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pdfNATIONAL
AGRICULTURAL
STATISTICS
SERVICE
U.S. Department of Agriculture
Rm 5030, South Building
1400 Independence Avenue, S.W .
W ashington, D.C. 20250-2000
1-800-727-9540
Fax: 202-690-2090
E-mail: nass-dc@ nass.usda.gov
for
2005 FRUIT CHEMICAL USE SURVEY
State:
Name of Farm, Ranch
or Operation:
Version:
Operator’s Name:
ID:
Form Approved
O.M.B. Number 0535-0218
Approval Expires 08/31/07
Project Code 141
TELEPHONE QUALITY
CONTROL WORKSHEET
Subtract:
Address:
Enumerator:
Interview Date & Time:
Telephone:
Operator/Mgr
Spouse
Accountant/
Bookkeeper
Partner
Other
Operator/Mgr
Spouse
Accountant/
Bookkeeper
Partner
Other
Survey Respondent:
Current Respondent:
INTRODUCTION
[Introduce yourself, and ask for the survey respondent. Rephrase in your own words.]
Recently you should have been contacted by one of our interviewers, Mr./Ms.
,
for the Fruit Chemical Use Survey. This telephone call is part of our survey quality assurance measures, to verify that personal contact
was actually made with you for that purpose. Your response is voluntary and not required by law, but your cooperation will be appreciated.
Facts about your farm/ranch will be kept confidential.
1. During the past few days, do you recall an interview with Mr./Ms.
purpose of obtaining information about your farming/ranching operation?
, for the
YES - [Go to item 3.]
NO -
[Go to item 2.]
DON’T REMEMBER - [Go to item 2.]
2. During the past few days, did any other person from the
Agricultural
Statistics Service, NASS or USDA, interview you to obtain information about your farm/ranch?
YES - [Go to item 3.]
NO -
[Conclude interview.]
DON’T REMEMBER - [Conclude interview.]
3. Did the person conducting the interview ask you to verify the spelling of your name, address and
the operation name?
YES - [Continue on back.]
NO -
[Continue on back.]
DON’T REMEMBER [Continue on back.]
4. Now I need to verify items that are critical to our survey procedures.
Reported
Verified
a. Total acres of all fruit (Section A, item 4).
b. Chemical Applications to Target Fruit
5. Did Mr./Ms.
and professional manner?
None, Positive
conduct the interview in a knowledgeable
YES
NO - Explain:
This concludes the interview. Thank you for your help.
Additional Comments:
Signature:
Date:
None, Positive
File Type | application/pdf |
File Title | telephone worksheet NASS (DC) |
Author | JEWEAN.SMD.HQ.NASS |
File Modified | 2008-06-13 |
File Created | 2005-09-19 |