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OMB No. 0535-0218 Approval Expires: 05/31/2023 Project Code: 136 QID: 035219 SMetaKey: 2069
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NATIONAL AGRICULTURAL STATISTICS SERVICE |
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U.S. Department of Agriculture National Operations Division 9700 Page Avenue, Suite 400 St. Louis, MO 63132-1547 Phone: 1-888-424-7828 Fax: 1-855-415-3687 E-mail: nass@nass.usda.gov |
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ENTERPRISE |
VERSION 01 |
POID ___ ___ ___ ___ ___ ___ ___ ___ ___ |
SUBTRACT ___ ___ |
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CONTACT RECORD |
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DATE |
TIME |
NOTES |
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INTRODUCTION: [Introduce yourself, and ask for the operator. Rephrase in your own words.]
We are collecting information on chemical use and need your help to make the information as accurate as possible. 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. For more information on how we protect your information please visit: https://www.nass.usda.gov/confidentiality. Response is voluntary. We encourage you to refer to your records during the interview.
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 60 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. |
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BEGINNING TIME [MILITARY]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
004 __ __ __ __ |
[Name, address and partners verified and updated if necessary.] |
During the screening phase of the Vegetable Chemical Use Survey conducted in June and July, your operation was found to be growing or intending to grow vegetables this year. I now need to verify some of the information collected during the screening survey. |
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Verify operation name and operator on label and/or screener. |
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CHANGE IN OPERATING STATUS |
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[ENUMERATOR NOTE: Skip this section if there is no change in operation name or operator.] |
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1. Has there been a change in operation name or operator? |
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NO - [Go to Enumerator Note below.] |
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YES - [Enter code 1, complete name and address information below for new operator, and read Enumerator Note.]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
CODE |
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023 |
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Operation Name __________________________________ |
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Operator Name __________________________________ |
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Address ________________________________________ |
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________________________________________ |
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Phone ( ) ________________________________ |
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[ENUMERATOR NOTE: |
If the operation on the face page was in business part of the 2020 crop year, complete this questionnaire for the part of the year during which the operation did business, unless the operation has been taken over by a new operator. If the operator has changed midyear, please conduct this interview start to finish with the new operator after reading “Valid Substitution” rules in section 4 of the Interviewer’s Manual.] |
2. Has the operation printed on this questionnaire been combined or merged with any other farming operations? |
Yes - [Go to "Conclusion".]
No - [Continue.] |
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SCREENING |
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1. Did this operation have any of the target crops during the 2020 crop year? |
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YES - [Continue.] |
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NO - [Write notes explaining situation then go to “Conclusion” on back page.] |
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Notes: ______________________________________________________________________________________ |
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2. Are the day-to-day
decisions for this operation (name on label) made by
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one individual? [Go to Section A.] |
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a hired manager? [Go to Section A.] |
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partners? [Continue with questions 3 and 4.] |
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3. How many individuals are involved in the day-to-day decisions of this operation? [Enter the number of partners, including the partner named on the label. Identify the other persons in this partnership below, then go to Section A.] (Partners jointly operate land and share in decision making. Do not include landlords and tenants as partners.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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NUMBER |
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4. Please identify the other person(s) in this partnership, then go to Section A. [Verify partners’ names and make necessary corrections if names have already been entered.] |
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PARTNERS |
POID__ __ __ __ __ __ __ __ __ |
PARTNERS |
POID__ __ __ __ __ __ __ __ __ |
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PARTNER NAME |
PARTNER NAME |
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ADDRESS |
ADDRESS |
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CITY |
STATE |
ZIP |
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CITY |
STATE |
ZIP |
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PHONE NUMBER |
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PHONE NUMBER |
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PARTNERS |
POID__ __ __ __ __ __ __ __ __ |
PARTNERS |
POID__ __ __ __ __ __ __ __ __ |
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PARTNER NAME |
PARTNER NAME |
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ADDRESS |
ADDRESS |
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CITY |
STATE |
ZIP |
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CITY |
STATE |
ZIP |
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PHONE NUMBER |
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PHONE NUMBER |
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A |
LAND OPERATED |
A |
ACRES OPERATED |
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[Enumerator Action: If acreage on the insert is verified as correct, enter code 1 in box 801, then skip to Section B. If acreage has changed, ask ALL questions.]. . . . . . . . . . . . . . . . . . . . |
801 |
Now I would like to ask about the total acres operated under this land arrangement. |
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1. How many acres does this operation--- |
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ACRES |
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a. Own?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . + |
901 |
. ___ |
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b. Rent or lease from others or use rent free? (Exclude land used on an animal unit month (AUM) basis.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . + |
902 |
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c. Rent to others?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - |
905 |
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2. [Calculate item 1a + 1b - 1c.] Then the total acres operated are:. . . . . . . . . . . . . . . . . . . . . . . . . . = |
900 . ___ |
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a. Does this include the farmstead, all cropland, woodland, pasture land, wasteland, and government program land?
