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pdf2016 VEGETABLE CHEMICAL USE SURVEY
OMB No. 0535-0218
Approval Expires: xx/xx/xxxx
Project Code: 136 QID: 035219
SMetaKey: 2069
NATIONAL
AGRICULTURAL
STATISTICS
SERVICE
National Agricultural Statistics Service
U.S Department of Agriculture
NOC Division
9700 Page Avenue, Suite 400
St. Louis, MO 63132-1547
Phone: 1-888-424-7828
Fax: 314-595-9990
E-mail: [email protected]
VERSION
POID
SUBTRACT
01
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___
DATE
TIME
CONTACT RECORD
NOTES
INTRODUCTION:
[Introduce yourself, and ask for the operator. Rephrase in your own words.]
We are collecting information on chemical use and need your help to make the information as accurate as possible. The information
you provide will be used for statistical purposes only. In accordance with the Confidential Information Protection provisions of Title V,
Subtitle A, Public Law 107-347 and other applicable Federal laws, your responses will be kept confidential and will not be disclosed in
identifiable form to anyone other than employees or agents. By law, every employee and agent has taken an oath and is subject to a
jail term, a fine, or both if he or she willfully discloses ANY identifiable information about you or your operation. Response is
voluntary.
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 0535-0218. The time required to complete this information collection is estimated to average 70 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.
We encourage you to refer to your records during the interview.
004
BEGINNING TIME [MILITARY]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
[Name, address and partners verified and updated if necessary.]
__ __ __ __
-2-
During the screening phase of the Vegetable Chemical Use Survey conducted in June and July, your operation was found
to be growing or intending to grow vegetables this year. I now need to verify some of the information collected during the
screening survey.
Verify operation name and operator on label and/or screener.
If no changes, go to Section A, page 4.
If changed, continue to “Change in Operating Status”.
CHANGE IN OPERATING STATUS
[ENUMERATOR NOTE: Skip this section if there is no change in operation name or operator.]
1. Has there been a change in operation name or operator?
NO - [Go to Enumerator Note below.]
CODE
YES - [Enter code 1, complete name and address information below for new operator,
and read Enumerator Note.]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
023
______________________________________
Operation Name __________________________________
______________________________________
Operator Name __________________________________
______________________________________
Address ________________________________________
______________________________________
________________________________________
______________________________________
[ENUMERATOR NOTE:
Phone (
) ________________________________
If the operation on the face page was in business part of the 2014 crop year, complete this
questionnaire for the part of the year during which the operation did business, unless the
operation has been taken over by a new operator. If the operator has changed midyear, please
conduct this interview start to finish with the new operator after reading “Valid Substitution” rules
in section 4 of the Interviewer’s Manual.]
2. Has the operation printed on this questionnaire been combined or merged with any other farming operations?
Yes - [Go to "Conclusion".]
No - [Continue.]
-3-
SCREENING
1. Did this operation have any of the target crops during the 2014 crop year?
YES - [Continue.]
NO - [Write notes explaining situation then go to “Conclusion” on back page.]
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
2. Are the day-to-day decisions for this operation (name on label) made by –
[Check one.]
one individual? [Go to Section A.]
a hired manager? [Go to Section A.]
partners? [Continue.]
3. How many individuals are involved in the day-to-day decisions of this operation?
[Enter the number of partners, including the partner named on the label.
Identify the other persons in this partnership below, then go to Section A.]
NUMBER
(Partners jointly operate land and share in decision making. Do not include landlords and tenants as partners.). . . . . . . . . .
4. Please identify the other person(s) in this partnership, then go to Section A.
[Verify partners’ names and make necessary corrections if names have already been entered.]
PARTNERS
POID__ __ __ __ __ __ __ __ __
PARTNERS
PARTNER NAME
PARTNER NAME
ADDRESS
ADDRESS
CITY
PARTNERS
STATE
ZIP
PHONE NUMBER
POID__ __ __ __ __ __ __ __ __
CITY
PARTNERS
PARTNER NAME
PARTNER NAME
ADDRESS
ADDRESS
CITY
STATE
ZIP
PHONE NUMBER
CITY
POID__ __ __ __ __ __ __ __ __
STATE
ZIP
PHONE NUMBER
POID__ __ __ __ __ __ __ __ __
STATE
ZIP
PHONE NUMBER
-4-
CALIFORNIA SCREENING
1. What ID (pesticide permit number) does this operation use
for reporting pesticide applications on the target
acres to the County Agricultural Commissioners?. . . . . . . . . . . . . . . . . . . . . . . . . .
COUNTY
NUMBER
2. Is this ID used to report pesticide applications for any other operations?
YES - [Continue.]
NO - [Go to item 3.]
a. What other operation(s) is this ID used to report for?
Name________________________________________
Name__________________________________________
Address______________________________________
Address________________________________________
Phone (
Phone (
) __________________________________
) __________________________________
3. Does this operation use any OTHER ID’s to report pesticide applications
on the target acres to the County Agricultural Commissioners?
YES - [Continue.]
NO - [Go to Section A.]
COUNTY
NUMBER
a. What are these other ID numbers?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Do you use any of these ID’s to report pesticide applications
for any other operation(s)?
YES - [Continue.]
NO - [Go to Section A.]
(i) What other operation(s) use this ID for reporting? [Identify operation and ID.]
Name________________________________________
Name__________________________________________
Reporting ID____________________________________
Reporting ID____________________________________
Address______________________________________
Address________________________________________
Phone (
Phone (
) __________________________________
) __________________________________
-5-
A
LAND OPERATED
A
ACRES OPERATED
CODE
[Enumerator Action: If acreage on the insert is verified as correct, enter code 1 in box 801,
then skip to Section B. If acreage has changed, ask ALL questions.] . . . . . . . .
801
Now I would like to ask about the total acres operated under this land arrangement.
1. How many acres does this operation--ACRES
901
. ___
a. Own?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
b. Rent or lease from others or use rent free?
902
. ___
(Exclude land used on an animal unit month (AUM) basis.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . +
905
c.
Rent to others?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -
. ___
900
2. [Calculate item 1a + 1b - 1c.] Then the total acres operated are:. . . . . . . . . . . . . . . . . . . . . . . . . . =
. ___
a. Does this include the farmstead, all cropland, woodland, pasture land,
wasteland, and government program land?
YES - [Continue.]
NO - [Make corrections, then continue.]
The remaining questions in this survey refer to these [item 2] acres.
3. Of the total acres operated, how many acres are considered cropland, including
land in hay, summer fallow, cropland idle, cropland used for pasture and cropland
in government programs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
802
4. Of the total acres operated, how many acres are vegetables?
803
(Include both target and non-target vegetables planted on the operation.) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.___
. ___
-6-
ADA-ESD SCREENING
[ENUMERATOR NOTE: If box is checked, begin with item 1.
If box is NOT checked, go to page 6.]. . . . . . . . . . . . . .
1. What Pesticide Grower Permit number does this operation use for reporting
chemical applications on these [Section A, item 2] acres to the Arizona
Department of Agriculture – Environmental Services Division [ADA-ESD]? . . . . . . . . . .
PGP 10 NUMBER
020
2. Is this permit number used to report chemical applications
for acres other than these [Section A, item 2] acres?
YES - [Continue.]
NO - [Go to item 3.]
