the certificate number. Record the aflatoxin results and averages.

D id lot fail Aflatoxin test requirement? Yes: No: Certificate #:

R esult for Test 1: Result for Test 2: Result for Test 3:

A verage result:

Average of Test 1 and 2 Average of Test 1,2,3

S ignature: Date:

F orm Initiator: Company:

A ddress: City: State: Zip code:

The making of any false statements 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 $250,000 for individuals and $500,000 for organizations or imprisonment of not more than five years, or both.

According 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 OMB control number. The valid OMB control number for this information collection is 0581-0215. The time required to complete this information collection is estimated to average 12 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require 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, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

ACP 2 (5/06)

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