QID Telephone Quality Control Worksheet for Fruit Chemical U

Agricultural Resource Management Phase 1 & 2 and Chemical Use Surveys

0218 - Quality Control Form - Fruit Chemical Use Survey

Agricultural Resource Management, Chemical Use, and Contractor Expense Surveys

OMB: 0535-0218

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NATIONAL AGRICULTURAL STATISTICS

SERVICE

TELEPHONE QUALITY

CONTROL WORKSHEET

for

FRUIT CHEMICAL USE SURVEY

Form Approved

OMB Number 0535-0218

Approval Expires XX/XX/XXXX

Project code 141

U.S. Department of Agriculture

Rm 5829, South Building

1400 Independence Avenue, S.W.

Washington, D.C. 20250-2000

1-800-727-9540

Fax: 202-690-2090

E-mail: [email protected]


State: _________________________________________________


Farm, Ranch, or

Operation Name: __________________________________________

Version:


Operator’s name: __________________________________________

ID/POID: ______________________________________________


Address: __________________________________________________

Enumerator: __________________________________________


__________________________________________________




Interview Date & Time: ________________________________


Telephone: ________________________________________________

Survey Respondent: __________________________________

Operator/Mgr Spouse Accountant/ Partner Other

Bookkeeper

Current Respondent: __________________________________

Operator/Mgr Spouse Accountant/ Partner Other

Bookkeeper





















INTRODUCTION:

[Introduce yourself, and ask for the survey respondent. Rephrase in your own words.]


Recently you should have been contacted by one of our interviewers, Mr./Ms. , for the Fruit Chemical Use Survey. This telephone call is part of our survey quality assurance measures to verify that personal contact was actually made with you for that purpose. Your response is voluntary and not required by law, but your cooperation will be appreciated. Facts about your farm/ranch will be kept confidential.





















1. During the past few days, do you recall an interview with Mr./Ms. , for the purpose of obtaining information about your farming or ranching operation?

YES - [Go to item 3.]

NO - [Go to item 2.]

DON'T REMEMBER - [Go to item 2.]

2. During the past few days, did any other person from the Agricultural Statistics Service, NASS, or USDA, interview you to obtain information about your farm or ranch?

YES - [Go to item 3.]

NO - [Conclude interview.]

DON'T REMEMBER - [Conclude interview.]

3. Did the person conducting the interview ask you to verify the spelling of your name, address and the

operation name?

YES

NO

DON'T REMEMBER

[Continue on back.]




4. Now I need to verify items that are critical to our survey procedures.


Reported

Verified


a. Total acres of all fruit (Section A, item 4)


_______________________



_______________________



b. Chemical applications to target fruit


None, Positive



None, Positive











5. Did Mr./Ms. conduct the interview in a knowledgeable and professional manner?

YES

NO – Explain: ____________________________________________________________________________________________________

____________________________________________________________________________________________________

____________________________________________________________________________________________________


6. Do you have any additional comments you would like to make concerning our survey contact?

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

This concludes the interview. Thank you for your help.


Signature:___________________________________________________

Date:____________________________________________________



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