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pdfOMB No. 0581-0274
Supplement - Multiple Plants Reporting Screening Table
Note: This supplement is required for all operations answering "YES" to Question 1 in Section 1 of the Annual Validation.
1. Please list your company's headquarters location, all dairy plant locations, any plants/companies owned or partially owned producing or selling dairy
products, plants/companies with whom you have tolling agreements, or plants/companies with whom you have exclusive marketing agreements.
Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.
Office
Use
Company Name
Physical Address
Contact Name
List ALL Dairy Products
Produced at Plant
Plant
Id
Plant Name
Mailing Address
Telephone Number
(Check the box ONLY if ALL PRODUCTS LISTED
are NOT REPORTABLE )
Question Answer Log
(For plants with reportable products, answer
questions in the boxes below)
Question 2
Question 3
Question 4
HQ
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P1
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P2
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P3
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
[Interviewer Note: In the Question Answer Log - For each plant listed in the supplement with reportable products , answer questions 2, 3 and 4 listed below.]
2. Does your office have full access to (insert Plant Name of each entry) weekly sales data (i.e. all ledgers, contracts,
invoices, and cash receipts)?
3. Does (insert Plant Name of each entry) produce and/or market products outside of the information you can provide to AMS (i.e. cheese is
reported through your office but the plant listed above sells dry whey using a different office)?
4. Does (insert Plant Name of each entry) market products of the same type outside of information you can provide to AMS (i.e. the plant
listed above may have cash sales you cannot access)?
5. If any of the above are checked “No” or "Unknown", please explain:
[After completion of the supplement return to the Annual Validation Worksheet in Section 1, Question 2.]
DA-230-S (Supplement sheet to DA-230)
Page 1 of 3
Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.
Office
Use
Company Name
Physical Address
Contact Name
List ALL Dairy Products
Produced at Plant
Plant
Id
Plant Name
Mailing Address
Telephone Number
(Check the box ONLY if ALL PRODUCTS
LISTED are NOT REPORTABLE )
Question Answer Log
(For plants with reportable products, answer
questions in the boxes below)
Question 2
Question 3
Question 4
P4
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P5
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P6
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P7
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P8
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P9
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P10
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P11
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P12
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P13
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
DA-230-S (Supplement sheet to DA-230)
Page 2 of 3
Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.
Office
Use
Company Name
Physical Address
Contact Name
List ALL Dairy Products
Produced at Plant
Plant
Id
Plant Name
Mailing Address
Telephone Number
(Check the box ONLY if ALL PRODUCTS
LISTED are NOT REPORTABLE )
Question Answer Log
(For plants with reportable products, answer
questions in the boxes below)
Question 2
Question 3
Question 4
P14
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P15
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P16
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P17
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P18
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P19
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P20
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P21
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P22
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
P23
Yes
No
Unknown
Yes
No
Unknown
Yes
No
Unknown
DA-230-S (Supplement sheet to DA-230)
Page 3 of 3
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |