19. Will you guarantee 120-day notice if lease is canceled?

CCC-560 U.S. DEPARTMENT OF AGRICULTURE A. LEAVE BLANK - FOR CCC USE ONLY

(08-22-03) Commodity Credit Corporation 1. Date Approved 2. Contract No. 3. Warehouse Code No.

 (MM-DD-YYYY)

APPLICATION FOR APPROVAL OF WAREHOUSE

(Processed Commodities) RETURN TO: KANSAS CITY COMMODITY OFFICE

DAIRY AND DOMESTIC OPERATIONS DIVISION

P. 0. BOX 419205 - STOP 8718

(See Page 2 for Privacy Act and Public Burden Statements) KANSAS CITY, MO 64141-6205

Prepare an application for each building. On all but the initial application, omit items 8 through 14 and other items not appropriate.

B. MANAGEMENT C. FACILITIES (Continued)

4. Type of Storage: 16. Warehouse is: If Leased, answer

Items 17 through 21. Dry Cooler Freezer Owned Leased

5. Legal Name of Operating Entity 17. Name of Lessor

6. Main Office Address of Operating Entity

18. Written lease?

20. Renewal option?

7a. Telephone No. (Include Area Code) 21. Expiration Date (MM-DD-YYYY)

CHECK

22. No. Floors (Include basement)

8. Type of Operating Entity:

 a. Corporation

b. Cooler c. Freezer

b. General Partnership

a. Dry

23. Area of each type of

 Storage (Square Feet)

c. Individual

CHECK

d. Limited Partnership

24. Type of construction:

a. Concrete

e. Other: (Specify)

b. Brick

c. Iron clad

9. If corporation, does purpose clause of articles of

 incorporation authorize "public warehouse business?''

d. Wood frame

a. Basement b. Ground Floor

10. If a Partnership, list names of partners (Indicate by " * " those authorized to

 bind Partnership.)

25. Material Used For:

c. Other Floors d. Walls e. Roof

26. Age of Warehouse 27. Is Building (for dry storage only)

Insulated Heated

28. Original use for which building was intended

12. Name of Warehouse Manager or Superintendent

13. Warehouse Operated As: Public Private

29. If cooler, can 28 degrees F to 32 degrees F and 50

 percent to 70 percent humidity be maintained?

14. License No. (If applicable)

30. If freezer, can 0 degrees F or lower be maintained?

a. State b. U.S. Warehouse Act

31. Is auxiliary equipment available for maintaining

 temperature in event of breakdown? (Items 29 and 30)

C. FACILITIES OFFERED

D. MATERIAL HANDLING EQUIPMENT

15. Name and Location of Warehouse (if different than above)

32. Palletized system? (Explain "NO" in item 64)

33. Are gasoline powered vehicles equipped with approved

 spark arrestors and extinguishers?

34. No. Handtrucks

37. No. Trailers

YES NO

YES NO

11. If a Corporation, list names or titles of all authorized to execute contract

 (Attach either an excerpt from the by-laws or a copy of resolution of the

 board of directors giving this authority.)

YES NO

35. No. Gasoline Tractors 36. No. Electric

 Tractors

38. No. Gasoline Lift or

 Fork Trucks

39. No. Electric Lift

 or Fork Trucks

Check if propane.

This form is available electronically.

7b. FAX No. (Include Area Code)

7c. E-Mail Address
CCC-560 (08-22-03) Page 2

E. HANDLING CAPACITY G. FIRE PROTECTION

40. Does building have a car door level loading platform?

55b. If ''YES''

41. Does building have a truck bed level loading dock?

Wet

42. In an 8-hour day, number of cars, trucks, and pounds that can be:

Dry

a. Cars b. Trucks c. Pounds

56. Outdoor water hydrant system?

Loaded

57. Chemical fire extinguishers?

a. Cars b. Trucks c. Pounds

Unloaded

F. TRANSPORTATION FACILITIES

43. Railroads serving warehouse (Indicate railroad which spots cars) 58. Are public fire fighting facilities available?

H. OTHER PROTECTION

59a. Security service provided?

44. Are reciprocal switching privileges available?

 (If "YES", identify number and list names of RR in

 Item 53.)

59b. If ''YES'', describe system (include inclusive hours

 and by whom). (If more space is needed, use

 ''Remarks'' section.)

45. Is storage in transit available? (If ''YES'' identify by number

 and list commodities in Item 53.)

46. Railroad siding immediately adjacent to warehouse?

59c. If ''NO'', describe protection afforded the warehouse

48. If team track, are commodities moved to and from during non-operating hours.

 warehouse in covered or insulated trucks?

49. Frequency of switch 50. Maximum number of cars spotted

 at one time

60a. Insect control program provided?

60b. If ''YES'', by

52. If no siding, indicate distance

 to nearest track (miles) Commercial Contract Warehouse Personnel

60c. Name of Firm (If applicable)

53. Information from Items 44 and 45 61a. Rodent control program provided?

61b. If ''YES'', by

Commercial Contract Warehouse Personnel

61c. Name of Firm (If applicable)

54. Source of Water Supply

63. Are records kept of control measures taken?

64. REMARKS

NOTE:

The applicant certifies that all statements made herein are true and correct to the best of his or her knowledge and belief.

65. Legal name of operating entity (warehouse operator)

66. By (Authorized Official) 67. Title 68. Date (MM-DD-YYYY)

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race color, national origin gender, religion age disability, political beliefs sexual orientation, and

marital or family status. (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 USDA Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence

Avenue, SW, Washington, D. C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.

YES NO

YES NO

47. Do you have exclusive use of this siding?

55a. Is automatic sprinkler system

 installed (or present)?

YES NO

SIZE/TYPE NO.

YES NO

62. If ''NO'', in Items 60a and 61a, are you willing to

 institute an insect and rodent control program as

 recommended by USDA?

51. Maximum number cars worked at

 one time

The authority for collecting the following information is Pub. L. 107-171. This authority allows for the collection of information without prior OMB approval mandated by the Paperwork Reduction Act

of 1995. The time required to complete this information collection is estimated to average 60 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 following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a). The authority for requesting the following information is 15 U.S.C. 714 and regulations promulgated

thereunder (7 CFR Parts 1423 and 1403). The information will be used to complete the terms of an agreement between the warehouse operator and CCC. Furnishing the requested information is

voluntary, however, without it, eligibility to enter into an agreement with CCC cannot be determined. This information may be provided to other agencies, IRS, Department of Justice, or other State

and Federal Law enforcement agencies, and in response to a court magistrate or administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 371, 641, 651,

1001; 15 USC 714m; and 31 USC 3729, may be applicable to the information provided. RETURN THIS COMPLETED FORM TO THE KANSAS CITY COMMODITY OFFICE, P.O. BOX 419205,

STOP 8718, KANSAS CITY, MO 64141-6205..