YES - [Continue.] NO - [Make corrections, then continue.] |
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The remaining questions in this survey refer to these [item 2] acres. |
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3. Of the total acres operated, how many acres are considered cropland, including land in hay, summer fallow, cropland idle, cropland used for pasture and cropland in government programs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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802 |
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4. Of the total acres operated, how many acres are vegetables? (Include both target and non-target vegetables planted on the operation.). . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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803 . ___ |
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TARGET CROPS & CODES |
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FLORIDA |
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MINNESOTA |
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PENNSYLVANIA |
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613 BEANS, SNAP |
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766 CORN, SWEET |
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613 BEANS, SNAP |
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808 CABBAGE |
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855 PEAS, GREEN |
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738 PUMPKINS |
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766 CORN, SWEET |
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798 CUCUMBERS |
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NEW JERSEY |
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SOUTH CAROLINA |
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736 PEPPERS, BELL |
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736 PEPPERS, BELL |
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752 WATERMELONS |
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742 SQUASH |
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742 SQUASH |
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748 STRAWBERRIES |
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TEXAS |
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770 TOMATOES |
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NEW YORK |
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808 CABBAGE |
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752 WATERMELONS |
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613 BEANS, SNAP |
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798 CUCUMBERS |
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808 CABBAGE |
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824 ONIONS |
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GEORGIA |
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766 CORN, SWEET |
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738 PUMPKINS |
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613 BEANS, SNAP |
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824 ONIONS |
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752 WATERMELONS |
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808 CABBAGE |
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738 PUMPKINS |
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766 CORN, SWEET |
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742 SQUASH |
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WASHINGTON |
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798 CUCUMBERS |
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701 ASPARAGUS |
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824 ONIONS |
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NORTH CAROLINA |
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632 CARROTS |
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736 PEPPERS, BELL |
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798 CUCUMBERS |
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766 CORN, SWEET |
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742 SQUASH |
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736 PEPPERS, BELL |
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824 ONIONS |
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752 WATERMELONS |
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738 PUMPKINS |
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855 PEAS, GREEN |
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742 SQUASH |
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ILLINOIS |
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752 WATERMELONS |
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WISCONSIN |
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613 BEANS, SNAP |
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613 BEANS, SNAP |
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738 PUMPKINS |
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OHIO |
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808 CABBAGE |
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736 PEPPERS, BELL |
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632 CARROTS |
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INDIANA |
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738 PUMPKINS |
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766 CORN, SWEET |
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738 PUMPKINS |
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798 CUCUMBERS |
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752 WATERMELONS |
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OREGON |
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855 PEAS, GREEN |
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613 BEANS, SNAP |
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MICHIGAN |
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766 CORN, SWEET |
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701 ASPARAGUS |
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824 ONIONS |
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613 BEANS, SNAP |
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855 PEAS, GREEN |
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798 CUCUMBERS |
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742 SQUASH |
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738 PUMPKINS |
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742 SQUASH |
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B |
VEGETABLE ACREAGE |
B |
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1. What target
vegetables were on
these [Section A,
item 2]
acres of vegetables not intended for harvest in 2020.) |
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[ENUMERATOR NOTE: If no target acreage is present, write notes and skip to “Conclusion” on back page.] |
OFFICE USE LINES IN TABLE |
TABLE 001 |
199 |
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2 |
3 |
4 |
5 |
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L I N E
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How many acres were PLANTED for harvest in the 2020 crop year? (Include 2020 acres which were planted in other years.) |
Were any commercial fertilizers applied to this crop? |
Were any herbicides, insecticides fungicides, etc. applied to this crop?
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INCLUDE: |
TARGET CROPS ONLY.
All acreage of TARGET CROPS for processing or fresh market.
All acreage equal to or greater than one tenth of an acre.
All bearing acreage of TARGET CROPS for roadside stands, farmer’s markets or U-pick sales.
Acreage not harvested due to weather, economic or other reasons.
Crops planted in the fall of 2017 if they were part of the 2020 crop.
Double Cropping
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CROP |
CROP CODE |
ACRES |
[YES = 1] |
[YES = 1] |
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01 |
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11 |
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12 |
13 |
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02 |
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11 |
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12 |
13 |
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03 |
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11 |
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12 |
13 |
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04 |
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11 |
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12 |
13 |
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EXCLUDE: |
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05 |
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11 |
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12 |
13 |
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EXCLUDE: |
ALL CROPS GROWN IN ANOTHER STATE.
All crops grown in greenhouses, hothouses and home gardens.
Plantings of crops not intended for harvest in 2020.
New plantings and other plantings which are not yet bearing (asparagus & strawberries)
All vegetables grown for commercial transplanting.
All mushrooms, potatoes, dry beans, sweet potatoes.
All vegetable acreage grown for seed only.
All vegetable acres grown by institutional, experimental, research and university farms.
Non-target vegetables.
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06 |
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11 |
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12 |
13 |
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07 |
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11 |
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12 |
13 |
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08 |
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11 |
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12 |
13 |
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09 |
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11 |
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12 |
13 |
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10 |
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11 |
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12 |
13 |
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11 |
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12 |
13 |
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12 |
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13 |
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13 |
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11 |
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12 |
13 |
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14 |
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11 |
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12 |
13 |
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15 |
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11 |
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12 |
13 |
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NOTES: |
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D |
PESTICIDE APPLICATIONS |
D |
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[ENUMERATOR ACTION: If pesticides were reported in Section B, column 5, continue. Otherwise, skip to Section E.] |
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1.
Now I need to get complete information on all of the chemicals
applied, including applications made by you and/or by custom
applicators during the 2020
crop year to each of the target
VEGETABLE
crops
you grew. Let’s
start with the first application to your [crop]
since the 2017
crop year
harvest. |
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OFFICE USE LINES IN TABLE |
TABLE 001 |
399 |
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CHEMICAL PRODUCT NAME |
L I N E
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CROP |
CROP CODE |
What products were applied to the [crop]?
[Enter product code.] |
Was this product bought in liquid or dry form?
[Enter L or D.] |
Was this part of a tank mix?