OFFICE USE
012
a. What other operation(s) is this permit number used to report for?
Name __________________________________
Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address ________________________________
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone (
Phone (
) ____________________________
) ____________________________
3. Does this operation use any OTHER Pesticide Grower Permit number
to report chemical applications to ADA–ESD for these [Section A, item 2] acres?
YES - [Continue.]
OFFICE USE
013
NO - [Go to Section B.]
PGP 10 NUMBER
015
a. What are these PGP numbers?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
016
017
018
b. Do you use any of these ID’s to report chemical applications
for any other operation(s)?
YES - [Continue.]
019
NO - [Go to Section B.]
(a) What other operation(s) use this Pesticide Grower Permit for reporting?
[Identify operation and ID]
Name __________________________________
Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Reporting ID ____________________________
Reporting ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address ________________________________
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Phone (
Phone (
) ____________________________
).............................
-7-
B
VEGETABLE ACREAGE
B
1. What target vegetables were on these [Section A, item 2] acres
during the 2014 crop year? (Exclude new plantings of vegetables
not intended for harvest in 2014.)
[Enumerator Note: If no target acreage is present, write notes
and skip to “Conclusion” on back page.]
1
CROP
TABLE
001
199
3
4
5
6
7
How many acres
of [crop] did this
operation have?
Were any
commercial
fertilizers
applied to
this crop?
Were any
herbicides,
insecticides,
fungicides, etc.
applied to
this crop?
On what date
did you complete
harvest of your
2014 crop year
on these
[crop] acres?
On what date
did you complete
harvest of your
2014 crop year
[crop]?
2
L
I
N
E
OFFICE USE
LINES IN TABLE
CROP CODE
ACRES
[YES = 1]
11
01
[YES = 1]
MM DD YY
MM DD YY
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
12
13
14
15
.___
11
02
.___
11
03
.___
11
04
.___
11
05
.___
11
06
.___
11
07
.___
11
08
.___
11
09
.___
11
10
.___
11
11
.___
11
12
.___
11
13
.___
11
14
.___
11
15
.___
CALIFORNIA – CROP CODES
701 ASPARAGUS
BEANS, SNAP
803
FRESH MARKET
705 BROCCOLI
CARROTS
812
FRESH MARKET
912
PROCESSING
715 CELERY
CABBAGE
808
FRESH MARKET
CORN, SWEET
818
709 CANTALOUPE
714 CAULIFLOWER
FRESH MARKET
CUCUMBERS
820
730 HONEYDEW
LETTUCE
743
SQUASH, SUMMER
725
HEAD
744
SQUASH, WINTER
728
OTHER, includes Romaine
748 STRAWBERRIES
732 ONIONS, BULB
TOMATOES
736 PEPPERS, BELL
850
FRESH MARKET
738 PUMPKINS
950
PROCESSING
SPINACH
FRESH MARKET
723 GARLIC
SQUASH
840
FRESH MARKET
752 WATERMELONS
-8-
B
VEGETABLE ACREAGE
L
I
N
E
CAL – EPA SITE LOCATION NUMBER
(If Required)
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
INCLUDES AND EXCLUDES
INCLUDE:
EXCLUDE:
TARGET CROPS ONLY
ALL CROPS GROWN IN ANOTHER STATE.
All acreage equal to or greater than one tenth of an acre.
All crops grown in greenhouses and hothouses.
All acreage for processing or fresh market.
All vegetables grown for commercial transplanting.
All acreage for roadside stands, farmer’s markets or U-pick sales.
HOME GARDEN vegetable acreage.
Acreage not harvested due to weather, economic or other reasons.
All mushrooms, potatoes, sweetpotatoes, dry beans.
Crops planted in the fall of 2013 if they were part of the 2014 crop.
All vegetable acres grown by institutional, experimental,
Double Cropping.
research and university farms.
Non-target vegetables.
B
-9-
B
VEGETABLE ACREAGE
B
1. What target vegetables were on these [Section A, item 2] acres
during the 2014 crop year? (Exclude new plantings
of vegetables not intended for harvest in 2014.)
[ENUMERATOR NOTE: If no target acreage is present, write notes
and skip to “Conclusion” on back page.]
1
2
L
I
N
E
CROP
3
4
5
How many acres
were PLANTED
for harvest in the
2014 crop year?
(Include 2014 acres
which were planted
in other years.)
Were any
commercial
fertilizers
applied to
this crop?
Were any
herbicides,
insecticides,
fungicides,
etc. applied
to this crop?
CROP CODE
ACRES
[YES = 1]
11
01
02
11
11
11
11
07
08
13
Acreage not harvested due to weather,
economic or other reasons.
12
13
Crops planted in the fall of 2013
if they were part of the 2014 crop.
12
13
12
13
12
13
12
13
All crops grown in greenhouses,
hothouses and home gardens.
12
13
Plantings of crops not intended
for harvest in 2014.
12
13
12
13
12
13
Double Cropping
EXCLUDE:
EXCLUDE: ALL CROPS GROWN
IN ANOTHER STATE.
.___
11
09
New plantings and other plantings
which are not yet bearing
(asparagus & strawberries)
.___
11
10
All vegetables grown for commercial
transplanting.
.___
11
11
.___
11
12
12
13
All mushrooms, potatoes, dry beans,
sweet potatoes.
12
13
All vegetable acreage grown
for seed only.
12
13
12
13
.___
11
13
.___
11
14
All vegetable acres grown by
institutional, experimental, research
and university farms.
.___
11
15
709
840
714
752
12
.___
11
728
808
All bearing acreage of TARGET
CROPS for roadside stands, farmer’s
markets or U-pick sales.
.___
11
705
725
[YES = 1]
13
.___
06
TARGET CROPS ONLY.
12
.___
05
199
All acreage equal to or greater than
one tenth of an acre.
.___
04
TABLE
001
All acreage of TARGET CROPS
for processing or fresh market.
.___
03
730
803
INCLUDE:
.___
11
701
709
OFFICE USE
LINES IN TABLE
Non-target vegetables.
.___
ARIZONA – CROP CODES
ASPARAGUS
CANTALOUPES
BEANS, SNAP
HONEYDEW
FRESH MARKET
LETTUCE
BROCCOLI
HEAD
CABBAGE
OTHER, includes Romaine
FRESH MARKET
SPINACH
CANTALOUPE
FRESH MARKET
CAULIFLOWER
WATERMELON
CALIFORNIA – CROP CODES
NOTES:
CARROTS
812
FRESH MARKET
912
PROCESSING
715 CELERY
CORN, SWEET
818
FRESH MARKET
CUCUMBERS
820
730 HONEYDEW
LETTUCE
SQUASH, SUMMER
SQUASH, WINTER
725
HEAD
744
728
OTHER, includes Romaine
748 STRAWBERRIES
732 ONIONS, BULB
TOMATOES
736 PEPPERS, BELL
850
FRESH MARKET
738 PUMPKINS
950
PROCESSING
SPINACH
FRESH MARKET
723 GARLIC
SQUASH
743
840
FRESH MARKET
752 WATERMELONS
- 10 -
TARGET CROPS & CODES
COLORADO
CORN, SWEET
818
FRESH MARKET
FLORIDA
BEANS, SNAP
803
FRESH MARKET
CABBAGE
808
FRESH MARKET
CORN, SWEET
818
820
920
736
742
748
FRESH MARKET
CUCUMBERS
FRESH MARKET
PROCESSING
PEPPERS, BELL
SQUASH
STRAWBERRIES (bearing age)
TOMATOES
850
FRESH MARKET
752 WATERMELONS
803
808
818
820
732
736
742
752
GEORGIA
BEANS, SNAP
FRESH MARKET
CABBAGE
FRESH MARKET
CORN, SWEET
FRESH MARKET
CUCUMBERS
FRESH MARKET
ONIONS, DRY
PEPPERS, BELL
SQUASH
WATERMELONS
ILLINOIS
BEANS, SNAP
903
PROCESSING
CORN, SWEET
818
FRESH MARKET
738 PUMPKINS
MICHIGAN
701 ASPARAGUS
903
812
818
820
920
738
742
BEANS, SNAP
PROCESSING
CARROTS
FRESH MARKET
CORN, SWEET
FRESH MARKET
CUCUMBERS
FRESH MARKET
PROCESSING
PUMPKINS
SQUASH
MINNESOTA
CARROTS
912
PROCESSING
CORN, SWEET
918
PROCESSING
PEAS, GREEN (exclude dried)
935
PROCESSING
NEW JERSEY
CORN, SWEET
818
820
736
743
744
850
803
903
808
818
820
732
742
FRESH MARKET
CUCUMBERS
FRESH MARKET
PEPPERS, BELL
SQUASH
SUMMER SQUASH
WINTER SQUASH
TOMATOES
FRESH MARKET
NEW YORK
BEANS, SNAP
FRESH MARKET
PROCESSING
CABBAGE
FRESH MARKET
CORN, SWEET
FRESH MARKET
CUCUMBERS
FRESH MARKET
ONIONS, DRY
SQUASH
NORTH CAROLINA
BEANS, SNAP
803
808
818
820
920
736
742
850
752
818
920
738
850
OREGON
BEANS, SNAP
903
PROCESSING
CORN, SWEET
818
FRESH MARKET
732 ONIONS, DRY
PEAS, GREEN (exclude dried)
935
PROCESSING
748 STRAWBERRIES (bearing age)
PENNSYLVANIA
BEANS, SNAP
903
PROCESSING
CORN, SWEET
818
FRESH MARKET
738 PUMPKINS
SOUTH CAROLINA
CUCUMBERS
920
PROCESSING
752 WATERMELONS
TENNESSEE
BEANS, SNAP
803
FRESH MARKET
TOMATOES
850
FRESH MARKET
TEXAS
CABBAGE
808
FRESH MARKET
709 CANTALOUPE
CARROTS
812
FRESH MARKET
CORN, SWEET
FRESH MARKET
CABBAGE
FRESH MARKET
CORN, SWEET
FRESH MARKET
CUCUMBERS
FRESH MARKET
PROCESSING
PEPPERS, BELL
SQUASH
TOMATOES
FRESH MARKET
WATERMELONS
818
OHIO
CORN, SWEET
FRESH MARKET
CUCUMBERS
PROCESSING
PUMPKINS
TOMATOES
FRESH MARKET
912
920
732
840
752
903
808
818
918
920
732
935
FRESH MARKET
CUCUMBERS
PROCESSING
ONIONS, DRY
SPINACH
FRESH MARKET
WATERMELONS
WISCONSIN
BEANS, SNAP
PROCESSING
CABBAGE
FRESH MARKET
CARROTS
PROCESSING
CORN, SWEET
FRESH MARKET
PROCESSING
CUCUMBERS
PROCESSING
ONIONS, DRY
PEAS, GREEN (exclude dried)
PROCESSING
- 11 -
NOTES
- 12 -
WASHINGTON – CROP CODES
701
912
918
732
935
748
ASPARAGUS
CARROTS
PROCESSING
CORN, SWEET
PROCESSING
ONIONS, DRY
PEAS, GREEN (exclude dried)
PROCESSING
STRAWBERRIES
NOTES
:
- 13 -
C
FERTILIZER APPLICATIONS
C
Enumerator Note--If column 4 of the table in Section B is YES for any crops, continue with item 1.
If column 4 of the table in Section B is NO for all crops, go to Section D, page 10.
1. I need to record complete information on all commercial fertilizers applied
to the target vegetables grown during the 2014 crop year.
Include all applications regardless of how they were applied (irrigation
water, foliar applications, etc.). [Record amount of analysis of fertilizers
applied or pounds of actual plant nutrients applied. Complete the table
below (and any necessary supplemental fertilizer tables). Exclude
micronutrients, lime, and gypsum.]
1
2
L
I
N
E
CROP
CROP
CODE
3
4
5
6
N
I
T
R
O
G
E
N
P
H
O
S
P
H
A
T
E
P
O
T
A
S
H
S
U
L
F
U
R
N
P205
K20
S
OFFICE USE
LINES IN TABLE
7
How much
was applied
per acre per
application?
[Leave this
column blank
if actual
nutrients
were
reported.]
299
TABLE
001
8
9
10
How many
acres was this
applied to?
How
many
times
was it
applied?
UNIT CODES
1
12
13
15
28
19
Pounds
Gallons
Quarts
Liquid Oz.
Dry Oz.
Actual
Nutrients
ACRES
NUMBER
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
31
32
33
34
36
37
40
41
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
- 14 -
C
FERTILIZER APPLICATIONS
1
2
L
I
N
E
CROP
CROP
CODE
3
4
5
6
7
8
N
I
T
R
O
G
E
N
P
H
O
S
P
H
A
T
E
P
O
T
A
S
H
S
U
L
F
U
R
How much
was applied
per acre per
application?
UNIT CODES
N
P205
K20
S
[Leave this
column blank
if actual
nutrients
were
reported.]
1
12
13
15
28
19
Pounds
Gallons
Quarts
Liquid Oz.
Dry Oz.
Actual
Nutrients
9
10
How many
acres was this
applied to?
How
many
times
was it
applied?
ACRES
31
32
33
34
36
31
32
33
34
36
18
37
40
37
40
. ___
19
31
32
33
34
36
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
31
32
33
34
37
36
40
32
33
34
37
36
40
41
. ___
37
. ___
41
. ___
. ___
31
41
. ___
. ___
39
41
. ___
. ___
38
41
. ___
. ___
37
41
. ___
. ___
36
41
. ___
. ___
35
41
. ___
. ___
34
41
. ___
. ___
33
41
. ___
. ___
32
41
. ___
. ___
31
41
. ___
. ___
30
41
. ___
. ___
29
41
. ___
. ___
28
41
. ___
. ___
27
41
. ___
. ___
26
41
. ___
. ___
25
41
. ___
. ___
24
41
. ___
. ___
23
41
. ___
. ___
22
41
. ___
. ___
21
NUMBER
41
. ___
. ___
20
40
C
40
41
. ___
- 15 -
D
PESTICIDE APPLICATIONS
D
[ENUMERATOR ACTION: If pesticides were reported in Section B, column 5, continue. Otherwise, skip to Section E.]
1. Now I need to get complete information on all of the chemicals applied, including applications made by you and/or by
custom applicators during the 2014 crop year to each of the target vegetable crops you grew. Let’s start with the
first application to your [crop] since the 2013 crop year harvest.
[Complete the table for all chemical applications to the target vegetable crops. Use supplemental tables if necessary. ]
(Include herbicides, insecticides, nematicides, miticides, fungicides, chemical thinners, growth regulators, microbial agents, pheromones,
rodenticides, and soil fumigants. Exclude seed treatments, foliar applications of nutrients, and applications made to vegetables after harvest.)
OFFICE USE
LINES IN TABLE
1
2
L
I
N
E
CHEMICAL
PRODUCT NAME
CROP
CROP
CODE
TABLE
001
399
3
4
5
What products
were applied
to the [crop]?
Was this
product
bought in
liquid or
dry form?
Was this
part of a
tank mix?
[Enter product code.]
[Enter L or D.]
[If tank mix, enter
line number
of first product
in mix.]
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicide, Insecticide, Fungicide, etc.)
Trade Name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 16 -
D
PESTICIDE APPLICATIONS
D
CODES FOR COLUMN 8
1 POUNDS
6
L
I
N
E
40 KILOGRAMS
13 QUARTS
41 LITERS
14 PINTS
46 SPIRALS
15 OUNCES, LIQUID
47 PACKETS
28 OUNCES, DRY
50 OTHER (Specify__________________)
OR
How much
was
applied
per acre
per
application?
7
What was the
total
amount
applied
per
application?
65
73
. ___ ___
01
65
65
65
77
83
. ___
77
83
. ___
77
83
. ___
77
83
. ___
74
73
65
83
77
83
. ___ ___
. ___ ___
15
77
. ___
74
73
65
83
. ___ ___
. ___ ___
14
77
. ___
74
73
65
83
. ___ ___
. ___ ___
13
77
. ___
74
73
65
83
. ___ ___
. ___ ___
12
77
. ___
74
73
65
83
. ___ ___
. ___ ___
11
77
. ___
74
73
65
83
. ___ ___
. ___ ___
10
77
. ___
74
73
65
09
83
. ___ ___
. ___ ___
08
77
. ___
74
73
. ___
74
77
83
. ___ ___
73
. ___ ___
YY
83
. ___ ___
. ___ ___
DD
. ___
74
73
MM
77
. ___ ___
. ___ ___
07
ACRES
74
73
65
CODE
. ___ ___
. ___ ___
06
When
was it
applied?
74
73
65
How many acres
were
treated
with this
product?
. ___ ___
. ___ ___
05
[Enter unit
code
from
above.]
74
73
65
10
. ___ ___
. ___ ___
04
9
74
73
65
03
8
. ___ ___
. ___ ___
02
30 GRAMS
12 GALLONS
. ___
74
77
83
. ___ ___
. ___
[For pesticides not listed in Respondent Booklet, specify---]
Pesticide Type
Line No.
(Herbicide, Insecticide, Fungicide, etc.)
Tradename
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 17 -
D
PESTICIDE APPLICATIONS
1
2
L
I
N
E
CHEMICAL
PRODUCT NAME
CROP
CROP
CODE
D
3
4
5
What products
were applied
to the [crop]?
Was this
product
bought in
liquid or
dry form?
Was this
part of a
tank mix?
[Enter product code.]
[Enter L or D.]
[If tank mix, enter
line number
of first product
in mix.]
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicide, Insecticide, Fungicide, etc.)
Trade Name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 18 -
D
PESTICIDE APPLICATIONS
1
12
13
14
15
28
6
L
I
N
E
OR
65
16
7
8
What was the
total
amount
applied
per
application?
[Enter unit
code
from
above.]
9
How many acres
were
treated
with this
product?
CODE
ACRES
73
. ___ ___
65
17
73
65
65
65
20
83
77
83
. ___
74
73
65
77
77
83
. ___ ___
. ___ ___
33
83
. ___
74
73
65
77
. ___ ___
. ___ ___
32
83
. ___
74
73
65
77
. ___ ___
. ___ ___
31
83
. ___
74
73
65
77
. ___ ___
. ___ ___
30
83
. ___
74
73
65
77
. ___ ___
. ___ ___
29
83
. ___
74
73
65
77
. ___ ___
. ___ ___
28
83
. ___
74
73
65
77
. ___ ___
. ___ ___
27
83
. ___
74
73
65
77
. ___ ___
. ___ ___
26
83
. ___
74
73
65
77
. ___ ___
. ___ ___
25
83
. ___
74
73
65
77
. ___ ___
. ___ ___
24
83
. ___
74
73
65
77
. ___ ___
. ___ ___
23
83
. ___
74
73
65
77
. ___ ___
. ___ ___
22
83
. ___
74
73
65
21
77
. ___ ___
. ___ ___
. ___
74
77
83
. ___ ___
73
. ___ ___
YY
. ___
74
73
DD
83
. ___ ___
. ___ ___
MM
. ___
74
73
10
When
was it
applied?
77
. ___ ___
. ___ ___
19
74
. ___ ___
. ___ ___
18
CODES FOR COLUMN 8
30 GRAMS
40 KILOGRAMS
41 LITERS
46 SPIRALS
47 PACKETS
50 OTHER (Specify______________________)
POUNDS
GALLONS
QUARTS
PINTS
OUNCES, LIQUID
OUNCES, DRY
How much
was
applied
per acre
per
application?
D
. ___
74
77
83
. ___ ___
. ___
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicides, Insecticides, Fungicides, etc.)
Trade name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 19 -
D
PESTICIDE APPLICATIONS
D
[ENUMERATOR ACTION: If pesticides were reported in Section B, column 5, continue. Otherwise, skip to Section E.]
1. Now I need to get complete information on all of the chemicals applied, including applications made by you and/or by
custom applicators during the 2014 crop year to each of the target vegetable crops you grew. Let’s start with the
first application to your [crop] since the 2013 crop year harvest.
[Complete the table for all chemical applications to the target vegetable crops. Use supplemental tables if necessary. ]
(Include herbicides, insecticides, nematicides, miticides, fungicides, chemical thinners, growth regulators, microbial agents, pheromones,
rodenticides, and soil fumigants. Exclude seed treatments, foliar applications of nutrients, and applications made to vegetables after harvest.)
OFFICE USE
LINES IN TABLE
1
2
L
I
N
E
CHEMICAL
PRODUCT NAME
CROP
CROP
CODE
TABLE
001
399
3
4
5
What products
were applied
to the [crop]?
Was this
product
bought in
liquid or
dry form?
Was this
part of a
tank mix?
[Enter product code.]
[Enter L or D.]
[If tank mix, enter
line number
of first product
in mix.]
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicide, Insecticide, Fungicide, etc.)
Trade Name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 20 -
D
PESTICIDE APPLICATIONS
D
CODES FOR COLUMN 8
1 POUNDS
14 PINTS
30 GRAMS
46 SPIRALS
12 GALLONS
15 OUNCES, LIQUID
40 KILOGRAMS
47 PACKETS
13 QUARTS
28 OUNCES, DRY
41 LITERS
50 OTHER (Specify_____________)
6
L
I
N
E
OR
How much
was applied
per acre per
application?
7
What was the
total amount
applied per
application?
8
9
10
[Enter unit code
from above.]
How many acres
were treated
with this product?
How many times
was it applied?
