Survey ID: 9119 Conservation Effects Assessment Project - Quality Contro

QUALITY CONTROL WORKSHEET
CONSERVATION EFFECTS ASSESSMENT
PROJECT (CEAP) 2024

MONTH

YEAR

_____________________

_______________

OMB No.0535-0245
Approval Expires: XX/XX/20xx
Project Code: 912
Survey ID: 9119

United States
Department of
Agriculture

State:

______________________________________

POID:

______________________________________

Point #:

______________________________________

Enumerator:

______________________________________

Interview Date:

______________________________________

Farm, Ranch, or Operation Name:

______________________________________

Operator's Name:

______________________________________

Address:

______________________________________

NATIONAL
AGRICULTURAL
STATISTICS
SERVICE

______________________________________

Telephone:
Survey
Respondent:
Current
Respondent:

______________________________________

________________________________

Operator

Spouse

Acct/Bkpr

Other

_________________________________

Operator

Spouse

Acct/Bkpr

Other

Good (Morning/Afternoon/Evening): [Introduce yourself, and ask for the survey respondent. Rephrase in your
own words.]
I am ________________________ with NASDA and representative of ______________________ Regional
Field Office of NASS. Recently you should have been contacted by one of our enumerators, Mr./Ms.
__________________, to obtain agricultural information for the CEAP 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 or ranch will be kept confidential. Will you help me by answering a few questions about the interview?
1. During the past few days, do you recall an interview with Mr./Ms. ___________________, for the purpose of
obtaining information about a particular field:
Yes - [Go to item 3]
DK or Don't Remember - [Go to item 2]
No - [Go to item 2]

2. During the past few days, did any other person from the _________________ Regional Office, NASS, or
USDA, interview you to obtain information about a particular field?
Yes - [Go to item 3]
DK or Don't Remember - [Conclude Interview]
No - [Conclude Interview]
3. Did the person conducting the interview ask you to verify the spelling of your name, address, and operation
name?
Yes - [Continue]
DK or Don't Remember - [Continue]
No - [Continue]
4. Now I would like to verify reported acres from your particular field.

Verified

Reported

a. Total acres planted or cropped, EXCLUDING greenhouse and
nursery crops (selected field)? (Section A, item 1a)
b. Total acres in the conservation area of interest? (Section A, item 2)
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: ________________________