ACP-3 Failed Lot Disposition and Rework Report

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
Administrative Committee for Pistachios (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:
Product Shipped To:
Address:
Description of use:
B2. Export:
Customer:
Address:

Pounds shipped:

BL No.:
Phone No.:

Pounds shipped:

BL No.:
Country:

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:
Address:

Pounds shelled:

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
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instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information.
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ACP-3 (Rev. 05/2014. Destroy previous editions.)