OMB No.: 0581-0309 | |||||||||||
USDA-FGIS | |||||||||||
DOCKAGE CHECKTEST | |||||||||||
NOTE: TEST UNIT OPERATOR - FILL IN SHADED AREAS ONLY | |||||||||||
DATE | FIELD OFFICE | AGENCY | LOCATION | ||||||||
AIR NO. | FEED NO. | RIDDLE NO. | TOP NO. | MIDDLE NO. | BOTTOM NO. | ||||||
MACHINESET UP | SIEVES | ||||||||||
TEST UNIT | |||||||||||
MAKE | MODEL | SERIAL NO. | REMARKS | ||||||||
THROUGH | OVER | ||||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
SAMPLE | HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | ||||
NUMBER | (SECS.) | (SECS.) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | ||||
1 | |||||||||||
2 | |||||||||||
3 | |||||||||||
AVERAGE | |||||||||||
TEST UNIT AVERAGE | % | % | % | % | % | ||||||
RESULTS BY: | DATE | ||||||||||
STANDARD UNIT | |||||||||||
MAKE | MODEL | SERIAL NO. | REMARKS | ||||||||
THROUGH | OVER | ||||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
SAMPLE | HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | ||||
NUMBER | (SECS.) | (SECS.) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | ||||
1 | |||||||||||
2 | |||||||||||
3 | |||||||||||
AVERAGE | |||||||||||
STANDARD UNIT AVERAGE | % | % | % | % | % | ||||||
RESULTS BY: | DATE | ||||||||||
DOCKAGE TESTER SUMMARY | |||||||||||
THROUGH | OVER | ||||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | |||||
(SECS.) | (SECS.) | (%) | (%) | (%) | (%) | (%) | |||||
TEST UNIT (Enter average results of test unit) | |||||||||||
STANDARD (Enter average results of standard unit) | |||||||||||
DEVIATION | 0 | 0 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | ||||
ALLOWABLE DEVIATION | 0.10 | 0.10 | 0.10 | 0.15 | |||||||
RESULTS | IN | IN | IN | IN | |||||||
REMARKS | |||||||||||
SUMMARY BY: | DATE | ||||||||||
Form FGIS-928 (01/21) Previous editions are obsolete. Expires XX-XX |
OMB No.: 0581-0309 | |||||||||||
USDA-FGIS | |||||||||||
DOCKAGE CHECKTEST | |||||||||||
NOTE: TEST UNIT OPERATOR - FILL IN SHADED AREAS ONLY | |||||||||||
DATE | FIELD OFFICE | AGENCY | LOCATION | ||||||||
1 | 2 | 3 | 4 | ||||||||
AIR NO. | FEED NO. | RIDDLE NO. | TOP NO. | MIDDLE NO. | BOTTOM NO. | ||||||
MACHINESET UP | 5 | SIEVES | 6 | ||||||||
TEST UNIT | |||||||||||
MAKE | MODEL | SERIAL NO. | REMARKS | ||||||||
7 | 8 | 9 | |||||||||
THROUGH | OVER | 22 | |||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
SAMPLE | HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | ||||
NUMBER | (SECS.) | (SECS.) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | ||||
1 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | ||||
2 | |||||||||||
3 | |||||||||||
AVERAGE | 17 | 18 | |||||||||
19 | TEST UNIT AVERAGE | % | % | % | % | % | |||||
RESULTS BY: | 20 | DATE | 21 | ||||||||
STANDARD UNIT | |||||||||||
MAKE | MODEL | SERIAL NO. | REMARKS | ||||||||
THROUGH | OVER | ||||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
SAMPLE | HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | ||||
NUMBER | (SECS.) | (SECS.) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | (GRAMS) | ||||
1 | |||||||||||
2 | 23 | ||||||||||
3 | |||||||||||
AVERAGE | |||||||||||
STANDARD UNIT AVERAGE | % | % | % | % | % | ||||||
RESULTS BY: | DATE | ||||||||||
DOCKAGE TESTER SUMMARY | |||||||||||
THROUGH | OVER | ||||||||||
CLEARED | RIDDLE | AIR | BOTTOM | TOTAL | BOTTOM | ||||||
HOPPER | SIEVE | SEPARATION | SEPERATION | SIEVE | DOCKAGE | SIEVE | |||||
(SECS.) | (SECS.) | (%) | (%) | (%) | (%) | (%) | |||||
TEST UNIT (Enter average results of test unit) | 24 | ||||||||||
STANDARD (Enter average results of standard unit) | 25 | ||||||||||
DEVIATION | 26 | ||||||||||
ALLOWABLE DEVIATION | 27 | 0.10 | 0.10 | 0.10 | 0.15 | ||||||
RESULTS | 28 | ||||||||||
REMARKS | |||||||||||
29 | |||||||||||
SUMMARY BY: | DATE | ||||||||||
30 | 31 | ||||||||||
Form FGIS-928 (01/21) Previous editions are obsolete. Expires January 2024 |
Instructions for Completing FGIS-928 | ||
1 | Date mailed. | |
2 | Field office that performed the test, when applicable. | |
3 | Agency that performed the test, when applicable. | |
4 | Location of test unit dockage tester. | |
5 | For tests using wheat, show: air - 4, feed - 6, riddle - 2. | |
For tests using corn, show: air - 1, feed - 10, riddle - n/a. | ||
6 | For tests using wheat, show: top - n/a, middle - 2 & I.D. No., bottom - 2 & I.D. No. | |
For tests using corn, show: top - 3, middle - n/a, bottom - n/a. | ||
7 | Make of the test unit dockage tester. | |
8 | Model of the test unit dockage tester. | |
9 | Serial number of the test unit dockage tester. | |
10 | Time elapsed for each sample to clear the hopper, shown in whole seconds. | |
11 | Time elapsed for each sample to clear the middle sieve, shown in whole seconds. | |
12 | Weight of the separation that passes over the riddle, shown to 0.01 g. | |
13 | Weight of the separation that is removed by air, shown to 0.01 g. | |
14 | Weight of the separation that passes through the bottom sieve, shown to 0.01 g. | |
15 | Total dockage (riddle, air, and through-the-bottom), shown to 0.01 g. | |
16 | Weight of the separation that passes over the bottom sieve, shown to 0.01 g. | |
17 | Averages of the test unit’s hopper and sieve clearance times, shown in whole seconds. | |
18 | Averages of the test unit’s test results, shown to 0.01 g. | |
19 | Convert the average separation weights to a percentage of the total sample weight, shown to 0.001 %. | |
20 | Name of the person who tested the unit. | |
21 | Date that testing of the test unit was completed. | |
22 | Test unit operator’s remarks and RPM information. | |
23 | Standard unit’s information and test results. | |
24 | Test unit’s average test results, shown to 0.01 %. | |
25 | Standard unit’s average test results, shown to 0.01 %. | |
26 | Difference ( 24 minus 25). Show the plus or minus deviation. | |
27 | Allowable deviations. | |
28 | Indicate IN or OUT of tolerance for each type of separation. | |
29 | Remarks | |
30 | Name of person who completed the Summary section. | |
31 | Date the summary was completed. |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |