Vegetable and Specialty Crops Mandatory

THIS IS TO CERTIFY THAT THE FOOLOWING DESCRIBED COMMODITY WAS WEIGHTED, MEASURED, OR COUNTED BY A WEIGHMASTER, WHOSE SINGATURE IS ON THIS CERTIFICATE, WHO IS A RECOGNIZED AUTHORITY OF ACCURACY, AS PRESCRIBED BY CHAPTER 7 (COMMENCING WITH SECTION 12700) OF DIVISION 5 OF THE CALIFORNIA BUSINESS AND PROFESSIONS CODE, ADMINISTERED BY THE DIVISION OF MEASUREMENT STANDARDS OF THE CALIFORNIA DEPARTMENT OF FOOD AND AGRICULTURE.

VARIETY OF OLIVE (CIRCLE ONE)

DATE

TIME

RECEIVED AT:

SEVILLANO

MANZANILLO

ASCOLANO

MISSION

RECEIVED FROM:

Code Area:

BAROUNI

OBLIZA

HAULED TO STATION BY TRUCKING CO.

BUYER GROWER

TRUCK LIC. NO.

TRAILER LIC. NO.

VEHICLE
GROSS
WEIGHT
LBS.

CALIFORNIA OLIVE COMMITTEE FRESNO, CA
INSPECTION CERTIFICATION:

THE UNDERSIGNED CERTIFIES TO THE CALIFORNIA OLIVE COMMITTEE AND THE SECRETARY OF AGICULTURE OF THE UNITED STATES THAT THIS REPORT IS A COMPLETE AND ACCURATE RECORD OF GRADE OF THE LOT OF OLIVES LISTED.

CONTAINER
INFORMATION

BOX BIN

VEHICLE
TARE
LBS.

CODE

FRUIT AND
CONTAINER
WEIGHT LBS.

COUNT

HANDLER AUTHORIZED OFFICIAL

COMMON TARE

TOTAL
CONTAINER
TARE LBS.

TITLE DATE

BUYERS CONTAINERS
OTHER CONTAINERS

AVERAGE NET FRUIT
PER CONTAINER

LBS

NET
WEIGHT
LBS.

THIS LOT WAS WEIGHED, SAMPLED AND SIZE GRADED UNDER
THE DIRECT SUPERVISON OF THE FEDERAL STATE INSPECTION
SERVICE.

WEIGHED AT:

ADDRESS:

INSPECTOR DATE

DELIVERED TO (BUYER)

WEIGHMASTER

BY
DEPUTY

HANDLERS USE ONLY

OFFICIAL INSPECTION CERTIFICATE

FACTOR:

DEFECTS

GRADED BY:

SAMPLE

LOT

CODE
AREA

OLIVE GRADE
WEIGHTS

OVERRIPE

SIZE

MUTILATED

SIZE

CODE

OZ./LB.

COUNT

POUNDS

WRINKLED

SUPER COLOSSAL

DEFORMED

COLOSSAL

CONTAMINATED

JUMBO

BRUISED

SEV.
EX. LARGE "C"

SCALE

SEV.
EX. LARGE "L"

SOFTNOSE

EX. LARGE

LARGE

MEDIUM

SMALL

PETITE

LO/A

SUB-PETITE

UNDERSIZE

CULLS

TRASH

TOTAL:

TOTALS

TAKEN OUT

TAKEN IN EMPTY

BOXES

BINS

PALLETS

BINS

THIS INFORMATION IS USED TO VERIFY THE PROVISIONS OF THE ORDER, 7 CFR 932.151 MAKING ANY FALSE STATEMENTS OR REPRESENTATIONS IN ANY MATTER WITHIN THE JURISDICTION OF ANY
AGENCY OF THE UNITED STATES, KNOWING IT TO BE FALSE, IS A VIOLATION OF TITLE 18 SECTION 1001, UNITED STATES CODE, WHICH PROVIDES FOR PENALTY OF A FINE, OR IMPRISONMENT, OR BOTH.

Current Burden Statement and Non-Discrimination Statement : 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 0581-0178. The time required to complete this information collection is estimated to average 15 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.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD).

To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

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