CODE
01
02
65
73
. ___ ___
65
65
73
65
10
11
12
13
14
79
77
79
. ___
74
77
79
. ___ ___
73
. ___
74
77
79
. ___ ___
73
. ___ ___
. ___
74
77
79
. ___ ___
73
. ___ ___
65
77
. ___
74
73
. ___ ___
15
79
. ___ ___
. ___ ___
65
77
. ___
74
73
65
79
. ___ ___
. ___ ___
65
77
. ___
74
73
65
79
. ___ ___
. ___ ___
65
77
. ___
74
73
65
79
. ___ ___
. ___ ___
09
77
. ___
74
73
65
79
. ___ ___
. ___ ___
08
77
. ___
74
73
65
79
. ___ ___
. ___ ___
07
77
. ___
74
73
65
79
. ___
. ___ ___
. ___ ___
06
. ___
74
73
65
77
. ___ ___
. ___ ___
05
74
. ___
74
77
79
. ___ ___
73
. ___ ___
NUMBER
79
. ___ ___
. ___ ___
04
77
. ___ ___
73
. ___ ___
03
ACRES
74
. ___
74
77
79
. ___ ___
. ___
[For pesticides not listed in Respondent Booklet, specify---]
Pesticide Type
Line No.
(Herbicide, Insecticide, Fungicide, etc.)
Tradename
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 21 -
D
PESTICIDE APPLICATIONS
1
2
L
I
N
E
CHEMICAL
PRODUCT NAME
CROP
CROP
CODE
D
3
4
5
What products
were applied
to the [crop]?
Was this
product
bought in
liquid or
dry form?
Was this
part of a
tank mix?
[Enter product code.]
[Enter L or D.]
[If tank mix, enter
line number
of first product
in mix.]
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
61
63
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicide, Insecticide, Fungicide, etc.)
Trade Name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 22 -
D
PESTICIDE APPLICATIONS
D
CODES FOR COLUMN 8
1 POUNDS
14 PINTS
30 GRAMS
46 SPIRALS
12 GALLONS
15 OUNCES, LIQUID
40 KILOGRAMS
47 PACKETS
13 QUARTS
28 OUNCES, DRY
41 LITERS
50 OTHER (Specify_____________)
6
L
I
N
E
OR
How much
was applied
per acre per
application?
7
8
9
10
What was the
total amount
applied per
application?
[Enter unit code
from above.]
How many acres
were treated
with this product?
How many times
was it applied?
CODE
16
17
18
19
65
73
. ___ ___
65
73
65
27
28
29
30
31
77
79
. ___
74
77
79
. ___
74
77
79
. ___ ___
73
. ___
74
77
79
. ___ ___
73
. ___ ___
. ___
74
77
79
. ___ ___
73
. ___ ___
65
79
. ___ ___
. ___ ___
33
77
. ___
74
73
65
79
. ___
74
73
. ___ ___
32
77
. ___ ___
. ___ ___
65
79
. ___
74
73
65
77
. ___ ___
. ___ ___
65
79
. ___
74
73
65
77
. ___ ___
. ___ ___
65
79
. ___
74
73
65
77
. ___ ___
. ___ ___
26
79
. ___
74
73
65
77
. ___ ___
. ___ ___
25
79
. ___
74
73
65
77
. ___ ___
. ___ ___
24
79
. ___
74
73
65
77
. ___ ___
. ___ ___
23
74
73
65
79
. ___
. ___ ___
. ___ ___
22
77
. ___ ___
73
65
79
. ___
74
73
. ___ ___
21
77
. ___ ___
. ___ ___
65
. ___
74
73
. ___
74
77
79
. ___ ___
73
. ___ ___
NUMBER
79
. ___ ___
. ___ ___
65
ACRES
77
. ___ ___
. ___ ___
20
74
. ___
74
77
79
. ___ ___
. ___
[For pesticides not listed in Respondent Booklet, specify---]
Line No.
Pesticide Type
(Herbicides, Insecticides, Fungicides, etc.)
Trade name
and Formulation
Form Purchased
(Liquid or Dry)
EPA Reg. No.
- 23 -
E
PEST MANAGEMENT PRACTICES
E
Now I have some questions about pest management practices
you may have used on any of the total vegetable acres
on this operation. (Include both target and non-target vegetable crops grown.)
By pests, we mean insects, weeds, and diseases.
1. [Enumerator Action: Were PESTICIDE APPLICATIONS reported in Section B, column 5 on page 5?]
YES - [Continue.]
No - [Go to item 5.]
CODE
2. Was weather data used to assist in determining either the need or
when to make pesticide applications?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
600
YES = 1
3. Were any biological pesticides such as Bt (Bacillus thuringiensis),
insect growth regulators (Courier, intrepid, etc.), neem or other
natural/biological based products sprayed or applied to manage pests?. . . . . . . . . . . . . . . . .
YES = 1
4. Were pesticides with different mechanisms of action rotated or tank
mixed for the primary purpose of keeping pests from becoming
resistant to pesticides?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
601
602
1 By deliberately going to the vegetable acres specifically
for scouting activities. (Enter code 1 and go to item 6.)
5. In 2014, how were your
vegetable acres primarily
scouted for insects, weeds,
diseases and/or beneficial
organisms? . . . . . . . . . . . . . . . .
2 By conducting general observations while performing
routine tasks. (Enter code 2 and go to item 8.)
608
.............
3 The vegetable acres were not scouted.
(Enter code 3 and go to item 11.)
6. Was an established scouting process used (systemic sampling,
recording counts, insect traps, etc.) on any vegetable acres?. . . . . . . . . . . . . . . . . . . . . . . . .
609
YES = 1
7. Was scouting for pests done on these vegetable acres due to--610
a. a pest advisory warning?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
b. a pest development model?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
611
2
1
[If column 1 is YES, ask---]
Who did the majority
of the scouting for [column 1]—
1
2
3
4
5
6
8. Were your vegetable acres scouted for –-YES = 1
a. weeds?. . . . . . . . . . . . . . . . . . . . . . . . . .
b. insects and mites?. . . . . . . . . . . . . . . . .
c.
disease?. . . . . . . . . . . . . . . . . . . . . . . . .
Operator, partner or family member
An employee
Farm supply or chemical dealer
Independent crop consultant or commercial scout
Processor
Other (specify: __________________________ )
CODE
612
614
615
617
618
620
- 24 -
E
PEST MANAGEMENT PRACTICES
E
CODE
9. Were written or electronic records kept to track the activity or
numbers of weeds, insects or diseases?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
10. Was scouting data compared to published information on infestation
thresholds to determine when to take measures to manage pests?. . . . . . . . . . . . . . . . . . . . .
YES = 1
11. Was field mapping data used for making pest management decisions?. . . . . . . . . . . . . . . . .
YES = 1
12. Were the services of a diagnostic laboratory used for pest identification or
soil or plant tissue pest analysis?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
13. Were crop residues plowed down or removed to manage pests?. . . . . . . . . . . . . . . . . . . . . .
YES = 1
14. Were crops rotated during the past three years for the purpose of managing pests?. . . . . . .
YES = 1
15. Were ground covers, mulches, or other physical barriers
maintained to manage pest problems?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
16. Was a crop variety chosen because it had resistance to a specific pest?. . . . . . . . . . . . . . . .
YES = 1
17. Was no-till or minimum till used to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
18. Were planting locations planned to avoid infestation of pests?. . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
19. Were planting or harvesting dates adjusted to manage pests?. . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
20. Were row spacing or plant density adjusted to manage pests?. . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
21. Was a trap crop grown to help manage insects?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
22. Were any beneficial organisms (insects, nematodes, fungi)
applied or released to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
23. Were floral lures, attractants, repellants, pheromone traps or
other biological pest controls used on any vegetable acres?. . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
24. Were any vegetable acres cultivated for weed control during the growing season?. . . . . . . . .
YES = 1
25. Were field edges, lanes, ditches, roadways or fence lines chopped,
mowed, plowed, or burned to manage pests on any vegetable acres?. . . . . . . . . . . . . . . . . .
