Form 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: 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.

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Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.

ACP-3 (Rev. 05/2017. Destroy previous editions.)