This form is available electronically. Form Approved - OMB No. 0581-0305
WA-580 U.S. DEPARTMENT OF AGRICULTURE (07-31-18) Agricultural Marketing Service
PORT FACILITY EXAMINATION CHECKLIST
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NOTE: |
The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a - as amended). The authority for requesting the information identified on this form is 7 CFR Part 735, 7 CFR Part 1423, the United States Warehouse Act (Pub. L. 106-472), and the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.). The information will be used to document port terminal inspections. The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated) and USDA/FSA-3, Consultants File. Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility to obtain new licensing or retain existing licensing under the United States Warehouse Act and ineligibility to store and handle Commodity Credit Corporation interest commodities.
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 0581-0305. 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. RETURN THIS COMPLETED FORM TO THE WAREHOUSE AND COMMODITY MANAGEMENT DIVISION, STOP 9148, P.O. BOX 419205, KANSAS CITY, MO 64141-6205. |
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2. License No.: |
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3. Location: |
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4. Name of Port: |
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5. Examiner: |
6. Examination Date: |
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PART A – FACILITY INFRASTRUCTURE |
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ITEM |
REQUIREMENT |
YES |
WA-125 |
N/A |
COMMENTS |
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1 |
Facility construction suitable for proper storage and handling of commodities. |
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2 |
Outside premises are well drained. |
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3 |
Facility structures properly maintained to protect commodities in storage. |
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4 |
Adjoining property or nearby water source does not constitute an undue physical hazard to commodities in store. |
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5 |
Facility premises and grounds are free of weeds, clutter, trash, unused equipment, or spilled commodities. |
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6 |
Dock areas are clean with a minimal accumulation of dust. |
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7. Fire Protection: |
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A. Automatic Sprinkler YES NO |
B. Inside Standpipes and Hoses YES NO |
C. Fire Extinguishers YES NO |
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PART B – COMMODITY STORAGE CONDITIONS |
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1 |
Commodities stored in an orderly manner. |
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2 |
Commodities stored in currently approved space. |
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3 |
Commodities stored and handled according to specific commodity storage requirements. |
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4 |
Commodities in store properly marked or identified. |
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5 |
Commodities are clean and protected from bird droppings, dust, filth, and stains. |
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6 |
Proper dunnage is used. |
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7 |
Adequate and clean pallets are used. |
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8 |
Storage areas are kept dry. |
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USDA is an equal opportunity provider, employer, and lender.
WA-580 (07-31-18) Page 2 of 2
PART B – COMMODITY STORAGE CONDITIONS (Continued from Page 1) |
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ITEM |
REQUIREMENT |
YES |
WA-125 |
N/A |
COMMENTS |
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9 |
Facility is clean and proper housekeeping practices are used. |
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10 |
Facility is free of objectionable odors. |
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11 |
Hazardous materials or contaminants are not stored near commodities. |
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12 |
Damaged or nonconforming products are removed from the commodity storage areas. |
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PART C – PEST CONTROL |
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1 |
Facility is free of pests or insects. |
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2 |
Doors, windows and entry points are maintained to discourage bird entry. |
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3 |
Dock doors are closed during periods of facility inactivity. |
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4 |
Records are maintained of pest and insect control actions and inspections. |
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5 |
Facility is inspected for rodent activity and infestation on a routine and frequent basis. |
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6 |
EPA registered pesticides used exclusively. |
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7 |
Inspections and applications performed by qualified individuals or companies. |
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8. Record of Rodent Control Service: |
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A. Last Date Serviced |
B. Number of Traps |
C. Number of Bait Stations |
D. Number of Entrapments |
E. Service Provider |
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9. Record of Infestation Control Service: |
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A. Last Date Serviced |
B. Materials Used |
C. Areas Treated |
D. Service Provider |
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FOGGED |
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SPRAYED |
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PART D - SECURITY |
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1 |
Access is granted for authorized personnel only. |
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2 |
Security of the physical structures and grounds is adequate. |
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3 |
All buildings can be locked. |
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4 |
The port facility certifies that it has implemented a U.S. Coast Guard approved security plan. |
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PART E - SIGNATURE |
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1. NAME OF WAREHOUSE EXAMINER |
2. SIGNATURE OF WAREHOUSE EXAMINER |
3. DATE (MM-DD-YYYY) |
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | This form is available electronically |
Author | liz.ashton |
File Modified | 0000-00-00 |
File Created | 2021-01-14 |