YES = 1
26. Were equipment and implements cleaned after completing
field work to reduce the spread of pests?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
27. Were any vegetable acres irrigated for the 2014 crops?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
623
624
625
626
627
628
629
630
631
632
633
634
635
636
637
640
642
643
644
a. [If item 27 = YES, ask---]
Were water management practices (excluding chemigation)
such as irrigation scheduling, controlled drainage, or treatment
of retention water used to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
COMPLETION CODE for
FERTILIZER APPLICATIONS
1 Incomp/R
3 Valid Zero
200
COMPLETION CODE for
PESTICIDE APPLICATIONS
1 Incomp/R
3 Valid Zero
300
645
YES = 1
COMPLETION CODE for
PEST MANAGEMENT PRACTICES
1 Incomp/R
500
- 25 -
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MICROBIAL FOOD SAFETY PRACTICES
F
The next few pages contain questions that ask about your operation’s total produce acreage, in addition to the fruit covered
previously, regardless of the state where that acreage is located. Exclude any acreage outside of the U.S. For the
purposes of this part of the survey, produce includes: fruit, berries, vegetables, herbs, tree nuts, dry beans, peas and
lentils, peanuts, sprouts, and mushrooms. These questions only ask about food safety practices with respect to microbial
contamination.
Acres
1. In 2015, how many acres on your operation were used to grow produce? (Include each acre only
once even if multiple crops were grown on it.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
2. Including multi-cropped acres, how many total acres of produce were grown on your operation
in 2015?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
.__
.__
3. What produce crops grown on your operation made up the most acreage in 2015, and how were they sold? Report the
top five crops starting first with the one that made up the most acreage in row (a).
1
Crop
2
3
Acres
Direct-toConsumer
Sales
4
5
6
Fresh market
Fresh-cut
market
Processed
market
(Percent)
(Percent)
(Percent)
(Percent)
(include multicropped acres)
(Number)
xxx
Non Direct-to-Consumer Sales
xxx
xxx
a.
xxx
xxx
%
xxx
xxx
xxx
b.
xxx
xxx
xxx
xxx
xxx
c.
xxx
d.
xxx
xxx
e.
%
xxx
xxx
% 100%
xxx
%
%
xxx
%
% 100%
xxx
%
%
xxx
%
xxx
xxx
% 100%
xxx
%
%
xxx
%
xxx
%
xxx
xxx
%
% 100%
xxx
%
%
% 100%
4. Over the last three years, 2012-2014, what was your operation’s average annual gross value of all produce sales?
xxx
1
Less than $25,000
4
$500,000 to $999,999
7
$10,000,000 to $19,999,999
2
$25,000 to $249,999
5
$1,000,000 to $4,999,999 8
$20,000,000 to $39,999,999
3
$250,000 to $499,999
6
$5,000,000 to $9,999,999 9
$40,000,000 and above
[If the value of sales reported in Item 4 is less than $500,000, continue; otherwise go to Item 6]
5. Over the last three years, 2012-2014, was your operation’s average annual gross value of
food sales (including your produce sales) less than $500,000? Food includes articles used
for food or drink for humans or other animals. . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .
xxx
1
None
6. In 2015, how many of your operation’s produce acres were either certified organic or in
transition to become certified?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
3
No
Acres
xxx
.__
7. In 2015, were commercial livestock located adjacent to your produce acreage on land:
a. You operate? (Include livestock on your produce acreage) . . . . . . . . . . . . . . . . . . . . . . .
b. Someone else operates? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
1
Yes
3
No
1
Yes
3
No
xxx
- 26 -
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MICROBIAL FOOD SAFETY PRACTICES
F
8. In 2015, which of the following activities were completed for your operation’s produce and where were they done?
1
Activity
2
3
4
On your produce
operation
Off your produce
operation
Did you have an
ownership interest in this
activity?
YES = 1
a. U-Pick
b. Harvest
c.
Field Pack
d. Pack (other than field pack)
e. Cool
f.
Wash
g. Hold/Store/Warehouse
h. Fresh Cut
i.
Other processing (freezing,
canning, juicing)
YES = 1
YES = 1
YES = 1
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
9. Excluding any direct-to-consumer sales, do you sell your own produce to retailers,
foodservice, wholesalers, terminal markets, etc, instead of letting another firm (shipper, sales
agent, marketer, etc.) sell for you? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
1
Yes
3
No
1
Yes
3
No
10. Do you have a food safety plan that covers your produce operation in 2015?
xxx
1
Yes – Continue
3
No – Go to Item 12
xxx
a. Is the food safety plan written?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. In 2015, did your food safety plan cover all of your produce commodities?
xxx
1
2
Yes – Go to Item 12
No – Continue
Plans
xxx
a. How many different food safety plans did you have for your produce commodities in 2015?. . . . . . . .
12. Did you have any third party food safety audits that covered your produce operation in 2015?
xxx
1
Yes – Go to Item 13
3
No – Continue
N/A
a. What was the most recent year you had a third party food safety audit
that covered your produce operation? Then go to Item 16 . . ..
Year (YYYY)
xxx
- 27 -
F
MICROBIAL FOOD SAFETY PRACTICES
F
13. Which of the following types of microbial third party food safety audits covered your
produce operation in 2015?
xxx
a. Produce farm/ranch (field) audit. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Yes
3
No
1
Yes
3
No
1
Yes
3
No
1
Yes
3
No
1
Yes
3
No
xxx
b. Produce harvesting crew. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
c. Produce packinghouse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
d. Produce cooler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
e. Other (Specify: xxx _________________________________________________). . . . . .
14. How many of the following types of third party food safety audits covered your produce operation in
2015?
None
Number
a. Global Food Safety Initiative benchmark audit (Primus GFS, Safe Quality Food (SQF),
Global Gaps, Canada Gap, British Retail Consortium (BRC)). . . . . . . . . . . . . . . . . . . . . .
xxx
b. Other general private audit that is not benchmarked to the Global Food Safety Initiative
(Primus, AIB, SCS, etc.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
xxx
c.
Addendum to standard audit for a particular buyer or processor. . . . . . . . . . . . . . . . . . . . . .
xxx
d. Stand-alone buyer-specific audit you pay for (excluding addendum). . . . . . . .. . . . . . . . . . .
xxx
e. California or Arizona Leafy Greens Marketing Agreement audit . . . . . . . . . . . . . . . . . . . . . .
xxx
f.
California Cantaloupe Advisory Board food safety standard audit . . . . . . .. . . . . . . . . . . . .
xxx
g. Tomato Food Safety Audit Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
h. USDA audit service which may be administered by a State Department of Agriculture
(GAP’s, GHP’s, Harmonized Gaps, or others). . . . . . . . . . . . . .. . . ………………………….
xxx
i.
