SCALE TEST REPORT (RAILROAD TRACK)

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OMB Approved: 0580-0013
LAST DATE TESTED

U.S. DEPARTMENT OF AGRICULTURE
GRAIN INSPECTION, PACKERS AND STOCKYARDS ADMINISTRATION
FEDERAL GRAIN INSPECTION SERVICE
FIELD MANAGEMENT DIVISION

TEST DATE

PAGE

OF

TEST NO.
MANUFACTURER

MODEL OF SCALE

SCALE CODE NO.

SCALE CAPACITY

MINIMUM DIVISION

SERIAL NO.

SCALE LENGTH

SECTIONAL CAPACITY

SCALE NO.

SCALE TEST REPORT - R.R. TRACK
TESTING AGENCY(INSPECTOR'S NAME, ADDRESS)

INSPECTOR
TELEPHONE

SCALE TYPE

FIELD OFFICE LOCATION

SECTIONAL TEST LOAD

FULL ELEC.

MECH

LEVER TR.

OTHER

TEST WEIGHT INFORMATION

SCALE OWNER
SCALE LOCATION (ADDRESS)

TYPE

TEST CAR OWNER

I.D. NUMBER

COMPOSITE
L.W.B.

LAST REVERIFICATION DATE

WEIGHT

L.W.B. w/j
FGIS CAR

TEST RESULTS
SENSITIVITY
ZERO

DISCRIMINATION
CAP.

SCALE CONDITION AS FOUND

ZERO

ZERO BALANCE AS FOUND

CAP.

TEST
DIRECTION

BAL.

SEC.1R

SEC. 2L

SEC. 2R

SEC. 3L

SEC. 3R

SUBSTITUTION STRAIN TEST
LOAD

CAL. TEST LOAD

SEC. 4L

SEC. 4R

SEC. 5L

BAL.

PRETEST INSPECTION

INDICATION

ERROR

ENVIRONMENTAL PROTECTION
CONDITION OF PIT
CONDITION OF APPROACHES
CONDITION OF PLATFORM
APPROACH & LIVE RAIL GAP
KIND OF DRAINAGE
ZERO BALANCE CHANGE DURING TEST

THE ERRORS IN THIS SCALE AS INDICATED ABOVE

ARE

lb

ARE NOT WITHIN THE ACCURACY REQUIREMENTS

PRESCRIBED BY THE FEDERAL GRAIN INSPECTION SERVICE.
REPAIRS, ADJUSTMENTS, MODIFICATIONS OR RECOMMENDATIONS MADE AT THIS TIME:

Return completed form to the above Field Office.
NEXT TEST IN:

45 DAYS

30 DAYS

ACCEPTANCE

MAINTENANCE

RECEIPT OF REPORT ACKNOWLEDGED (Signature)

FORM FGIS-965-1 (10/02)
Edition dated (12/84) may be used.

Expires January 2015

60 DAYS

APPROVAL SEAL APPLIED

APPLICABLE TOLERANCE ( "x" one)

90 DAYS
DATE:

180 DAYS
REJECTION TAG NO.

BY
FGIS WITNESS (Signature)

FORM APPROVED OMB NO. 0580-0013: 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 0580-0013. The time required to complete this information collection is estimated to average 1 hours 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.

Instructions for Completing Scale Test Reports
1

Testing Agency. The name of the organization, name of the person testing, address, and telephone number.

2

Field Office Location. The city and state of the field office which has jurisdiction for the scale being tested.

3

Scale Owner. Facility name and designation; i.e., Mid-South Grain, House A.

4

Scale Location. The street address of the elevator.

5

Last Date Tested. Date of the last test.

6

Test Date. The month, day, and year of the test.

7

Test No. Inspector’s assigned serial number, plus consecutive test number for the fiscal year. Cary Brown’s assigned serial (which is 1000),
the first test of FY 2004, would be: "1001-04", the second would "1002-04", and so forth. In order of testing, regardless whether a hopper,
vehicle, or railway track scale test.

8

Manufacturer. The name of the company, corporation, person, etc., who manufactured the indicating element.

9

Model of scale. The model name, number, or designation which has been assigned by the manufacturer.

10

Scale Code No. The code number of the scale which was assigned by the FGIS Policies and Procedures Branch for use in the ADP Scale
Test Monitoring System.

