PPQ 543 Black Stem Rust Inspector's Report

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 0579-0088. The time required
to complete this information collection is estimated to average 30 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.
U.S. DEPARTMENT OF AGRICULTURE
1. DATE OF INSPECTION

OMB Approved
0579-0088
EXP XX/XXXX

ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

BLACK STEM RUST INSPECTOR’S REPORT
2. TYPE OF ESTABLISHMENT (Check applicable box(es))
NURSERY

3. TOTAL ACRES IN NURSERY

DEALER

SEED GROWER

4. NAME AND MAILING ADDRESS OF ESTABLISHMENT (include ZIP Code)

5. LOCATION OF ESTABLISHMENT

6. SOURCES OF BERBERIS, MAHOBERBERIS, AND MAHONIA PLANT SEEDS AND FRUITS (Report growing stock in nursery in A, C, D, and E; report anticipated source
of plants for dealer in A only; report plants used for seed sources by a grower in A,B, C, and D).
PLANTS FROM
SPECIES
NAME AND ADDRESS
LOCATION OF
NUMBER OF
(Check one)
AND
OF GROWER
SEED PLANTS
PLANTS
VARIETY
SEED
CUTTINGS
LINERS
A.
B.
C.
D.
E.

7. PLANTS RESTRICTED FROM MOVEMENT PENDING FURTHER INSPECTION, RUST SUSCEPTIBILITY, OR POST ENTRY
SCIENTIFIC NAME
NUMBER OF PLANTS
SOURCE
A.
B.
C.

8. DISPOSITION OF PLANTS FROM POST ENTRY

LOCATION OF PLANTS
D.

9. ESTIMATED POUNDS OF SEED GROWER
WILL HARVEST

RUST RESISTANT
ELIGIBLE FOR RELEASE

RUST SUSCEPTIBLE
TO BE DESTROYED

10. NUMBER FIRST YEAR SEEDLINGS GROWN BY ESTABLISHMENT

11. LOCATION OF SEEDLINGS

12. PLANTS OBTAINED AS ONE-YEAR SEEDLINGS
SCIENTIFIC NAME
A.

NUMBER OF PLANTS
RECEIVED

B.

SURVIVING

DATE OBTAINED

SOURCE

C.

D.

SIGNATURE OF INSPECTOR:

PPQ FORM 543
SEP 2011

Previous editions are obsolete

RECOMMENDED
DISPOSITION
(Check one)
RELEASE
HOLD
E.