Document

Telephone Quality Control Worksheet - Vegetables

ICR 201804-0535-002 · OMB 0535-0218 · Object 82893101.

Document Viewer [docx]

Status: Original and derived artifacts are available for this document.

Download: docx | pdf | html

Primary: docxSource: application/vnd.openxmlformats-officedocument.wordprocessingml.document
Loading document viewer…

Document Metadata

Record metadata
application/vnd.openxmlformats-officedocument.wordprocessingml.document
Telephone Quality Control Worksheet - Vegetables
Carol Pinto
Writer
2018-05-07
2026-11-04
complete

Extracted Text


NATIONAL AGRICULTURAL STATISTICS
SERVICE
TELEPHONE QUALITY
CONTROL WORKSHEET
for
20XX VEGETABLE CHEMICAL USE SURVEY
Form Approved
OMB Number 0535-0218
Approval Expires XX/XX/XXXX
Project code 136
U.S. Department of Agriculture
Rm 5829, South Building
1400 Independence Avenue, S.W.
Washington, D.C.  20250-2000
1-800-727-9540
Fax:  202-690-2090
E-mail: [email protected]



State:  _________________________________________________

Farm, Ranch, or
Operation Name:  __________________________________________
Version:

Operator’s name:  __________________________________________
ID/POID:  ______________________________________________

Address:  __________________________________________________
Enumerator:  __________________________________________

		   __________________________________________________



Interview Date & Time:  ________________________________

Telephone:  ________________________________________________
Survey Respondent:  __________________________________
  Operator/Mgr    Spouse    Accountant/    Partner    Other
								 Bookkeeper
Current Respondent:  __________________________________
  Operator/Mgr    Spouse    Accountant/    Partner    Other
								 Bookkeeper





















INTRODUCTION:
[Introduce yourself, and ask for the survey respondent.  Rephrase in your own words.]

Recently you should have been contacted by one of our interviewers, Mr./Ms.						,
for the Vegetable Chemical Use Survey.  This telephone call is part of our survey quality assurance measures
to verify that personal contact was actually made with you for that purpose.  Your response is voluntary and not required by law, but your cooperation will be appreciated.  Facts about your farm/ranch will be kept confidential.





















1.	During the past few days, do you recall an interview with Mr./Ms.					, for the purpose of obtaining information about your farming or ranching operation?
   YES - [Go to item 3.]
   NO - [Go to item 2.]
   DON'T REMEMBER - [Go to item 2.]
2.	During the past few days, did any other person from the 						 Agricultural Statistics Service, NASS, or USDA, interview you to obtain information about your farm or ranch?
   YES - [Go to item 3.]
   NO - [Conclude interview.]
   DON'T REMEMBER - [Conclude interview.]
3.	Did the person conducting the interview ask you to verify the spelling of your name, address
	and the operation name?
   YES
   NO
   DON'T REMEMBER
[Continue on back.]



4. 	Now I need to verify items that are critical to our survey procedures.

Reported
Verified

a. 	Total acres of all vegetables (Section A, item 4)

_______________________


_______________________


b. 	Chemical applications to target vegetables

None, Positive


None, Positive











5. 	Did Mr./Ms. 					 conduct the interview in a knowledgeable and professional manner?
 YES
 NO – Explain:  ____________________________________________________________________________________________________
			   ____________________________________________________________________________________________________
			   ____________________________________________________________________________________________________

6. 	Do you have any additional comments you would like to make concerning our survey contact?
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
This concludes the interview.  Thank you for your help.

Signature:___________________________________________________
Date:____________________________________________________