Agricultural Marketing Service, Specialty Crops Program, Specialty Crops Inspection Division

This PATCH represents official guidance. This PATCH is scheduled to be incorporated into the 

document listed above. After incorporation into the document listed above this PATCH will 

become obsolete. USDA is an equal opportunity provider, employer, and lender. 

PATCH # 061 Brief description of subject (November 30, 2020) 

SCI Division Inspection Series 

Page 1 of 1 

PATCH # 061

DOCUMENT: Federal-State Inspection Certificate (FV-184) Handbook, April 1994 

REMARKS: The following information regarding all certificates completed for the purposes of 

Commodity Procurement contracts will be edited in the Fed-State Inspection Certificate (FV184) Handbook to reflect updated information to be placed in REMARKS.

Commodity Procurement

The AMS Commodity Procurement Staff buys fresh fruits and vegetables for distribution to 

various organizations. These purchases are required to be inspected by the SCI Division and 

Fed-State collaborators for contractual compliance purposes. Before inspecting any of these 

purchases, each office will receive specific instructions from their respective Federal Program 

Manager that will provide documentation with specific information, including delivery dates, the 

commodity, and grade requirements. Do not inspect purchased products until you receive 

instructions. Do not deviate from the instructions without authorization from Regional 

Operations Support staff or Fed-State Inspection Management. 

The purchase order (PO) contains all the information that is required to be recorded on the 

issuing certificate. All certificates must contain the following statement: 

“Meets (Fails to Meet) the Requirements of Solicitation ___, Solicitation Sales Order 

number __, Purchase order number ___ , and Purchase Line Item number .” 

If the load/lot fails the requirements an additional statement of “Account ___” will be added to 

clarify the factor that caused the failure, such as: 

“Fails to Meet the Requirements of Solicitation ___, Solicitation Sales Order number 

___, Purchase order number ___, and Purchase Line Item number account marked size.” 

Provide additional information in Remarks as necessary to further clarify the account factor, such 

as: 

“Size marked on cartons is not the size required per the Solicitation.” 

For those collaborators completing FEIRS certificates, there is a drop-down remark available to 

complete this statement efficiently and accurately. 
United States 

Department of Federal-State Inspection Agriculture 

'· Agricultural 

Marketing Certificate (FV-184) Service 

Fruit and 

Vegetable Handbook 

Division 
Federal-State 

Inspection Certificate 

(FV-184) Handbook 

These instructions are intended to supersede all prior instructions regarding 

. Shipping Point certificate writing in the General Shipping Point Inspection 

Instructions as well as those contained in the various commodity inspection 

instructions. They are not intended to supersede or change any sampling or 

grading procedures. 

Instructions for completing the FV-184 certifictate that would be in· 

conflict with those in this handbook may not be issued without approval fro·m 

Headquarters. 

, _ _./ . . . 

APRIL 1994 

This publication may be duplicated without authorization from USDA 

REPRINTED MARCH zoos· 
TABLE OF CONTENTS 

SECTION ............................................... , ...................................................... PAGE 

GENERAL INSTRUCTIONS ............................................................................. 1 

LINE-BY-LINE INSTRUCTIONS ....................................................................... 4 

( 1 ) Sublot. .............................................................................................. 4 

(2) Inspection Started ............................................................................ 4 

(3) Inspection Completed ...................................................................... 4 

(4) Applicant .............................. : ...... _ ......... ............................................ 5 

(5) Inspection Point ......................... : ..................................................... 5 

(6) Conveyance No ....................................... ·: ....................................... 5 

(7) PLI. ................................................................................................... 6 

(8) Other ID ........................................................................................... 6 

(9) Notesheet No ................................................................................... 7 

(10) Product/ Variety .............................................................................. 7 

(11) Number and Size of Container ........................................................ 7 

(12) Description of.Product. .................................................................... 8 

(13) Grade .............................................................................................. 9 

(14) Blank Heading ......... _. ..................................................... ................... 9 

(15) Above Pro~ucts Meet Requirements of Marketing Order ............... 9 

(16) REMARKS ...................................................................................... 9 

(17) Inspector's Signature ...................................................................... 10 

( 18) Date Issued ..................................................................................... 10 

(19) Fee Block ........................................................................................ 1 O 

(20) Estimated Total ............................................................................... 1 O 

Certifying Product for Be Import Requirements or Government Purchases ...... 11 

EXAMPLES ....................................................................................................... 12 
GENERAL INSTRUCTIONS 

The Federal-State Inspection Certificate (FV-184) is the only non-commodity 

specific certificate available from the USDA to certify shipping point inspections. For 

instructions for completing any of the commodity specific shipping point certificates, 

contact your supervisor. 

These instructions cover the minimum information that is required to be 

entered on the FV-184. Your Federal or Federal-State supervisor may issue 

_ additional instructions that address the oonc~ms of the industry and/or inspection 

program for a particular State, area, or commodity. 

The certificates are accountable documents. Accordingly, the certificates are 

serially numbered, and each office is supplied with books of certificates bearing 

consecutive numbers. The certificates should be issued as much as possible in 

ascending order as numbered. Before a certificate is issued, it is important to check 

that each certificate copy bears the same number as the original. If a certificate is 

discovered with serial numbers that do not match the original, the certificate should 

be voided immediately and each occurrence reported to the Regional/Headquarters 

office. If for any reason two certificates are given the same number and are issued 

: -prior to discovery of the duplicate numbers, all outstanding copies of one set, 

, including the original, should be recalled and a superseding certificate issued. The 

number of the certificate being superseded and date and time of the inspection shall 

be included under "REMARKS" of the superseding certificate. In a case where the 

certificate being superseded and the certificate with the duplicated serial number 

were issued on the same day and the same time, then the commodity and number 

of packages ( or any other information that makes one certificate different from the 

other) shall also be included. 

Example: REMARKS: This certificate supersedes certificate number 

M-000000-0 dated January 3, 1994, 8:05 a.m. for 1000 sacks of White GranexGrano Onions. 

Corrections shall never be made on the following entries, which are 

considered vital points of the certificate: 

• Carrier initials or numbers 

• Date or Time 

• Name of applicant or shipper 

• Grade statements 

• Percentages of defects or size 

• Number of containers (when certified by the inspector) 

1 
If a mistake is discovered on a vital point before certificate issuance, the 

certificate must be VOIDED. If a mistake is discovered on a vital point .a.fler 

issuance, the Gertificate must be superseded. Corrections of other information 

must be initialed by the inspector. 

The standardized notesheet, Form FV-184-13, was specifically developed to 

coincide with the FV-184. Other notesheets may be used at the State program's 

discretion. 

It is mandatory that all information which appears on the certificate b.e 

supported by information on the notesheet. However, only such information as 

needed to complete the certificate or as directed by your supervisor is required on 

the notesheet. 

Remember, the notesheet should be complete and legible so that any 

inspector can write a complete certificate from your notes. 

The Data Entry block in the bottom left hand corner of the FV-184 is intended 

to facilitate automated billing, collection, and data processing procedures. 

Completion of this section is. voluntary, and any State program wishing to use this 

portion of the certificate for their own purposes may do so. 

/ 

2 
AGhlCUt 1 UHAt. MAHi<.( flNC S(l\\l'IC( 

fl\UlT ANO V(C(TAOl( OIVl~OH sFEDERAL-ST ATE INSPECTION CERTIFICATE o SUBLOT 0 

• 

1NSf'£CTION '. M "· U '. O 0 .. Y. 

STARlED: . I I I .· \ . ~ '··<' u u b 0 , y INSf'£CTION , 

COM~ I I I I N'l'UCANT: 0 NSPl;CTION POINT: ( g ) 

y @(otr Min.' 

I 

Y ~ 'Hour Min. 

I 3 I CJTY/ STATE; 

. 

P\.I: 0 

a) 

I 

i 

i 

! 