11

Scale Capacity. The maximum gross load that can be accepted for official weight certification as determined by an official scale inspector.

12

Minimum Division. The value of the smallest unit that can be indicated on the primary indicating element during normal weighing.

13

Serial No. The nonrepetitive number which was assigned by the manufacturer and affixed to the indicating element or beam.

14

Scale Type. Check the appropriate box to indicate whether the scale is full electronic, levertronic, a full capacity beam (FCB) mechanical
scale, or a counterpoise (CPB) mechanical scale.

15

Scale No. The number assigned to the scale by the owner which usually includes S and/ or R designations to differentiate between shipping
and receiving.

16

Sectional Capacity. The maximum gross load that can be applied to any one section of the scale without causing structural deflections
affecting the accuracy of the scale.

17

Platform Size. The length and width of the vehicle scale platform.

18

Scale Length. The length of the live track on a railroad track scale.

19

Load Cell Capacity. The manufacturer's rated capacity of one of the load cells in the scale system.

20

Sectional Test Load. The maximum amount of test standards applied to any one section of a railroad track or vehicle scale.

21

Type and Mfg. For vehicle and hopper scales indicate the type of test weights; i.e., fab, basket, cast, etc., and the manufacturer. For
railroad track scales check the appropriate box.

22

Test Weight Owner. Indicate the test weight owner.

23

Total Weight. The total amount of the test weights combined.

24

Last Reverification Date. Indicate the month and year of the latest test weight reverification.

25

I.D. No. The identification of the test car.

26

Number of Weights. The total number of individual weights.

27

Sensitivity. The results of the sensitivity check in number of divisions at zero and at capacity.

28

Discrimination. The results of the discrimination check in number of divisions at ZERO and at CAPACITY.

29

Scale Condition as Found. Indicate the condition of the scale as found. (i.e., water in pit, dirty platform, etc.)

30

Zero Balance as Found. The weight indication on the primary indicating element with no load on the load receiving element at the time of
starting the official inspection and test.

31

Results. Check appropriate box; /x/ ARE‑for scales that are within tolerance or have been adjusted to be within tolerance, /x/ ARE NOT‑for
a scale that cannot be used for official weight certification because it cannot be adjusted or fixed and is consequently REJECTED.

32

Remarks. Indicate any repairs, adjustments, modifications, or recommendations. (i.e., scale serviced before test, load cell #2 replaced, A/D
converter replaced.)

33

Next Test In. Check the appropriate box to indicate approximately when the next test is due.

34

Applicable Tolerance. ("X" one.) Indicate which tolerance is to be applied.

35

Approval Seal Applied. Indicate the name of the inspector who applied the FGIS Approved Label for Inspected Machinery. If the person is
the same as the FGIS witness, just initial.

36

Date. Indicate the date of approval.

37

Rejection Tag No. Indicate the number of the rejection tag, if applicable.

38

Receipt of Report Acknowledged. Signature of the scale owner's representative.

39

FGIS Witness. FGIS or delegated official who observed the testing and approval of the scale.

40

Test Procedures. See test procedures for railway track scales in Chapter 3 of the FGIS Weighing Handbook.

41

Pretest Inspection. Make appropriate comments for listed scale conditions for vehicle and railroad track scales (No pretest inspection area (41) on Grain Hopper, FGIS-

Distribution of Scale Test Reports
"Scale Test Reports" are marked for distribution in the lower right‑hand corner of each copy. They shall be
distributed as follows:
1 Original (white) shall be retained in a separate file at the office (FGIS or State) to which the
responsibility for the scale is assigned. The hard copy printed record of the test indications shall be
attached to the original.
2 First Copy (blue) shall be given or sent to the owner/operator of the scale for their information and
records.
3 Second Copy (green) shall be sent to the FGIS, Policies and Procedures Branch by the FGIS scale
specialist responsible for the scale.
4 Third Copy (pink) shall be sent to the FGIS field office, which is responsible for the area in which the
scale is located.
5 Fourth Copy (yellow) is an extra copy available for an interested party (e.g., State Weights and Measures
supervisor or scale service company).

Questions Concerning This Form?
USDA, GIPSA
Field Management Division
Policy and Procedures Branch
1400 Independence Ave. Rm. 2409 N
Washington, DC 20250-3630
Telephone: (202) 690-0961
Fax questions: to (202) 720-1015
Email questions: to [email protected]