[If tank mix, enter line number of first product in mix.] |
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02 |
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03 |
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04 |
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05 |
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06 |
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07 |
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08 |
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09 |
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10 |
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12 |
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[For pesticides not listed in Respondent Booklet, specify---] |
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Line No. |
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Pesticide Type (Herbicide, Insecticide, Fungicide, etc.) |
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Trade Name and Formulation |
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Form Purchased (Liquid or Dry) |
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EPA Reg. No. |
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D |
PESTICIDE APPLICATIONS |
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CODES FOR COLUMN 8 |
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1 POUNDS |
14 PINTS |
30 GRAMS |
46 SPIRALS |
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12 GALLONS |
15 OUNCES, LIQUID |
40 KILOGRAMS |
47 PACKETS |
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13 QUARTS |
28 OUNCES, DRY |
41 LITERS |
50 OTHER (Specify_____________) |
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L I N E
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6 OR 7 |
8 |
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10 |
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How much was applied per acre per application?
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What was the total amount applied per application?
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[Enter unit code from above.]
CODE |
How many acres were treated with this product?
ACRES |
How many times was it applied?
NUMBER |
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01 |
65 . ___ ___ |
73 . ___ ___ |
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77 . ___ |
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02 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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03 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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04 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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05 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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06 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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07 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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08 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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09 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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10 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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11 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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12 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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13 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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14 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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15 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
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[For pesticides not listed in Respondent Booklet, specify---] |
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Line No. |
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Pesticide Type (Herbicide, Insecticide, Fungicide, etc.) |
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Tradename and Formulation |
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Form Purchased (Liquid or Dry) |
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EPA Reg. No. |
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D |
PESTICIDE APPLICATIONS |
D |
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1 |
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4 |
5 |
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CHEMICAL PRODUCT NAME |
L I N E
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CROP |
CROP CODE |
What products were applied to the [crop]?
[Enter product code.] |
Was this product bought in liquid or dry form?
[Enter L or D.] |
Was this part of a tank mix?
[If tank mix, enter line number of first product in mix.] |
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61 |
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20 |
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61 |
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61 |
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[For pesticides not listed in Respondent Booklet, specify---] |
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Line No. |
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Pesticide Type (Herbicide, Insecticide, Fungicide, etc.) |
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Trade Name and Formulation |
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Form Purchased (Liquid or Dry) |
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EPA Reg. No. |
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D |
PESTICIDE APPLICATIONS |
D |
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CODES FOR COLUMN 8 |
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1 POUNDS |
14 PINTS |
30 GRAMS |
46 SPIRALS |
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12 GALLONS |
15 OUNCES, LIQUID |
40 KILOGRAMS |
47 PACKETS |
|
|||||||||||||
|
13 QUARTS |
28 OUNCES, DRY |
41 LITERS |
50 OTHER (Specify_____________) |
|
|||||||||||||
|
|
|
|
|||||||||||||||
|
||||||||||||||||||
L I N E
|
6 OR 7 |
8 |
9 |
10 |
||||||||||||||
How much was applied per acre per application?
|
What was the total amount applied per application?
|
[Enter unit code from above.]
CODE |
How many acres were treated with this product?
ACRES |
How many times was it applied?
NUMBER |
||||||||||||||
16 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
17 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
18 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
19 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
20 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
21 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
22 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
23 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
24 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
25 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
26 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
27 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
28 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
29 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
30 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
31 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
32 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
33 |
65 . ___ ___ |
73 . ___ ___ |
74 |
77 . ___ |
79 |
|||||||||||||
[For pesticides not listed in Respondent Booklet, specify---] |
||||||||||||||||||
Line No. |
|
Pesticide Type (Herbicides, Insecticides, Fungicides, etc.) |
|
Trade name and Formulation |
|
Form Purchased (Liquid or Dry) |
|
EPA Reg. No. |
||||||||||
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
E |
PEST MANAGEMENT PRACTICES |
E |
Now I have some questions about pest management practices you may have used on any of the total vegetable acres on this operation. (Include both target and non-target vegetable crops grown.) By pests, we mean insects, weeds, and diseases. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
[Enumerator Action: Were PESTICIDE APPLICATIONS reported in Section B, column 5 on page 5?] |
|||
|
|||
YES - [Continue.] |
No - [Go to item 4.] |
||
|
|||
1. Was weather data used to
assist in determining either the need or |
|
CODE |
|
YES = 1 |
600 |
||
|
|
|
|
2. Were any biological
pesticides such as Bt (Bacillus thuringiensis), |
|
|
|
YES = 1 |
601 |
||
|
|
|
|
3. Were pesticides with
different mechanisms of action rotated or tank |
|
|
|
YES = 1 |
602 |
||
|
|
4. In 2020, how were your vegetable acres primarily scouted for insects, weeds, diseases and/or beneficial organisms?. . . . . . . . . |
1 By deliberately going to the vegetable acres specifically for scouting activities. (Enter code 1 and go to item 5.) 2 By conducting general observations while performing routine tasks. (Enter code 2 and go to item 7.) 3 The vegetable acres were not scouted. (Enter code 3 and go to item 10.) |
. . . . . . . . . . . . . |
|
608 |
|||
|
|
5. Was an established
scouting process used (systemic sampling, |
|
|
YES = 1 |
609 |
|
|
|
|
6. Was scouting for pests done on these vegetable acres due to--- |
|
|
a. a pest advisory warning?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
610 |
b. a pest development model?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
611 |
|
||
1 |
2 |
|
7. Were your vegetable acres scouted for –-- |
[If column 1 is YES, ask---]
Who did the majority of the scouting for [column 1]—
1 Operator, partner or family member 2 An employee 3 Farm supply or chemical dealer 4 Independent crop consultant or commercial scout 5 Processor 6 Other (specify: __________________________ ) |
|
|
YES = 1 |
CODE |
a. weeds?. . . . . . . . . . . . . . . . . . . . . . . . . . |
612 |
614 |
b. insects and mites?. . . . . . . . . . . . . . . . . |
615 |
617 |
c. disease?. . . . . . . . . . . . . . . . . . . . . . . . . |
618 |
620 |
E |
PEST MANAGEMENT PRACTICES |
E |
8.
Were written or electronic records kept to track the activity or
|
|
CODE |
|||||||||
YES = 1 |
623 |
||||||||||
9.
Was scouting data compared to published information on
infestation |
|
|
|||||||||
YES = 1 |
624 |
||||||||||
|
|
|
|||||||||
10. Was field mapping data used for making pest management decisions?. . . . . . . . . . . . . . . . . |
YES = 1 |
625 |
|||||||||
11.
Were the services of a diagnostic laboratory used for pest
identification or |
|
|
|||||||||
YES = 1 |
626 |
||||||||||
|
|
|
|||||||||
12. Were crop residues plowed down or removed to manage pests?. . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
627 |
|||||||||
|
|
|
|||||||||
13. Were crops rotated during the past three years for the purpose of managing pests?. . . . . . . |
YES = 1 |
628 |
|||||||||
14.
Were ground covers, mulches, or other physical
barriers |
|
|
|||||||||
YES = 1 |
629 |
||||||||||
|
|
|
|||||||||
15. Was a crop variety chosen because it had resistance to a specific pest?. . . . . . . . . . . . . . . . |
YES = 1 |
630 |
|||||||||
|
|
|
|||||||||
16. Was no-till or minimum till used to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
631 |
|||||||||
|
|
|
|||||||||
17. Were planting locations planned to avoid infestation of pests?. . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
632 |
|||||||||
|
|
|
|||||||||
18. Were planting or harvesting dates adjusted to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
633 |
|||||||||
|
|
|
|||||||||
19. Were row spacing or plant density adjusted to manage pests?. . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
634 |
|||||||||
|
|
|
|||||||||
20. Was a trap crop grown to help manage insects?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
635 |
|||||||||
21.
Were any beneficial organisms (insects,
nematodes, fungi) |
|
|
|||||||||
YES = 1 |
636 |
||||||||||
22.
Were floral lures, attractants, repellants, pheromone traps
or |
|
|
|||||||||
YES = 1 |
637 |
||||||||||
|
|
|
|||||||||
23. Were any vegetable acres cultivated for weed control during the growing season?. . . . . . . . . |
YES = 1 |
640 |
|||||||||
24.
Were field edges, lanes, ditches, roadways or fence lines
chopped, |
|
|
|||||||||
YES = 1 |
642 |
||||||||||
25.
Were equipment and implements cleaned after completing |
|
|
|||||||||
YES = 1 |
643 |
||||||||||
|
|
|
|||||||||
26. Were any vegetable acres irrigated for the 2020 crops?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
644 |
|||||||||
a. [If item 26 = YES, ask---]
Were
water management practices (excluding chemigation) |
|
|
|||||||||
YES = 1 |
645 |
||||||||||
|
|||||||||||
|
COMPLETION
CODE for |
|
COMPLETION
CODE for |
|
COMPLETION CODE for PEST MANAGEMENT PRACTICES |
|
|||||
|
1 Incomp/R 3 Valid Zero |
200 |
|
1 Incomp/R 3 Valid Zero |
300 |
|
1 Incomp/R
|
500 |
|
E-1 PEST MANAGEMENT PRACTICES E-1
Enumerator Note: For the remaining questions, primary target crop is defined as the largest target crop by acres planted for harvest in 2020, as reported in Section B, Question 1.
The primary target crop on this operation is: crop / crop code.
E-1 PEST MANAGEMENT PRACTICES E-1
1. Were any of the following pesticide spraying practices or activities used on this operation for [insert primary target crop] in 2020? Pesticides include insecticides, fungicides, herbicides, bactericides, nematicides, and plant growth regulators (PGR).
|
1 |
2 |
3 |
4 |
|
Pesticide Spraying Practice or Activity |
Was this used in 2020? |
Was it specifically used to keep pesticide application(s) on target (i.e., reduce pesticide drift)? |
[Complete column for every Yes in Column 1.] Considering labor, training, capital expenditures, and other costs, how easy or difficult was it to implement this practice or activity? |
[Complete column for every No in Column 1.] Why was this practice or activity not used? List all that apply. |
|
|
1 Yes 3 No 99 Don't Know |
1 Yes 3 No 99 Don't Know |
|
|
|
a. Altering spray time(s) depending on weather conditions (e.g., wind speed, wind direction) |
5170 |
5171 |
5172 |
5173 5174 Specify: |
|
b. Calibrate sprayer before the season |
5190 |
5191 |
5192 |
5193 5194 Specify: |
|
c. Calibrate sprayer during the season |
5195 |
5196 |
5197 |
5198 5199 Specify: |
|
d. Manually altering sprayer settings to improve the spray precision (e.g., altering spray pressure, ground speed, and/or boom height) |
5200 |
5201 |
5202 |
5203 5204 Specify: |
|
e. Electronic eye/infra-red |
5165 |
5166 |
5167 |
5168 |
|
or other sensor-based |
|
|
|
5169 |
|
technology (e.g., sonar) |
|
|
|
Specify: |
|
f. Other technologies to improve the spray precision (e.g., on/off nozzle spray technology, GPS technology, variable-rate technology) |
5205 |
5206 |
5207 |
5208 5209 Specify: |
|
g. Pulse Width Modulation (PWM) (e.g., Aim Command, Raven's Hawk Eye, John Deere's Exact Apply) |
5215 |
5216 |
5217 |
5218 5219 Specify: |
|
h. |
Other - Specify: |
5220 |
5221 |
5222 |
5223 |
|
5225 |
|
|
|
5224 |
|
|
|
|
|
Specify: |
E-1 PEST MANAGEMENT PRACTICES E-1
2. Which of the following spraying practices resulted in a sprayer re-calibration for [insert primary target crop] in 2020? Check all that apply.
