Form QID 082001 QID 082001 2018 Integrated Screening Form

Agricultural Resource Management, Chemical Use,Surveys - Substantive Change to MN Pest Survey

0218 - 2018 ARMS I - Integrated Screener

Agricultural Resource Management, Chemical Use, and Contractor Expense Surveys

OMB: 0535-0218

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2018 INTEGRATED SCREENING SURVEY



OMB No. 0535-0218

Approval Expires: 7/31/2018

Project Code: 905 QID: 082001

SMetaKey: 3102




NATIONAL

AGRICULTURAL

STATISTICS

SERVICE





U.S Department of Agriculture

National Operations Division

9700 Page Avenue, Suite 400

St. Louis, MO 63132-1547

Phone: 1-888-424-7828

Fax: 855-415-3687

E-mail: [email protected]


The information you provide will be used for statistical purposes only. Your responses will be kept confidential and any person who willfully discloses ANY identifiable information about you or your operation is subject to a jail term, a fine, or both. This survey is conducted in accordance with the Confidential Information Protection provisions of Title V, Subtitle A, Public Law 107-347 and other applicable Federal laws. Response to this survey is voluntary. For more information on how we protect your information please visit: https://www.nass.usda.gov/confidentiality.


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 15 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.

1. Please make any needed corrections to the name, including the correct operation name, and mailing address on the label.

2. During 2018, will this operation (name on label):

  • grow any crops, including field crops, fruits, vegetables, nursery/greenhouse, or other specialty crops; or

  • cut any hay; or

  • have any livestock, poultry, or bees; or

  • sell any agricultural products; or

  • receive government payments (CRP, WRP, etc.); or

  • have more than 19 acres of idle cropland or more than 99 acres of pastureland?

Exclude crops planted on land rented/leased to others.


YES – [Continue on next page.]

NO – [Complete items a and b, then go to CONCLUSION on back page.]

a. Has the operation name on the label been sold, rented, or turned over to someone else?

YES

NO

Will the land be used for any agricultural purpose by you (the individual listed on the label), or anyone else in the next year?

YES NO DON’T KNOW

b. What is the name and address of the new operator?

Please explain, then go to CONCLUSION on back page.

Operation Name: ____________________________________

__________________________________________________

Operator Name: ____________________________________

__________________________________________________

Address: __________________________________________

__________________________________________________

City: ________________

State: ________

Zip: ______

__________________________________________________

Phone: ( ) ________________________


__________________________________________________


SECTION 1 - 2018 TOTAL ACRES OPERATED


1. Including the farmstead, all cropland, woodland, pasture land, wasteland, and

government program land, how many total acres does this operation –

Acres

a. own? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

+

901




b. rent or lease from others, including for cash, shares or rent free?

(Exclude land used on an animal unit month (AUM) or fee per head basis under a grazing permit.) . . . . . . . . . . .

+

902




c. rent to others, including for cash, shares or rent free? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

905




2. Total Acres Operated: [item 1a + 1b - 1c] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

=

900




3. Of the total [item 2] acres operated, how many acres are considered cropland?

(Include hay land, summer fallow, idle cropland, cropland used for pasture, and cropland in government programs.) . . . . .

802




SECTION 2 - 2018 CROPS


1. For the crop listed below, please report acres planted and to be planted for all purposes for the 2018 crop year. (Include acres planted and to be planted, even if the crop will not be harvested (for instance, used for cover crop, plowed under or abandoned). Also report acres harvested and to be harvested for grain in the 2018 crop year. Exclude crops planted on land rented/leased to others.)



Check Here if NONE

Corn

Acres Planted

and to be Planted

for All Purposes

Corn

Acres Harvested

and to be Harvested

for Grain

Corn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

530

531


2. For the crop listed below, please report acres planted and to be planted for harvest in 2018. Also, report the acres to be harvested in 2018. (Include acres planted and to be planted, even if the crop will not be harvested (for instance, used for cover crop, plowed under or abandoned). Exclude crops planted on land rented/leased to others.)



Check Here if NONE

Peanut

Acres Planted

and to be Planted

for All Purposes

Peanut

Acres Harvested

and to be Harvested


Peanuts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

650

1650

3. For the crop listed below, please report acres planted and to be planted for all purposes for the 2018 crop year. (Include acres planted and to be planted, even if the crop will not be harvested (for instance, used for cover crop, plowed under or abandoned). Also report acres harvested and to be harvested for beans in the 2018 crop year. Exclude crops planted on land rented/leased to others.)




Check Here if NONE

Soybean

Acres Planted

and to be Planted

for All Purposes

Soybean

Acres Harvested

and to be Harvested

for Beans

Soybeans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

590

591





SECTION 3 - 2018 VEGETABLE CROPS




1. In 2018, did or will this operation grow vegetable crops in any of the following states?

  • Arizona

  • Georgia

  • Michigan

  • New York

  • Oregon

  • Texas

  • California

  • Illinois

  • Minnesota

  • North Carolina

  • Pennsylvania

  • Washington

  • Florida

  • Indiana

  • New Jersey

  • Ohio

  • South Carolina

  • Wisconsin

Yes – [Continue] No – [Go to SECTION 4]



ACRES

2. Of the total cropland acres reported, how many acres are or will be planted to vegetable crops? (Include double or other multiple croppings.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


803

.____




3. For each vegetable crop named, please give the total acres planted or intended to plant during the 2018 crop year. (Include any acres already planted and harvested in the 2018 crop year. For double or other multiple croppings, count each planting. Exclude “home garden”.)


Check here if NONE

ACRES



Check here if NONE

ACRES

Asparagus. . . . . . . . . . . .

300

.____


Lettuce, Head. . . . . . . . . .

420

.____

Beans, Snap. . . . . . . . . .

321

.____


Lettuce, Other. . . . . . . . .

423

.____

Broccoli. . . . . . . . . . . . . .

339

.____


Onions. . . . . . . . . . . . . . .

101

.____

Cabbage. . . . . . . . . . . . .

202

.____


Pea, Green. . . . . . . . . . . .

551

.____

Cantaloupes. . . . . . . . . .

354

.____


Peppers, Bell. . . . . . . . . .

453

.____

Carrots. . . . . . . . . . . . . . .

363

.____


Pumpkins. . . . . . . . . . . . .

456

.____

Cauliflower. . . . . . . . . . . .

366

.____


Spinach. . . . . . . . . . . . . .

715

.____

Celery. . . . . . . . . . . . . . .

369

.____


Squash. . . . . . . . . . . . . . .

474

.____

Corn, Sweet. . . . . . . . . . .

381

.____


Strawberries. . . . . . . . . . .

477

.____

Cucumbers. . . . . . . . . . .

390

.____


Tomatoes. . . . . . . . . . . . .

486

.____

Garlic. . . . . . . . . . . . . . . .

396

.____


Watermelons. . . . . . . . . .

489

.____

Honeydews. . . . . . . . . . . .

414

.____


























SECTION 4 - 2018 BEEF CATTLE

1. Is this operation in any of the following states?

  • Alabama

  • Florida

  • Kansas

  • Montana

  • Oklahoma

  • Texas

  • Arkansas

  • Georgia

  • Kentucky

  • Nebraska

  • Oregon

  • Virginia

  • California

  • Idaho

  • Mississippi

  • New Mexico

  • South Dakota

  • Wyoming

  • Colorado

  • Iowa

  • Missouri

  • North Dakota

  • Tennessee








Yes – [Continue] No – [Go to SECTION 5]


Check here if NONE

Number

2. During 2018, what was or will be the peak number of beef cows and beef heifers on this operation, regardless of ownership? Exclude dairy cattle and feedlot cattle.. . . . . . . . . . . . .

255





SECTION 5 - 2017 VALUE OF SALES



1. Considering:

  • sales of all crops, livestock, poultry, and livestock products (milk, eggs, etc.) sold in 2017;

  • the value of product removed for all crops, livestock, and poultry produced under contract in 2017;

  • sales of all miscellaneous agricultural products in 2017;

  • all government agricultural payments received in 2017; and

  • exclude dollars received on land rented to others.

a. What code represents the total gross value of sales, including government agricultural payments?

Total Value

GVS Code




None’ during 2017. . . . . . . . . . . . .

99













$

$

$

$

$

$

$

$

$

$

$

$

1

1,000

2,500

5,000

10,000

25,000

50,000

100,000

250,000

500,000

1,000,000

2,500,000

$

$

$

$

$

$

$

$

$

$

$

$

999 …..

2,499 …..

4,999 …..

9,999 …..

24,999 …..

49,999 …..

99,999 …..

249,999 …..

499,999 …..

999,999 …..

2,499,999 …..

4,999,999 …..

1

2

3

4

5

6

7

8

9

10

11

12

GVS Code


860




$

5,000,000 and over. . . . . . . . . . . .

13


b. Is the GVS Code in box 860 equal to ‘1’ or ‘99’?


YES – [Continue] NO – [Go to item 2.]




SECTION 5 - 2017 VALUE OF SALES (Continued)


c. Record all 2018 crops, land uses, and livestock or poultry now on the total acres operated.


Land Use

ACRES

Field Crops Intended For Harvest

ACRES

Other Crops

ACRES

CRP/WRP. . . . . . . . . . . . .


_______________. . . .


Cut Christmas

Trees. . . . . . . . . . . . . .


Idle Cropland. . . . . . . . . . .


_______________. . . .


Nursery &

Greenhouse. . . . . . . . .


Summer Fallow. . . . . . . . .


_______________. . . .


_______________. . . .


_________________. . . . .


_______________. . . .


_______________. . . .


Government Payments

WHOLE DOLLARS

Fruits/Nuts

ACRES

Livestock

NUMBER

CRP/WRP Payments. . . . .


_______________. . . .


Cattle - Dairy. . . . . . . .


Other Gov’t Payments. . . .


_______________. . . .


Cattle - Other. . . . . . . .




_______________. . . .


Chickens. . . . . . . . . . .


Pasture/Rangeland

ACRES

_______________. . . .


Hogs. . . . . . . . . . . . . . .


Cropland Used Only

For Pasture. . . . . . . . . .


_______________. . . .


Horses. . . . . . . . . . . . .


Permanent Pasture. . . . . .




Mules/Burros. . . . . . . .


Woodland Pasture. . . . . . .


Vegetables/Melons

ACRES

Sheep & Goats. . . . . . .




_______________. . . .


_______________. . . .


Aquaculture

NUMBER

_______________. . . .


_______________. . . .


Acres of Ponds in Use. . . .


_______________. . . .




Foodsize/Stockers. . . . . . .


Berries

ACRES


OFFICE USE

Fingerlings/Broodfish. . . . .


_______________. . . .



Total Points

Pasture Points

Trout Eggs. . . . . . . . . . . . .


_______________. . . .



861

869

Other Aquaculture. . . . . . .


_______________. . . .








SECTION 5 - 2017 VALUE OF SALES (Continued)


2. Which of these categories represents the largest portion of the gross income

from the operation in 2017?

Farm Type Code

1 Grains, Oilseeds, Dry Beans, and Dry Peas ……………….…………………..……..

(corn, flaxseed, grain silage and forage, grains and oilseeds, popcorn, rice,

small grains, sorghum, soybeans, sunflowers, straw, etc.)

2 Tobacco ………………………………………………………………….……………...…..

3 Cotton and Cottonseed ……………………………………………………….…...……..

4 Vegetables, Melons, Potatoes, and Sweet Potatoes ………………………………..

(beets, cabbage, cantaloupes, pumpkins, sweet corn, tomatoes, watermelons, vegetable seeds, etc.)

5 Fruit, Tree Nuts, and Berries ……………………………………………………...…..

(almonds, apples, blueberries, cherries, grapes, hazelnuts, kiwifruit,

oranges, pears, pecans, strawberries, walnuts, etc.)

6 Nursery, Greenhouse, Floriculture, and Sod ………………………………..............

(bedding plants, bulbs, cut flowers, flower seeds, foliage plants,

mushrooms, nursery potted plants, shrubbery, sod, etc.)

7 Cut Christmas Trees and Short Rotation Woody Crops ……………………….…..

8 Other Crops, Hay, CRP, and Pasture ……………………………………..................

(grass seed, hay and grass silage, hops, maple syrup, mint, peanuts, sugarcane, sugarbeets, CRP, etc.)

9 Hogs and Pigs …………………………………………………………………….………..

10 Milk and Other Dairy Products from Cows ……………………………………………

11 Cattle and Calves ………………………………………………………………................

(beef and dairy cattle for breeding stock, fed cattle, beef and dairy cull animals,

stockers and feeders, veal calves, etc.)

12 Sheep, Goats, and their Products …………………………………………………..….

(wool, mohair, milk and cheese)

13 Horses, Ponies, and Mules ………………………………………………………...…….

(burros and donkeys)

14 Poultry and Eggs ………………..……………………………………………...………....

(broilers, chickens, turkeys, ducks, eggs, emus, geese, hatchlings,

ostriches, pigeons, pheasants, quail, poultry products, etc.)

15 Aquaculture ………………………..…………..………………………………………......

(catfish, trout, ornamental and other fish, mollusks, crustaceans, etc.)

16 Other Animals and Other Animal Products ………………..………………...............

(bees, honey, rabbits, fur-bearing animals, semen, manure, other animal specialties, etc.)

1



2

3

4




5



6



7

8



9

10

11



12



13


14



15



16

Shape1


Farm Type Code



862








SECTION 6 – ARIZONA PESTICIDE GROWER PERMITS

1. Is this operation in Arizona?


Yes - [Continue] NO - [Go to SECTION 7]


2. Does this operation have a Pesticide Grower Permit number from the National Department of

Agriculture Environmental Services Division?


Yes - [Continue] NO - [Go to SECTION 7]





3. What Pesticide Grower Permit number does this operation use for reporting
chemical applications on these [item 2] acres to the National Department of

Agriculture – Environmental Services Division? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PGP 10 NUMBER


810







4. Is this permit number used to report chemical applications for acres other than these [item 2] acres?

OFFICE USE


YES - [Continue]

NO - [Go to SECTION 7]

012


a. What other operation(s) is this permit number used to report for?






Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Phone ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Phone ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .





5. Does this operation use any OTHER Pesticide Grower Permit number

to report chemical applications to ADA–ESD for these [item 2] acres?



YES - [Continue]

NO - [Go to SECTION 7]




PGP 10 NUMBER


a. What are these PGP numbers?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

811








812








813







b. Do you use any of these ID’s to report chemical applications

for any other operation(s)?

814







815







YES - [Continue]

NO - [Go to SECTION 7]

OFFICE USE


(i) What other operation(s) use this Pesticide Grower Permit for reporting?

[Identify operation and ID]

013





Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Reporting ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reporting ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .




Phone ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Phone ( ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .







SECTION 7 - OPERATION TYPE


1. Are the day-to-day decisions for this operation made by one individual,

a hired manager, or partners? [Check one]


One individual [Go to CONCLUSION.]

A hired manager – [Go to CONCLUSION.]

Partners – [Complete items a and b, then go to CONCLUSION.]




Number

  1. How many individuals, including the operator, are involved in the day-to-day

decisions for this operation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .



o



b. Please record partners’ names and addresses, then go to SECTION 8.

[Enter names and addresses of partners, including partners who jointly operate land and share in decision making.

Do not include landlords and tenants as partners.]


PARTNER 1

PARTNER 2

Partner name: ________________________________________

Partner name: ________________________________________

Address: ____________________________________________

Address: ____________________________________________

City: ________________

State: ________

Zip: ________

City: ________________

State: ________

Zip: ________

Phone: (______) __________________________

Phone: (______) __________________________     

PARTNER 3

PARTNER 4

Partner name: ________________________________________

Partner name: ________________________________________

Address: ____________________________________________

Address: ____________________________________________

City: ________________

State: ________

Zip: ________

City: ________________

State: ________

Zip: ________

Phone: (______) __________________________

Phone: (______) __________________________





















SECTION 8 - CONCLUSION


1. Do you (the operator named on the label) make any day-to-day decisions for another farm or ranch?

YES – Please list the other operation(s):__________________________________________________________


NO – [Continue.]

This completes the survey. Thank you for your help.


Reported by: __________________________________

9910

____ ____ ____ ____ 18

M M D D

9911


Telephone: ________________

OFFICE USE

R. Unit

Ptr 1 Str

Ptr 2 Str

Ptr 3 Str

Ptr 4 Str

OPS

SSO 1

ADJ

Optional Use

9921

9922

9923

9927

9928

923

9907

922

9906

9916

Response

Respondent

Mode

Enum.

POID

1-Comp

2-R

3-Inac

4-Office Hold

5-R – Est

6-Inac – Est

7-Off Hold – Est


9901

1-Op/Mgr

2-Sp

3-Acct/Bkpr

4-Partner

9-Other

9902

1-PASI (Mail)

2-PATI (tel)

3-PAPI (Face-to- Face)

4-CATI

5-Web

6-E-mail

7-Fax

8-CAPI

19-Other

9903

9998

9989


___ ___ ___ ___ ___ ___ ___ ___ ___

Eval.

Change

9900

9985



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