ACP-3 Failed Lot Disposition and Rework Report

Pistachios Grown in California

3 ACP - Disposition Form

Pistachios Grown in California

OMB: 0581-0215

Document [docx]
Download: docx | pdf

OMB No. 0581-0215


Administrative Committee for Pistachios

4938 East Yale Avenue, Suite 102

Fresno, CA 93727

Tel (559) 255-6480; Fax (559) 255-6485

Email: [email protected]


FAILED LOT DISPOSITION AND REWORK REPORT

Section A: Complete and submit the following information for the failed lot within 10 days after rework is completed. Send original to the ACP and retain a copy for your records. If rework is not selected as a remedy, submit the failed lot disposition within 10 days to the ACP. Inshell lots can be reworked only once for aflatoxin. Upon second rejection they must be shelled, sold as export or for non-human consumption.


Lot description: Lot ID marks:

Weight: Lbs. Container size/description:

Handler of the product:

Address:

Maximum Aflatoxin: pass / fail Cert No.: Date:

Minimum Quality: pass / fail Cert No.: Date:

Is this an inshell lot and has it failed aflatoxin more than once? (yes/no)

Section B: Complete the applicable sections based on product disposition.


B1. Non-Human Consumption: Pounds shipped: BL No.:

Product Shipped To: Phone No.:

Address:

Description of use:


B2. Export: Pounds shipped: BL No.:

Customer: Country:

Address:


B3. Rework: Total Pounds: Accepted: Rejected:

Location of rework:

Address: City: State: Zip code: _______

Description of use:

New lot description: New lot ID:

New container / size description:

If reworked for Minimum Quality did lot pass retest? (yes/no): Cert No.:

If reworked for Maximum Aflatoxin, did the lot pass retest? (yes/no):______Cert No.:

Aflatoxin Results: Sample 1: Sample 2: Sample 3:

Average: Samples 1 & 2: Samples 1, 2, & 3:


B4. Shelled: Pounds shelled:

Address:



Handler Signature: Date:

Name: Title:


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-3 (Rev. 08/10. Destroy previous editions.)

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleFailed Lot Notification
AuthorDSzeflin
File Modified0000-00-00
File Created2021-02-01

© 2024 OMB.report | Privacy Policy