5261 Computer
calibration alert system
5262 Change
in product being applied
5263 Observed
change in spray pattern (e.g., from worn
nozzles)
5264 Scheduled
calibration (e.g., daily,
monthly,
annually)
5265 When
moving to a different block or
crop
5266 Other,
specify: 5268
5267 None
of the above
3.
Excluding application of herbicides, which of the following methods
of spraying did this operation use to apply
insecticide/ fungicide/bactericides/nematicides/plant growth
regulator for [insert primary target crop] in
2020? Check all that apply.
5405 |
Ground boom sprayer(s) |
5406 |
Aerial application(s) |
5407 |
Spot treatments (e.g., backpack sprayers) |
5410 |
Chemigation (such as through drip irrigation or micro-sprinklers) |
xxxx |
![]() Air blast / Air-assisted sprayer(s) |
5413 |
Other, specify: 5400
|
|
|
|
|
4. Pre-emergence pesticide applications are pesticides that are applied both prior to planting and/or before the emergence of the vegetables for early-season pest management. Pesticides include insecticides, fungicides, herbicides, bactericides, nematicides, and plant growth regulators (PGR). Did this operation make any pre-emergence pesticide applications using air blast sprayer and/or ground boom sprayers for [insert primary target crop] in 2020?
0000
0000
0000
Yes, made pre-emergence pesticide applications using air blast / air-assisted sprayer(s) - Complete Column 1 Yes, made pre-emergence pesticide applications using ground boom sprayers - Complete Column 2
No, did not make pre-emergence pesticide applications - Go to item 5
What pesticide type(s) were used in this [insert
systems type] pre-emergence in 2020? Check all that apply.
What is the typical spray volume, in Gallons per Acre (GPA), for pesticide applications pre-emergence in 2020? Select one item only.
What is the typical operating pressure, in PSI, for pesticide applications pre-emergence in 2020? Select one item only.
What is the typical nozzle used when spraying pesticide applications pre-emergence in 2020? Select one item only.
What is the typical ground speed when spraying pesticide applications pre-emergence in 2020? Select one item only.
What is the typical boom height above the ground when spraying pesticide applications pre-emergence in 2020? Select one item only.
1
For Air blast / Air-assisted sprayer(s)
systems
|
|
|
|
|
|
5421 Fungicides
5422 Herbicides
5423 Bactericides
xxxx Nematicides
5424 Plant Growth Regulators (PGRs)
5425 Other: specify: 5426
|
|
|
|
|
|
|
1 Less than 25 GPA
2 25 to <50 GPA
3 50 to <75 GPA
4 75 to <100 GPA
5 100 to <200 GPA
6 200 or greater GPA
99 Don't Know
|
|
|
|
|
|
|
1 Less than 50 PSI
2 50 to <75 PSI
3 75 to <100 PSI
4 100 to <150 PSI
5 150 to <200 PSI
6 200 or greater PSI
99 Don't Know
1 Hollow Cone
2 Full Cone
3 Disc/Core Nozzle
4 Flat fan
5 Air-inclusion (AI) Air-induction
6 Other, specify:
xxxx_____________
99 Don’t Know
|
|
|
|
|
|
|
1 Less than 1 mph
2 1 to <2 mph
3 2 to <3 mph
4 3 to <4 mph
5 4 to <5 mph
6 5 mph or greater
99 Don't Know
1 <24 inches
2 24 to <36 inches
3 36 inches or greater
4 Don’t know
2
For Ground Boom systems
|
|
|
|
|
|
5428 Fungicides
5429 Herbicides
5430 Bactericides
Xxxx Nematicides
5431 Plant Growth Regulators (PGRs)
5432 Other: specify: 5433
|
|
|
|
|
|
|
|
1 Less than 5 GPA
2 5 to <7.5 GPA
3 7.5 to <10 GPA
4 10 to <15 GPA
5 15 to <20 GPA
6 20 to <25 GPA
7 25 or greater GPA
99 Don't Know
|
|
|
|
|
|
|
|
|
|
|
1 Less than 10 PSI
2 10 to <20 PSI
3 20 to <30 PSI
4 30 to <40 PSI
5 40 to <50 PSI
6 50 to <60 PSI
7 60 to <70 PSI
8 70 to <80 PSI
9 80 to <90 PSI
10 90 PSI or greater
99 Don't know
|
|
|
|
|
|
|
1 Hollow Cone
2 Full Cone
3 Disc/Core Nozzle
4 Flat fan
5 Air-inclusion (Al)/Air-induction/Venturi
6 Other, specify: 5439
99 Don't Know
|
|
|
|
|
|
|
|
|
1 Less than 1 mph
2 1 to <2 mph
3 2 to <3 mph
4 3 to <4 mph
5 4 to <5 mph
6 5 to <6 mph
7 6 to <7 mph
8 7 mph or greater
99 Don't know
|
|
|
|
1 <24 inches
2 24 to <36 inches
3 36 inches or greater
99 Don't know
19
What is the typical target droplet size spectrum for pesticide applications pre-emergence in 2020? Select one item only.
For which of the following reasons did this operation change the airspeed (in revolutions per minute, or RPM) pre-emergence in 2020? Check all that apply.
For Air blast / Air-as1sisted sprayer(s) systems
5443
|
|
|
|
|
2 106-235 microns (Fine)
3 236-340 microns (Medium)
4 341-403 microns (Coarse)
5 404-502 microns (Very Coarse)
6 503-665
microns (Extremely Coarse)
7 Greater than 665 microns (Ultra Coarse)
99 Don't Know
|
|
|
5446 Change of product(s)
5447 Use of
specialty Plant Growth Regulator (PGR) applications (e.g., for
thinning or fruit
finish)
|
|
|
|
5449 Wind speed or wind direction
5450 Other, specify:5451
5452 Never
2
For Ground Boom systems
5444
|
|
|
|
|
2 106-235 microns (Fine)
3 236-340 microns (Medium)
4 341-403 microns (Coarse)
5 404-502 microns (Very Coarse)
6 503-665
microns (Extremely Coarse)
7 Greater than 665 microns (Ultra Coarse)
99 Don't Know
Which of the following practices were used pre-emergence in 2020? Check all that apply.
5453 Drift reducing adjuvant(s)
5454 Drift reducing
nozzle(s)
5454 Shielded sprayers
Xxxx Don’t know
5453
5454
5455
0000
Drift reducing adjuvant(s) Drift reducing nozzle(s) Shielded sprayers
|
|
|
|
5. Post-emergence pesticide applications are made to control pests that occur after emergence of the vegetables.
Pesticides include insecticides, fungicides, herbicides, bactericides, nematicides, and plant growth regulators (PGR). Did this operation make any post-emergence pesticide applications using air blast sprayers and/or ground boom sprayers for [insert primary target crop] in 2020?
-------------
For vegetables, copy the response options into this column for air-blast too.
5241
5240
5242
Yes, made post-emergence pesticide applications using air-assisted sprayer(s) - Complete Column 1 Yes, made post-emergence pesticide applications using ground boom sprayers - Complete Column 2 No, did not make post-emergence pesticide applications - Go to item 6
For Air blast / systems
1
Air-assisted
sprayer(s)
2
For Ground Boom systems
A. What pesticide type(s) were used in this [insert
systems type] post-emergence in 2020? Check all that apply.
B. What is the typical spray volume, in Gallons per Acre (GPA), for pesticide applications post-emergence in 2020? Select one item only.
C. What is the typical operating pressure, in PSI, for pesticide applications post-emergence in 2020? Select one item only.
D. What is the typical nozzle used when spraying herbicide applications post-emergence in 2020? Select one item only.
E. What is the typical ground speed when spraying pesticide applications post emergence in 2020? Select one item only.
1
2
3
4
F. What is the typical boom height above the ground or plant canopy when spraying herbicide applications post-emergence in 2020? Select one item only.
5420
|
|
|
|
|
|
5422
xxxx
5423
5424
5425
|
|
|
|
|
|
|
1
2
3
4
5
6
99
|
|
|
|
|
|
|
1
2
3
4
5
6
99
1
2
3
4
5
6
99
|
|
|
|
|
|
|
1
2
3
4
5
6
99
Insecticides Fungicides Herbicides Bactericides
Nematicides
Plant Growth Regulators (PGRs) Other: specify: 5426
Less than 25 GPA 25 to <50 GPA
50 to <75 GPA
75 to <100 GPA
100 to <200 GPA
200 or greater GPA Don't Know
Less than 50 PSI 50 to <75 PSI
75 to <100 PSI
100 to <150 PSI
150 to <200 PSI
200 or greater PSI Don't Know
Hollow Cone
Full Cone
Disc/Core Nozzle
Flat fan
Air-inclusion (Al)/Air-induction/Venture
Other, specify: xxxx_________
Don’t Know
Less than 1 mph 1 to <2 mph
to <3 mph
to <4 mph
to <5 mph
mph or greater Don't Know
< 24 inches
24 to <36 inches
36 inches or greater
Don’t know
5427
|
|
|
|
|
|
5429
5430
xxxx 5431
5432
|
|
|
|
|
|
|
|
1
2
3
4
5
6
7
99
|
|
|
|
|
|
|
|
|
|
|
1
2
3
4
5
6
7
8
9
10
99
|
|
|
|
|
|
|
1
2
3
4
5
6
99
|
|
|
|
|
|
|
|
|
1
2
3
4
5
6
7
8
99
|
|
|
|
1
2
3
99
Insecticides Fungicides Herbicides Bactericides
Nematicides
Plant Growth Regulators (PGRs) Other: specify: 5433
Less than 5 GPA 5 to <7.5 GPA
7.5 to <10 GPA 10 to <15 GPA 15 to <20 GPA 20 to <25 GPA
25 or greater GPA Don't Know
Less than 10 PSI 10 to <20 PSI
20 to <30 PSI
30 to <40 PSI
40 to <50 PSI
50 to <60 PSI
60 to <70 PSI
70 to <80 PSI
80 to <90 PSI
90 PSI or greater Don't know
Hollow Cone Full Cone
Disc/Core Nozzle Flat fan
Air-inclusion (Al)/Air-induction/Venturi Other, specify: 5439 Don't Know
Less than 1 mph 1 to <2 mph
to <3 mph
to <4 mph
to <5 mph
to <6 mph
to <7 mph
mph or greater Don't know
<24 inches
24 to <36 inches
36 inches or greater Don't know
For Air Blast / Air-as1sisted sprayer(s)
systems
5443
2
For
Ground Boom systems
5444
G. What is the typical target droplet size spectrum for pesticide applications post-emergence in 2020? Select one item only.
H. For which of the following reasons did this operation change the airspeed (in revolutions per minute, or RPM) post-emergence in 2020? Check all that apply.
Which of the following practices were used post-emergence in 2020? Check all that apply.
