DA-201B Application for Butter Grading Service

OMB APPROVED – NO. 0581-0126

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U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

CERTIFICATE NO.

APPLICATION FOR BUTTER GRADING SERVICE
TO: APPLICANT (Name and address)

SHIPPER OR SELLER (Name and address)

RECEIVER OR BUYER (Name and address)

DATE INSPECTED

NO. SAMPLES TAKEN

Email address:
INSPECTED AT (Name and address)1

INSPECTED BY:

CONDITION OF CONTAINERS

SAMPLE CONTAINERS STAMPED
WITH USDA LOT NO.

applicable U.S. standards for condition
of
food containers
MANUFACTURED BY (Name and address)1

CHURN
NUMBER

NO.
PKGS.

MFG.
DATE

SIGNATURE OF AGENT FOR APPLICANT

ANNOUNCEMENT
NO.

TEST
WEIGHT

CONTRACT NO.

CLASSIFICATION
FLAVOR

COLOR

REMARKS:
Grading Temp______

Net Wt

SIZE AND KIND OF CONTAINERS

DEFECT RATING
SALT

BODY

US GRADE
Marked

SEED NO.

COLOR

SALT

TOTAL

NO. OF PACKAGES

U.S.
GRADE

STORAGE LOT

COMMENTS
(S-Slight, D-Definite, P-Pronounced)

FAT

WEIGHT

%
H 2O

SALT

FEES

GRADE AA

lbs

INSPECTION

GRADE A

lbs

EXPENSE

GRADE B

lbs

LABORATORY

BELOW GRADE

lbs

TOTAL

$

$

(See next page for Burden Statement)

DA-201B (09/03)
U S DEPARTMENT OF AGRICULTURE
AMS, DAIRY PROGRAMS, DAIRY GRADING BRANCH
BUILDING A SUITE 370
800 ROOSEVELT ROAD
GLEN ELLYN, IL 60137-5832

SERVICE DATE

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