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    Because of Incomplete Information. Type of Inspection Must Be Selected Above

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    tstacct543
    This document is a request form for inspections or audits by the United States Department of Agriculture (USDA). It requests key information such as the applicant name and contact information, date and time of inspection, location of products, and products to be inspected. The form also provides information on USDA's auditing services and guidelines for Good Agricultural Practices and Good Handling Practices audits. USDA prohibits discrimination and ensures accessible services. The form collects required information to process inspection and audit requests in an accurate and timely manner.

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    Because of Incomplete Information. Type of Inspection Must Be Selected Above

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    tstacct543
    21 views2 pages
    This document is a request form for inspections or audits by the United States Department of Agriculture (USDA). It requests key information such as the applicant name and contact information, date and time of inspection, location of products, and products to be inspected. The form also provides information on USDA's auditing services and guidelines for Good Agricultural Practices and Good Handling Practices audits. USDA prohibits discrimination and ensures accessible services. The form collects required information to process inspection and audit requests in an accurate and timely manner.

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    USDA 237 plans

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    uSDA 237 plans

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    This document is a request form for inspections or audits by the United States Department of Agriculture (USDA). It requests key information such as the applicant name and contact information, date and time of inspection, location of products, and products to be inspected. The form also provides information on USDA's auditing services and guidelines for Good Agricultural Practices and Good Handling Practices audits. USDA prohibits discrimination and ensures accessible services. The form collects required information to process inspection and audit requests in an accurate and timely manner.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    21 views2 pages

    Because of Incomplete Information. Type of Inspection Must Be Selected Above

    Uploaded by

    tstacct543
    This document is a request form for inspections or audits by the United States Department of Agriculture (USDA). It requests key information such as the applicant name and contact information, date and time of inspection, location of products, and products to be inspected. The form also provides information on USDA's auditing services and guidelines for Good Agricultural Practices and Good Handling Practices audits. USDA prohibits discrimination and ensures accessible services. The form collects required information to process inspection and audit requests in an accurate and timely manner.

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    UNITED STATES DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE FRUIT AND VEGETABLE PROGRAMS FRESH PRODUCTS BRANCH

    REQUEST FOR:

    INSPECTION

    REINSPECTION

    APPEAL INSPECTION

    AUDIT

    (This is the only acceptable form for fax or electronic submission to USDA for inspection/audit requests)
    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 0581-0125. The time required to complete this information collection is estimated to average 2 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 individuals 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 USDAs 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.

    NOTE: Fill in all appropriate blocks; blocks with * must be completed. Inspection may be delayed because of incomplete information. Type of Inspection must be selected above.
    *Applicants (Company) Name: *Street Address: *City, State & Zip: *Contact Person: *Phone Number:
    Enter when different from Applicant:

    *Date: *Time: Type of Carrier: Car Number or Type: License Number: Car: Trailer: Lot Inspection Applicants P.O. Number:

    *E-Mail Address: *Shippers Name: City and State: Receivers Name: City and State: *Location of Product(s):

    Lots Separated by (Optional): PLI Numbers Grower Numbers Size Other, Specify: Digital Images Requested: Yes No

    *Inspection Requested For (Must select at least one): Quality and Condition (including size when applicable) Condition Only Size Net Weight Other, Specify: Auditing Services (Please fill out page 2): Products To Be Inspected

    *PRODUCTS

    BRANDS/MARKS

    *QUANTITY

    Type Container

    *Size

    Type/Variety

    Remarks/Special Instructions;

    FV-237 (03/07) Page 1 of 2 (Previous editions may be used)

    UNITED STATES DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE FRUIT AND VEGETABLE PROGRAMS FRESH PRODUCTS BRANCH

    REQUEST FOR GOOD AGRICULTURAL PRACTICES & GOOD HANDLING PRACTICES AUDIT (Only fill out this page if requesting an Audit)
    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 0581-0125. The time required to complete this information collection is estimated to average 2 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 individuals 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 USDAs 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.

    NOTE: Fill in all appropriate blocks; blocks with * must be completed. Audit may be delayed because of incomplete information. * Company Name: *Street Address: *City, State & Zip: *Phone Number: *Contact Person: *Phone Number(s) of Contact Person: *E-Mail Address: Website (if applicable): *Please Choose One: USDA GAP & GHP Audit USDA GAP & GHP Audit for Processed Products Branch QTV Program Client Requested GAP & GHP Audit
    Note: When choosing the USDA audits, the USDA checklist will be used. When choosing the Client requested audit, USDA will audit using a checklist supplied by the client.

    The GAP & GHP Checklist and scoresheet is available on the USDA website: http://www.ams.usda.gov/fv/fpbgapghp.htm * Check which sections of the GAP & GHP audit the farm/facility will be audited to and commodities covered: Part 1 Farm Review List Commodities being Reviewed Part 2 Field Harvest & Field Packing Activities Part 3 House Packing Facility Part 4 Storage and Transportation Part 5 Traceback Part 6 Wholesale Distribution Facility/Terminal Warehouse Part 6a Traceback Part 7 Food Defense Does the company have more than one facility that will be audited? (circle one) Has the company had a USDA GAP & GHP before? (circle one) Total acres farmed: Remarks/Special Instructions:
    FV-237 (03/07) Page 2 of 2 (Previous editions may be used)

    Yes Yes

    No No

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