Other (Specify: xxx ____________________________________________________). . . .
Dollars
15. What was the total amount you paid for the third party food safety audits that covered your
produce operation in 2015? (Include costs of belonging to CA and AZ LGMA and the CA
Cantaloupe Advisory Board. Exclude the costs of preparing for audits and the costs of
implementing changes afterwards. Exclude organic certification audits) . . . . . . . . . . . . . . . . . . . .
xxx
- 28 -
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MICROBIAL FOOD SAFETYPRACTICES
F
16. Which of the following types of water were used during the production, harvest, and post-harvest activities of your
operation’s produce in 2015? Use the response codes listed in the table at the bottom of the page.
1
2
3
4
5
How often did you test
the water from this
source in 2015 for
microbial content
(generic E. coli or other
indicator)? If code 7 or
8, go to column 5.
What water
standard did you
consider
acceptable?
What did you
use to treat this
water in 2015?
Water Use
What was the
largest source (in
terms of volume) of
water used for this
activity?
(See
column 4 code
below)
(See
column 5 code
below)
YES = 1
(See column 2 code
below)
(See column 3 code below)
a. Water used during production xxx
that does not touch the
harvested part of the crop
(furrow, drip, flood irrigation,
etc.)
xxx
xxx
xxx
xxx
b. Water used during production xxx
that touches the harvested
part of the crop (overhead
irrigation; pesticide/fungicide
applications; frost protection,
etc.)
xxx
xxx
xxx
xxx
xxx
Water used for harvest and
post-harvest activities
(including packing) where
water touches the produce or
a food contact surface
(hydrating, washing or cooling
produce; cleaning food
contact surfaces on tools or
machinery)
xxx
xxx
xxx
xxx
c.
RESPONSE CODES
1
2
3
4
5
6
7
8
Column 2
Column 3
Column 4
Column 5
Water Source Code
Frequency of Testing
During 2015 Code
Water Test Standard Code
Water Treatment
Code
Standing surface water
(ponds, lakes, reservoirs)
Flowing surface water (rivers,
canals, streams, irrigation
ditches)
Ground water (wells)
Public water system with
potable water
Treated waste water
Reclaimed tail water
Don’t know
Other: (Specify:
(___________________)
1
2
Once a year
Once every four
months
3 Once every three
Months
4 Once every two
months
5 Once every month
6 More often than once
a month
7 Water is never tested
8 N/A – Rely on
someone else’s tests
of this operation’s
water
9. Don’t know
10 Other: (Specify:
________________)
1
Normal or expected range based
on historic water samples
2 EPA Recreational Water Standard
(1986 or 2012 standard)
3 Leafy Greens Marketing Agreement
(LGMA) standard for water that
does not touch the harvested part of
the crop
4 Maximum of 1,000 E. coli CFU/mL
5 Maximum of 500 E. coli CFU/mL
6 EPA drinking water standard which is
no generic E. coli
7 Reclaimed water standard
8. Don’t know
9. Other: (Specify:
____________________)
1
2
3
4
5
6
Chemical
Ultra violet light
Filtration
N/A – didn’t treat
Don’t know
Other (Specify:
_______________)
- 29 -
F
MICROBIAL FOOD SAFETY PRACTICES
F
[If water tests were reported in Item 16, column 3 (codes 1, 2, 3, 4, 5, 6, 10), or water treatments in column 5
(codes, 1, 2, 3, 6) continue; otherwise go to Item 20]
For Items 17, 18, and 19, please consider all of the water sources used on your produce operation,
not just the largest source of water.
Number
17. How many total water tests for microbial contamination were conducted, or do you expect to have,
conducted, on your produce operation in 2015? (Include all tests on all water sources). . . . . . . . . .
xxx
18. What will be the total cost of all water tests on all water sources conducted for microbial
contamination on your produce operation in 2015? (Include lab costs, material costs (vials, etc.),
labor, and transportation costs.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
Dollars
None
Dollars
xxx
19. What will be the total costs in 2015 for water treatments? Include supplies, other
treatment costs, and labor.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
20. Were any of the following animal manure products applied to the produce acreage on your operation in 2015?
1
2
3
Manure Product
Is the compost made using a
method validated by a
scientifically recognized,
controlled microbial process that
is actively managed and meets
time/temperature requirements
from EPA?
What documentation do you have to
indicate the microbial content of your
manure products or the process used
to produce it?
YES = 1
xxx
xxx
a. Composted manure made on
your farm
1
3
2
xxx
xxx
1
b. Composted manure
purchased from others
Yes
No
Don’t know
3
2
Yes
No
Don’t know
Check all that apply
xxx
xxx
xxx
xxx
Time/temperature measurements
Microbial testing results
Other
None
xxx
xxx
xxx
xxx
xxx
Time/temperature measurements
Microbial testing results
Certificate of Conformance
Certificate of Analysis
Approved by an organic certifying
agent
Other
None
xxx
xxx
xxx
c.
xxx
xxx
Time/temperature measurements
Microbial testing results
Certificate of Conformance
Certificate of Analysis
Approved by an organic certifying
agent
Other
None
xxx
xxx
xxx
xxx
Microbial testing results
Other
None
xxx
xxx
xxx
xxx
Microbial testing results
Other
None
Manure treated with a physical
or chemical process
(pasteurization, heat drying,
alkali stabilization, etc.)
d. Decomposed manure (stored
or aged in stacks)
e. Raw manure
xxx
xxx
xxx
xxx
xxx
21. In 2015, was a pre-harvest assessment of the produce acres done within 3 days of harvest
in order to identify potential microbial contamination problems?. . . . . . . . . . . . . . . . . . . . . .
xxx
1
Yes 3
No
- 30 -
F
MICROBIAL FOOD SAFETY PRACTICES
F
xxx
22. How many days long was the produce harvest season in 2015? . . . . . . . . . . . . . . . . . . . . . . .
23. In 2015, did this operation pack or package any produce?
xxx
Yes - Continue 3
1
No – Go to Item 24
Days
xxx
a. How many days long was the produce packing season in 2015? . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
b. In 2015, did this operation pack or package produce in the field? . . . . . . . . .. . . . . . . . . . ..
c.
1
Yes 3
No
In 2015, did this operation pack or package produce in a packing house or packing shed?
xxx
1
Yes – Continue
3
No – Go to item 24
d. Which of the following best describes the structures where this operation packed or packaged fresh produce
in 2015? (Check all that apply)
xxx
1
2
3
4
5
6
A floor, such as a concrete slab, driveway, parking lot, etc.
A roof and a floor, such as a concrete slab
A floor, roof, and some walls or screening but not an enclosed structure
Enclosed structure with openings, such as unscreened doors or windows
Completely enclosed structure
Other (Specify: xxx_______________________________________)
24. Which of the following types of items that touched this crop during the 2015 season were used on this produce
operation? How often were the items cleaned and sanitized? Exclude items used during harvest or postharvest if this
crop was custom harvested or packed by someone else.
1
2
3
How often is this
item cleaned?
[Use Frequency
Code table below]
Item that TOUCHES the crop
a.
b.
Tools used for harvesting and/or field
packing
Machinery used for harvesting and/or field
packing
c.
