State and Local Governments

Appendix F09. PLATE WASTE OBSERVATION BOOKLET (GROUP 3)

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OMB Number: 0584-xxxx

Expiration Date: xx/xx/20xx

PLATE WASTE OBSERVATION BOOKLET

Employee ID: ______________________________________
School MPRID: ____________________________________ -10		Book: of ______
School name: _____________________________________		Date: _____________
Meal: £ Breakfast (-10) £ Lunch (-12)	Day: £ Mon £ Tue £ Wed £ Thu £ Fri
Total number of reimbursable breakfasts or lunches to be served during the day: __________________________

Meal period	Start time	End time	Grade level or range	Target number of tagged trays per data collector*	Share table available during meal period (Circle yes/no)
1					Y N
2					Y N
3					Y N
4					Y N
5					Y N
6					Y N
7					Y N
8					Y N
9					Y N

*Over the course of the day, each data collector should tag a total of 10 breakfast trays and 20 lunch trays, for a total of 20 breakfast trays and 40 lunch trays tagged during the day.

This information is being collected to assist the Food and Nutrition Service in understanding school food purchasing practices, the nutritional quality of school meals and snacks, the cost to produce school meals, and student participation and dietary intakes. This is a mandatory collection and FNS will use the information to monitor program operations. This collection does not request any personally identifiable information under the Privacy Act of 1974. 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 0584-[xxxx]. The time required to complete this information collection is estimated to average 0.17 hours 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22314 ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

FOOD LIST

Prior to meal service, list all foods that will be offered in the reimbursable meals being observed.

Tagging interval: _____________

Target number of tagged trays per data collector, per meal period: _____________

Row #	Food name	Reference portion (Size of 1 unit)	Food description
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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PLATE WASTE OBSERVATION FORM

[NOTE: This half-sized page will be printed 20 times, assembled into the booklet so that it appears only on the right side of an open booklet and the left side of the inside cover is visible at all times. The lines on this page will align with lines on the inside cover, where the Food List is displayed.]	In # units remaining column: For liquids, record fluid ounces REMAINING For solid foods, record FRACTION REMAINING, to the nearest 0, ¼, ½, ¾, or 1.
		tray #: ______ meal period: ______ £ tray not returned		tray #: ______ meal period: ______ £ tray not returned
	row #	# units taken	# units remaining	# units taken	# units remaining
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10
	11
	12
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	24
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	32

PLATE WASTE OBSERVATION NOTES
Use this space to make notes to aid your work and to record issues that arise.

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