1
2
3
4
5
6
7
99
5445
5446
5447
5448
5449
5450
5453 Drift reducing adjuvant(s)
5454
Drift reducing nozzle(s)
5455
Shielded sprayers
xxxx
Don’t Know
5452
Less than 106 microns (Extremely Fine or Very Fine)
|
|
|
|
|
236-340 microns (Medium)
341-403 microns (Coarse)
404-502
microns (Very Coarse) 503-665 microns (Extremely Coarse)
Greater than 665 microns (Ultra Coarse)
Don't Know
|
|
|
Change of product(s)
|
|
|
|
Wind speed or wind direction Other, specify:5451 Never
|
1
2
3
4
5
6
7
99
5453
5454
5455
0000
Less than 106 microns (Extremely Fine or Very Fine)
|
|
|
|
|
236-340 microns (Medium)
341-403 microns (Coarse)
404-502
microns (Very Coarse)
503-665 microns (Extremely Coarse)
Greater than 665 microns (Ultra Coarse)
Don't Know
|
|
|
|
Don't know
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
a. How often did this operation clean the system(s) in 2020? Check all that apply.
[If the never box is checked for Item 5464 in Column 1 or 5276 in Column 2, then skip item 25b and go to 25c; otherwise go to 24b.] |
1 For Air Blast / Air-assisted systems |
2 For Ground Boom systems |
5457 Before the season 5458 After the season 5459 Depended on the product(s) 5460 When switching from USDA certified organic to conventional blocks 5461 Regularly scheduled cleaning 5432 Other: specify: 5463 5464 Never |
5271 Before the season 5272 After the season 5273 Depended on the product(s) 5278 When switching from USDA certified organic to conventional blocks 5274 Regularly scheduled cleaning 5275 Other: specify: 5277 5276 Never |
|
b. For each time that the system(s) was cleaned, how often was a tank cleaner used? |
5473 1 Always (100%) 2 Often (51% or more) 3 Sometimes (50% or less) 4 Never (0%) 99 Don't know |
5279 1 Always (100%) 2 Often (51% or more) 3 Sometimes (50% or less) 4 Never (0%) 99 Don't know |
c. Did this operation use separate spray rigs for herbicides |
No Don’t Know |
|
d. What were the most common reasons for replacing the nozzles on the sprayers in 2020? Check all that apply. |
5481 Regularly scheduled calendar based replacement (i.e., annually, twice annually, monthly, etc.) 5482 Regularly scheduled replacement based on operating time (I.e., sprayer operating hours) 5483 Sporadic replacement based on area covered or general intuition (i.e., it feels like the right time to change nozzles) 5484 Calibration problems (i.e., too high or too low a flow rate) 5485 Observed nozzle damage (e.g., change in spray pattern or leaks) 5486 Availability of new nozzle technologies 5487 Expert and/or consultant recommendations (e.g., Cooperative Extension, crop consultants, etc.) 5488 Other, please specify: 5480 5489
None of the above |
5491 Regularly scheduled calendar based replacement (i.e., annually, twice annually, monthly, etc.) 5492 Regularly scheduled replacement based on operating time (I.e., sprayer operating hours) 5493 Sporadic replacement based on area covered or general intuition (i.e., it feels like the right time to change nozzles) 5494 Calibration problems (i.e., too high or too low a flow rate) 5495 Observed nozzle damage (e.g., change in spray pattern or leaks) 5496 Availability of new nozzle technologies 5497 Expert and/or consultant recommendations (e.g., Cooperative Extension, crop consultants, etc.) 5498 Other, please specify: 5490 5499
None of the above |
|
|
|
7.On
what proportion of fields did this operation wind-breaking
structures, such as hedge rows, that are at least one and a half
times the height of the crop canopy in
2020?
1 |
0% |
2 |
1% to 25% |
3 |
26% to 50% |
4 |
51% to 75% |
5 |
76% to 100% |
99 |
Don't know |
8.How often were the following sources of information used to inform pest management decisions in 2020?
Sources |
of |
Information |
1 How often was this source of information used?
99 Don't know Code |
|
a. Pesticide product labels........................................................... |
5301 |
|||
b. University and/or Agricultural Cooperative Extension resources/recommendations................................................... |
5303 |
|||
c. Non-university literature, such as trade magazines, catalogues,newspapers, etc.................... |
5305 |
|||
d. Commodity/trade groups.......................................................... |
5307 |
|||
e. Pesticide sales representatives and/or farm supply distributors............................................................................... |
5309 |
|||
f. Independent crop consultants paid for by the operation......... |
5311 |
|||
g. Crop consultants employed by pesticide companies or other distributors....................................................................................... |
xxxx |
|||
h. Other grower(s). 5 |
..3.1..3.. |
|||
i. Commercial or other non-university decision tools......................... |
5315 |
|||
j. Weather forecasting tools......................................................... |
5317 |
|||
k. |
Other, Specify:5319 |
.......... |
5320 |
9.[If 8b, column 1 equals 1, 2, 3, ask--] Which of the following types of services offered by the University and/or Agricultural Cooperative Extension were most often used as sources of pest management decisions in 2020?
University and/or Agricultural Cooperative Extension Services
....... |
How often was this source of information used?
99 Don't know ... Code |
....... a. Formal presentations (e.g., annual meetings, educational trainings).... |
.5..322 |
....... b. Field days/demonstration workshops.................................................... |
.5..323 |
....... c. Farm visits and/or one-on-one consultation.......................................... |
.5..324 |
....... d. Email lists.............................................................................................. |
.5..325 |
...... e. Newsletters and blogs............................................................................... |
..5.3. 26 |
....... f. Crop and/or Pest Protection Handbook................................................. |
..5.3.27 |
...... g. Other publications (e.g., fact sheets).................................................... |
..5.3. 28 |
...... h. Decision tools........................................................................................ |
..5.3. 29 |
i. Other, Specify:5330 ............................. |
5331 |
resistance
in 2020?