Tools used during packing or handling in a
packing house
d.
Fixed machinery and work surfaces in postharvest handling (mechanical sorter, work
surface, dunk tanks, flumes, etc.)
e.
f.
Reusable containers or bins used during
harvest
Reusable containers or bins used only to
transport the crop from the field to a
packinghouse
xxx
How often is this item Does this item contain any
sanitized
food contact surface made
(disinfected)?
of foam, paper, cardboard,
[Use Frequency Code wood, carpeting, or canvas?
table below]
(Code)
YES = 1
xxx
4
(Code)
xxx
xxx
1
3
2
xxx
xxx
xxx
xxx
1
3
2
xxx
xxx
xxx
xxx
1
3
2
xxx
xxx
xxx
xxx
1
3
2
xxx
xxx
xxx
xxx
1
3
2
xxx
xxx
xxx
xxx
1
3
2
Yes
No
Don’t know
Yes
No
Don’t know
Yes
No
Don’t know
Yes
No
Don’t know
Yes
No
Don’t know
Yes
No
Don’t know
Frequency Code
1 - Daily
2 - Weekly
3 - Monthly
4 - Once a season
5 - N/A
6 - Never
7 – Other: (Specify ______________)
- 31 -
F
MICROBIAL FOOSD SAFETY PRACTICES
F
None
Dollars
xxx
25. In 2015, what will be the total cost of cleaning and sanitizing the items in Item 25?
Include supplies and labor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
26. In 2015, did your operation have a designated person with the primary responsibility for microbial
food safety?
xxx
1
Yes - Continue 3
No – Go to Item 27
Percent
xxx
a. What percent of this person’s daily time was spent on food safety in 2015? . . . . . . . . . . . . . . . . . .
27. In 2015, how many other people (excluding the one reported in Item 26) were on your microbial food
safety staff? Exclude managers and others who have only a small share of their time on food safety
and are not primarily responsible for day-to-day food safety on your operation. Exclude people only
involved in food quality or quality assurance activities.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Number
xxx
[If Item 27 equals zero, go to Item 28; otherwise continue.]
Number
a. Of the (item 27) people on your food safety staff, how many were working full time on microbial
food safety during the season?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
28. In 2015, did you hire an outside microbial food safety consultant to develop or implement
your food safety plan? . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xxx
xxx
1
Yes 3
No
29. Which of the following types of people were used to harvest produce on your operation in 2015?
1
People
2
3
4
5
How many of
these people
were used to
harvest produce
on your
operation in
2015?
How many of these
people were trained
on microbial food
safety by your
operation in 2015? If
contract crews are
trained by someone
else, exclude them.
What was the
average number of
minutes of microbial
food safety training
that your operation
provided for these
people in 2015?
What were the total
training costs for visual
aids, signage,
notebooks, software
packages, and hired
trainers (instead of your
own staff trainers), etc.
for these people?
Include costs to instruct
customers at u-pick
operations about safety
while on your operation.
[If zero, go to
column 5]
YES = 1
(Number)
(Number)
(Dollars)
a. Customer
(e.g. Pick-your-own)
xxx
xxx
xxx
xxx
b. Unpaid labor including
family and volunteers
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
c.
Direct hire
d. Contract harvest crew
F
(Number)
xxx
MICROBIAL FOOD SAFETY PRACTICES
F
- 32 -
30. During the 2015 produce harvest season, did your operation provide toilets or handwashing sinks within one-quarter
mile of the produce field for those harvesting produce? Include portable facilities in the field, access to facilities in
nearby buildings, and facilities for u-pick operations.
1
Facility
2
3
During the 2015 produce harvest season,
how many of each facility were provided
to harvesters within one-quarter mile of
the produce field?
For how many days were these
facilities provided to people
harvesting produce?
(Number)
(Number)
YES = 1
xxx
xxx
xxx
xxx
xxx
xxx
a. Toilet/Port-a-potty
b. Hand washing sink
31. Which of the following methods were used on your produce operation to reduce the potential of uncontrolled water
runoff into the produce fields in 2015? Check all that apply.
xxx
xxx
xxx
xxx
xxx
xxx
xxx
Ditch
Berm
Vegetative buffer strip
Evaporation pond
Retention system or retention pond
Drainage system
Other (Specify: xxx_______________________________________)
xxx
32. In 2015, did you monitor your field to check for potential animal intrusion? . . . . . . . . . . . . . .
1
Yes
3
No
33. Which of the following methods were used on your produce operation to reduce potential animal intrusion into the
produce fields in 2015? Check all that apply.
xxx
xxx
xxx
xxx
xxx
xxx
xxx
Put up fencing around the fields
Put up fencing around standing surface water
Remove animal harborage and attractants (removing excess brush, old equipment, and cull piles)
Trap or shoot animals
Employ animal deterrents such as noise makers (including gunfire), Mylar strips, fake owls or coyotes, and
repellants
Clear a buffer zone around your field to increase your ability to detect animal intrusion
Other (Specify: xxx_______________________________________)
34. Have you heard of the Food Safety Modernization Act (FSMA) Proposed Rule for Produce Safety?
xxx
1
Yes - Continue 3
No – Go to Section G
35. Which of the following sources have you used for information on the Food Safety Modernization Act (FSMA) Proposed
Rule for Produce Safety? Check all that apply.
xxx
xxx
xxx
xxx
xxx
xxx
xxx
xxx
Produce/agricultural news
The FSMA legislation or proposed rules
FDA listening sessions, public meetings, webinar, or FSMA website
Produce Safety Alliance
University training/extension/education meetings
Commodity organization training/education meetings.
Neighbors or other growers
Other (Specify: xxx_______________________________________)
- 33 -
CONCLUSION
SURVEY RESULTS
1. To receive the complete results of this survey on the release date, go to
www.nass.usda.gov/results/. Would you rather have a brief summary
mailed to you at a later date? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CODE
9990
YES = 1
[Thank the respondent, then review this questionnaire.]
005
ENDING TIME [MILITARY]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
___ ___ ___ ___
OFFICE USE
TIME IN HOURS
006
. ___
RECORD USE
CODE
064
Did respondent use operation records to report pesticide data?. . . . . . . . . . . . . . . . . . . . . . . .
YES = 1
SUPPLEMENT USE
Record the total number of supplements used to complete this interview.
NUMBER
067
Fertilizer Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
068
Pesticide Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9911
9910
___ ___ ___ ___ ___ ___
Reported by: ________________________________
M
M
D
D
Y
Y
Telephone: ________________________
OFFICE USE
R. Unit
9921
Ptr 1 Str
9922
Response
1-Comp
2-R
3-Inac
4-Office Hold
Ptr 2 Str
9923
Ptr 3 Str
9927
Respondent
9901
1-Op/Mgr
2-Sp
3-Acct/Bkpr
4-Partner
9-Other
9902
Ptr 4 Str
9928
OPS
923
Mode
2-Tel
3-Face-to-Face
SSO 1
9907
ADJ
922
Enum.
9903
9998
Optional Use
9906
9916
POID
9989
___ ___ ___ ___ ___ ___ ___ ___ ___
Eval.
9900
Change
9985
| File Type | application/pdf |
| Author | millbr |
| File Modified | 2015-04-20 |
| File Created | 2015-04-20 |