I 

-:·:·,~:·:·,:·:·:·:·:·:·::,::,;.:;.,:~·~·:·:·,:·:·:·:·:·:·:·:·:·:,:,;.:,:.:,:.;,.;.::,:;;.;.;.,;.;,:,:•:•:A'90lm•:f!ROOUCTS,·:·ME£-T~:·RE<IU1REMENJ-S·::OF.:MARKalN(i:::-OAniAf~.\:15J ,.,;.,,,.:.;;~. ;,:,:•:·:·:·:·:·:~·:·X7'.·:·:·:··. ;.;;,.;.;.,:,:•:• 

:,:,:;:,:•:•:-::•:"2t:£<VMIEl¥.,ilF.fflo.Ouc:T.•:•NID:flUM88l.;-0F_...COH)'NNERS ,ME·l'fl0\IIOED:BX-:•:rtfE•~~:.)/\No:~«ot,;11EJNGCDmflED/ 8Y•;uiE·~Sl'ECT.OR~£SS;oJHfflW)SF.N<>1H.1•:•:;.·.:·:·:,•:•::·. 

01:aoY•••·-~..... " "''- REMARKS : r.. 6'\ " .·:,,,; .. -.,,< COR11£CTS';fV:1-.C'<:S1TIF1Cl'.TE'Nl1M8£R "t<, . -':!;xc ~J ''I ""'!------=~--------- ------------ ---~ 

,:. I I I . 1. ) 0 I - h ~ 

c ,•:-<:. ·~. •.·~-~ ~;,,.,,:;:,,. .,: i . : 

I <l:?:·,,~~1/ff\f;J.. ). _i~ _f{ ltj~'.i ·~t~;.,'J.:.~_,.,,r:~':«, ~·,·=,-_· .:r:.~'-·.E'~.,/. ,'.··-· ... : .. ·,. '1 .·1------------------------------------------1 -::,0

, ,. ,.'". · · 1,:; thli. u11,d11fsign11t/;{ t -'fuly ·.aL!f_ho_rii~d.,'i[i,sp11ctor :of the Unit11d Stat11s;, 

D.epe,:tment .. of 'Ag,:1cultur11, · do .. hereby sc11nify .. that samples. of .the FEE: $,---~----t 

~- "' · ~r · her.ein -.described ;~roilucl were ';n;j;"eci~d . and the grades , ii$' ,sho·;,,/11 . 19) . . NSPE~;··< . . ",:,~vu i I by-said samples were as h11rein ifi,tcd) , O.T.: $,_ __ ~--- BY MIL£S ' 

:. O.T. 1tn.,'j I EXP.:$ 

ESTIMATED TOT M. 

INSPECTOR'S SIGNATURE 

3 
LINE-BY-LINE INSTRUCTIONS 

The following are line-by-line instructions for completing the FV-184. Keep in 

mind that these are the minimum requirements and that any additional instructions 

by your Federal or Federal-State supervisor must also be followed. 

The previous page is an example of an FV-184. A circled number is located 

in each area of the certificate that corresponds with a numbered heading below. All 

examples refered to, are in the back of this book. 

If there is any unused space left in the body of the certificate after it has been 

completed, an X or a diagonal line should be drawn across the unused portion to 

prevent unathorized entries (see examples). 

(1) SUBLOT 

Whenever only a portion of a lot from a notesheet or from a previously issued 

master certificate is being certified on the certificate, enter an X in the "SUBLOT' 

box. For example, a certificate is being written for a trailer load of product that was 

sampled on a day's run notesheet. This trailer load is a sublet of the day's run. See 

section (9), "NOTESHEET NO." 

(2) INSPECTION STARTED 

The date and time shown in these blocks on the certificate should be the 

local time at which the inspection process begins. The inspection process is 

considered to have begun when the inspector has arrived at the inspection site and 

the product is available for sampling. Exact time should be recorded unless your 

supervisor instructs you otherwise. No reference should be made to standard or 

daylight savings. time. If necessary, include leading zeros when completing each 

area of the date and time section so that all entries are two digit numbers (see 

examples). 

Note: 12:00 noon shall be recorded as 12:00 pm and 12:00 midnight shall be 

recorded as 12:00 am. 

(3) INSPECTION COMPLETED 

The date and time in these blocks on the certificate should be the local time 

that the last sample was completed. Otherwise, all instructions from "INSPECTION 

STARTED" apply. 

4 
If a lot is being certified on a conveyance and the loading does not begin until 

after the insp~ction is completed, the date and time (beginning and end) of the 

loading may be entered under "REMARKS" (see Example No. 3). If the inspector 

does not witness the loading, the load can not be certified to the conveyance. 

(4) APPLICANT 

The company that requested the inspection and will be paying the fee is the 

applicant. At shipping point this is usually the shipper. The company name and the 

city and state where the company is located shall be entered in the "APPLICANr' 

- block. 

lff the shipper is someone other than the appli9ant, and the inspection is being 

performed at the shipper's facil_ity, the shipper's name and location shall be entered 

in the "INSPECTION POINr' block followed by the word "(SHIPPER)" in 

parenthesis (see Example No. 1 ). If the applicant is not the shipper and the 

inspection point is not at the shipper's facility, the shipper's name and location shall 

be entered under "REMARKS." 

.(~) INSPECTION POINT . . ./ ' The inspection point is the actual location where the inspection was 

performed. If the inspection point is in the same company and location described in 

the applicant block, it is permissible to enter "Same" in this block or "Applicant's 

packing shed," "Applicant's Warehouse," etc. If an applicant has !110re than one 

facility, enter the locally accepted name of the facility, such as "Applicant's 

Warehouse #1," "Plant #3," etc. In such c:ases it will not be necessary to enter the 

city and state again. If the inspection site is in a different city than is noted in the 

"APPLICANr' block, show the city, state and location where the inspection was 

performed. If the shipper is someone other than the applicant, enter "Shipper's 

warehouse," "Shipper's packing shed," etc. and enter the city and state. 

(6) CONVEYANCE NO. 

Under "CONVEYANCE NO." enter the identifying number of the conveyance 

such as the trailer license number, rail car number, etc. 

Under ''TYPE" enter the type of conveyance such as "open top trailer," 

"vented van," "rail car," etc . 

. If the load is not being certified to the conveyance but the applicant is 

providing the conveyance number, enter "Applicant states" and enter the number 

5 
provided. It is not necessary to enter the type if the applicant provides the 

conveyance number. If a conveyance number is entered in this block and is not 

qualified by a term such as "Applicant states," it means that the inspector obs.erved 

the product on the conveyance. 

If the load is not being certified to a conveyance and the applicant is not 

providing the conveyance number, enter "Lot inspection." 

Note: The "CONVEYANCE" block should never be left blank. Either the 

conveyance number certified by the inspector or stated by the applicant or 

"Lot inspection" must be entered in this block. 

(7) PLI 

Only Federal or Federal-State Positive Lot Identification numbers are to be 

entered in this block. If more than orie lot is being certified and each lot has its own 

separate PU number, enter "See below" in this block and write in the PU number 

under the "DESCRIPTION OF PRODUCT' section in the body of the certificate with 

each lot (see Example No. 1). Any PU number that is entered in the "PU" block 

applies to all lots entered on 'the certificate. 

, If a situation arises where more than one PU number would cover all lots on 

the certificate and there is· not adequate space in the "PLI" block, it is allowable to 

cross out "Other ID" in the next lower block and enter the additional PLI numbers in 

that block. If this still would not allow adequate room for the PU numbers, enter 

"See REMARKS" in the "PU" block and list all the PLI number.sunder "REMARKS." 

If no PU number is being noted on the certificate, the ,;PU" block shall be 

lined or X'd out. 