|
Only complete if operation uses herbicides |
Only complete if operation uses fungicides |
Only complete if operation uses insecticides |
|
Practice to Manage Resistance for Herbicide, Fungicide and Insecticide |
How often was each practice used on this operation to manage herbicide resistance? |
How often was each practice used on this operation to manage fungicide resistance? |
How often was each practice used on this operation to manage insecticide resistance? |
|
|
99 Don't know |
99 Don't know |
99 Don't know |
|
a. Scouting........................................................ |
5510 |
5511 |
5512 |
|
b. Field mapping weeds and/or keeping records of field history and pesticide use to assist pesticide decisions.............................. |
5332 |
5333 |
5334 |
|
c. Field Management/Sanitation Practices....... |
|
|
|
|
i. For weed control (e.g., managing weeds in field borders, tillage, preventing field-to-field and within field movement of weed seed)....................... |
5335 |
|
|
|
ii. For disease control (e.g., removing or incorporating unharvested material, cleaning transplant trays, sanitizing process or wash water) |
|
5336 |
|
|
iii. For insect control (e.g., removing or incorporating unharvested vegetables and/or other field litter)............................. |
|
|
5337 |
|
d. Planting disease-resistant cultivars and/or rootstock....................................................... |
|
5338 |
|
|
e. Use of pest diagnostic tools (e.g., Integrated Pest Management (IPM) treatment thresholds, predictive weather models (e.g., degree day models), pest forecasting systems, and/or assistance from diagnostic networks)............................. |
|
5342 |
5343 |
|
f. Pesticide Mode of Action (MOA) rotation...... |
5344 |
5345 |
5346 |
|
g. Pesticide Mode of Action (MOA) combination (i.e., tank mix or pre-mix product)......................................................... |
5347 |
5348 |
5349 |
|
h. |
Rotating crops |
0000 |
0000 |
0000 |
11. In an effort to reduce off-target impacts to plants, pollinators, and/or beneficial insects, did this operation communicate with or consult any of the following sources in 2020? Check all that apply.
5351 Neighboring
crop producers
5352 Nearby
beekeepers
5353 A
local expert, such as an Agricultural Cooperative Extension
agent
5354 State
managed pollinator
protection plans,
or MP3s
(MP3s are
state-developed efforts
that intend
to reduce
pesticide exposure through timely communication and coordination
among beekeeper growers, pesticide applicators, and landowners)
5355 Driftwatch
- Driftwatch is a voluntary communication tool that enables crop
producers, beekeeper and pesticide
applicators to
work together
to protect
crops and
apiaries through
the use
of mapping
programs.
5356 Other
communication tool(s), Specify:
5358
5357 Other,
Specify:5359
12. How often were the following Best Management Practice (BMPs) used during the season in 2020?
|
1 |
2 |
|
Best Management Practices |
How often was this practice used?
99 Don't know |
[Only answer if column 1 = 1, 2, or 3] Was this practice specifically used to prevent exposure to bees?
99 Don't know |
|
a. |
Avoid crop bloom time applications..................................... |
5520 |
5521 |
b. |
Make applications when temperatures are below 50°F........................................................................... |
5522 |
5523 |
c. Maintain buffer between known beehive locations..... |
5524 |
5525 |
|
d. |
Select pesticides that have the lowest residual toxicity to bees........................................................... |
5526 |
5527 |
e. |
Use alternative application methods of an active ingredient to prevent bee exposure (e.g., non-foliar applications when bees are foraging)......................... |
5528 |
5529 |
f. |
Avoid applications when dew is forecast.................... |
5530 |
5531 |
g. |
Manage blooming plants on the orchard floor before applying pesticides that are acutely toxic to bees (e.g., mowing)............................................................ |
5532 |
5533 |
h. |
Make application(s) at nighttime or no more than two hours prior to sunset............................................ |
5534 |
5535 |
i. |
Other, Specify:5536 .... |
5537 |
5538 |
13.Which of the following auditing systems, if any, did this operation participate in during 2020? Check all that apply.
5361 GLOBAL
G.A.P.
5362 State
Quality Food (SQF) Program
5363 Other,
Specify:5365
5364 The
operation did not participate in an auditing
system
5369 Don't
know
|
CONCLUSION |
|
SURVEY RESULTS |
||
1. To receive the complete results of this survey on the release date, go to http://www.nass.usda.gov/Surveys/Guide_to_NASS_Surveys/ |
|
|
To have a brief summary emailed to you at a later date, please enter your email address. |
1095 |
|
|
|
Would you rather have a brief summary mailed to you at a later date?. . . . . . . . . . . . . . . . . . |
|
CODE |
YES = 1 |
9990 |
|
[Thank the respondent, then review this questionnaire.] |
||
|
|
|
ENDING TIME [MILITARY]. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
005
___ ___ ___ ___ |
|
|
OFFICE USE TIME IN HOURS |
|
|
006
. ___ |
RECORD USE |
CODE |
|
Did respondent use operation records to report pesticide data?. . . . . . . . . . . . . . . . . . . . . . . . |
YES = 1 |
064 |
|
SUPPLEMENT USE |
|
Record the total number of supplements used to complete this interview. |
NUMBER |
Fertilizer Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
067 |
Pesticide Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
068 |
|
|
|
|||
Operation Email: (if different from above) Operation Phone
|
|||||
|
|
||
Reported by: ________________________________ |
9910
___ ___ ___ ___ ___ ___ M M D D Y Y |
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
|
9901 |
1-Op/Mgr 2-Sp 3-Acct/Bkpr 4-Partner 9-Other |
9902 |
2-PATI (tel) 3-PAPI (Face-to- Face) |
9903 |
9998 |
9989 ___ ___ ___ ___ ___ ___ ___ ___ ___ |
|||||||||
Eval. |
Change |
|||||||||||||||
9900 |
9985 |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Miller, Brenda - NASS |
File Modified | 0000-00-00 |
File Created | 2023-08-26 |