PSD- 4400 Vehicle Scale Test Report

OMB Control No. 0581-0308

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FAIR TRADE PRACTICES PROGRAM
PACKERS AND STOCKYARDS DIVISION

1 Page

Vehicle Scale Test Report

2a. Test Agency

3a. Scale Owner

b. Address

b. Physical Address of Scale

c. City

d. State

c. City

d. State

e. Phone

f. E-mail

4. Name and Address of Poultry Processor, Packer, or Dealer using Scale

5. Indicator Manufacturer

6. Serial Number

7. Model Number 8. Type of Indicator
Beam
Dial
Digital
9. Primary Category Weighed
10. Type of System
Poultry
Feed
Livestock
Straight
Truss
Pipe
Pipe and Load Cell
4 Cells
6 Cells
14. Minimum Division
15. Platform Size
11. Test Date (mm/dd/yyyy)
12. Previous Test Date (mm/dd/yyyy) 13. Scale Capacity
Lbs
Lbs
X

Test Data
16. Test Data
Position
(16a)
Balance

Weight
(16b)

16. Test Data

Scale Indication (lbs)
(16c)

Position
(16a)

Error
(16d)

1

Section 1

Weight
(16b)

2

10
9
Strain-Load Test
Left to Right
Section 2
Section 3

Scale Indication (lbs)
(16c)

17. Test load bearing points
3
4
8

Section 4

7

Error
(16d)

5
6

Right to Left
Section 5

Section 6

18 Indicated Weight of Empty Truck
19 Amount of Test Weight Added
20 Scale Indication, Truck Plus Weights
21 Error on Test Weights Added

22 Test Results Marking approved indicates that the errors indicated on this test report are within the accuracy
requirements specified in National Institute of Standards and Technology (NIST) Handbook
44 as required in the regulations (9 CFR 201.71)

Approved
Condemned
Rejected
Other ___________

23 Remarks (If serial number has changed, please note here)

24 Receipt of Report Acknowledged (Signature):

25 Scale Inspector (Signature):

Response is required in order to assure that tests and inspections have been made on scales to show their accuracy so that live poultry, feed or
livestock may be weighed (9 CFR 201.72). Information held confidential (9 CFR 201.96)

Form PSD 4400

Expires 02/28/2021

Page 1 of 4

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 is 0581-0308. The time required to complete
this information collection is estimated to average .75 hours 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.

In accordance with Federal law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from
discriminating on the basis of race, color, national origin, sex, age, disability, and reprisal or retaliation for prior civil rights activity. (Not all prohibited bases
apply to all programs.) 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 State or local Agency that administers the program 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 is also available in
languages other than English.
To file a complaint alleging discrimination, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html, or 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: (a)
mail:U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (b)
fax:(202) 690-7442; or (c) email: [email protected].

Form PSD 4400

Expires 02/28/2021

Page 2 of 4

Instructions to Complete Vehicle Scale Test Report Form PSD 4400
The scale inspector or person testing the scale must complete Form PSD 4400 to document the scale
tests required by the Packers and Stockyards Division.
Submit the completed form to the appropriate regional office of the Packers and Stockyards Division
that covers your state, as listed below.
If you have any questions regarding this form, please contact the appropriate regional office of the
Packers and Stockyards Division listed below. If additional forms are needed, please visit our
website at https://www.ams.usda.gov/.

Regional Offices of the Packers and Stockyards Division
Agricultural Marketing Service, Fair Trade Practices Program
Atlanta Regional Office
75 Ted Turner Dr, SW, Suite 230
Atlanta, GA 30303-3308
Telephone: (404) 562-5840
FAX: (404) 562-5848
e-mail:
[email protected]
States Covered
AL, AR, CT, DC, DE, FL, GA,
LA, MA, MD, ME, MS, NC, NH,
NJ, NY, PA, PR, RI, SC, TN,
VA, VT, WV

Line No.

1

2
a
through
f
3
a
through
d
4

5

Form PSD 4400

Denver Regional Office
3950 Lewiston St., Suite 200
Aurora, CO 80011-1556
Telephone: (303) 375-4240
FAX: (303) 371-4609
e-mail:
[email protected]
States Covered
AK, AZ, CA, CO, HI, ID, KS,
MT, NM, NV, OK, OR, TX,
UT, WA, WY

Subject

Page Number

Scale Test Agency

Des Moines Regional Office
210 Walnut Street, Room 317
Des Moines, IA 50309-2110
Telephone: (515) 323-2579
FAX: (515) 323-2590
e-mail:
[email protected]
States Covered
IA, IL, IN, KY, MI, MO, MN,
ND, NE, OH, SD, WI

Instruction

The page number is normally 1 of 1. If additional space is
needed, number pages identifying the current page number
and the total number of pages. For example, page 2 of 3.
Enter the name, address, city, state, phone number, and email address of the scale test agency.

Scale Owner and
Location

Enter name of firm that owns or operates the scale and the full
address of scale being tested, including street address, city, and
state.

Processor,
Packer, or
Dealer Name
Indicator
Manufacturer

Enter name and address of poultry processor, packer, or dealer
using scale.
Enter the name of the manufacturer of the beam, dial or digital
indicator

Expires 02/28/2021

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Line No.

Subject

Instruction

6

Serial Number

7

Model Number

Enter the serial number of the indicator being tested. If the
serial number has changed since the last test, show the previous
serial number in the remarks.
Enter the model number from the manufacturer’s ID plate.

8

Type of Indicator

Check the appropriate box to indicate the type of indicator.

9

Category Weighed

Check the appropriate box to indicate the category weighed

10

Type of System

Check the appropriate boxes to indicate the type or design of
the lever system or load cell.
Enter the date you tested the scale (mm/dd/yyyy).
Enter the date the scale was previously tested (mm/dd/yyyy).
Enter the total scale capacity (maximum nominal capacity), in
Enter minimum graduation. For example, 10 lbs., or 20 lbs.
Enter length and width of platform, in feet.
It is important that you conduct the test in accordance with
Handbook 44 procedures and that you fill out the test report
in the sequence and in the manner you conduct the test. If you
begin a test and determine that the scale is defective, and then
correct the defective condition, record this in sequence on the
test report. Enter each of the following in the respective
columns:
(a) The location or position on the platform (left to
right looking from the scale indicator) used for the
test.
(b) The total amount of test weights on the scale, in
pounds.
(c) The indicated or printed weight amount in
pounds
(d) Subtract column c from column b; enter the
amount, in pounds, as the error.

11
12
13
14
15
16
a
through
d

Test Date
Previous Test Date
Scale Capacity
Minimum Division
Platform Size
Test Data

17

Test load bearing
points

18
19

Empty Truck
Weight
Test Weights

20
21
22

Scale Indication
Error on Test
Test Results

Enter the scale indication, truck plus weights in pounds.
Enter the error on test weights added in pounds.
The scale inspector or person(s) testing the scale enters the
test results.

23

Remarks

24

Receipt Signature

Use the “Remarks” section to enter needed explanations,
comments, adjustments you made, recommendations
needed to correct a defective condition, etc. If the serial
The owner or responsible person must sign the form
acknowledging receipt of a copy of the test report form.

25

Inspector Signature

Form PSD 4400

Test pattern prescribed in Handbook 44 N.1.3.3.2. Enter
indicated error in pounds.
Enter the indicated weight of empty truck in pounds.
Enter the amount of test weights added in pounds.

The scale inspector or person(s) testing the scale must sign
the test report form.

Expires 02/28/2021

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