(8) OTHER ID 

The "OTHER ID" block is used to enter any identifying marks other than 

Federal or Federal-State PU. These would include grower numbers, State lot 

numbers, P.O. numbers, Bill of Lading numbers, etc. The use of this block is 

optional but should be used if the applicant requests that additional identification be 

noted or if your supervisor specifies that additional identification be used. 

If there is not adequate space in the "OTHER ID" block, enter "See Remarks" 

and list all additional identification under "REMARKS." 

If no additional identification is being note.don the certificate, the "OTHER ID" 

block shall be lined or X'd out. 

6 

-· 
(9) NOTESHEET NO. 

If the certificate is being written from notes on a serially numbered notesheet, 

the serial number(s) shall be entered in the "NOTESHEET NO." block (see Example 

No. 1 ). If the certificate is being written from a previously issued master certificate, 

the word "NOTESHEEr' should be crossed out and "Certificate" written in and the 

certificate number should be entered in this block. In this case, the "SUBLOT" 

check box at the top of the certificate should be checked. 

If there is not adequate space in the "NOTESHEET NO." block to list all 

notesheet or certificate numbers, enter "See REMARKS" and list the numbers under 

-"REMARKS" and note whether they are ·notesheet or certificate numbers. 

If the "NOTESHEET NO." block is not being U$ed, it should be lined or X'd 

out. 

(10) PRODUCT/ VARIETY 

The common name of the commodity is to be shown under the 

"PRODUCTNARIETY'' heading. The type, when applicable, may also be ~hown 

under this heading or if the type Js marked on the container it may be entered under 

:'the "DESCRIPTION OF PRODUCr' heading. Variety may also be shown under the 

, "PRODUCTNARIETY'; heading. The certificate provides a disclaimer stating that 

the variety is not beil')g certified by the inspector. 

(11) NUMBER AND SIZE OF CONTAINER 

The number of containers must be entered under this heading along with the 

type of container, such as "sx," "ctns," etc. If the size of the container is not included 

with the container markings under "DESCRIPTION OF PRODUCT" it will be 

acceptable to state under this heading "25 lb. size sx," "50 lb. size ctns," etc. If the 

lot is bulk, state "bulk" and enter the weight. If the lot is in bins, state "bulk bins." 

The certificate provides a disclaimer stating that the number of containers is 

not being certified by the inspector unless otherwise noted. If the inspector is 

certifying the number of containers a statement such as the following must be made 

under "REMARKS" (See Example No. 3): 

REMARKS: Number of containers certified by Inspector 

If a statement such as this is not made, the number of containers may be 

changed by crossing out the number with a single line and entering the corrected 

number. The inspector shall initial the correction. If the number .of containers is 

7 
being certified by the inspector, the only way it can be corrected is to supersede the 

certificate. 

For multiple lots when only certain lots are being counted by the inspector, an 

asterisk shall be placed immediately before each count being certified by the 

inspector with a statement such as the following under "REMARKS:" 

REMARKS: Number of containers marked with asterisk certified by 

Inspector 

(12) DESCRIPTION OF PRODUCT 

The brand on the container must be entered under this heading. If a brand is 

not marked on the container, enter "No brand." Any other markings on the container 

may be entered under this heading such as net weight, size of container, count, 

size, pack, etc. 

Any descriptive information about the lot may also be entered under this 

heading, such as percentage of defects, offsize or decay, condition of load or 

container, etc. · 

, If a lot is in grade, it is not necessary to state the percentage of decay or 

whether the offsize or defects are within or average within tolerance unless your 

supervisor has instructed you otherwise or it is requested by the applicant. If a 

statement is made about either the offsize, defects or decay, then the others must 

be stated also, although if decay is stated along with the grade, it is not necessary to 

repeat it under this heading. If a lot is reported as failing to grade, a statement must 

be made as to the percentage of defects, offsize and decay. For a percentage 

grade lot, it is not necessary to show the range of defects and the percentage of 

decay unless the lot is also being shown as failing to meet a grade or marketing 

order. When a pear or apple lot is being certified after storage or transit, and the 

grade statement is being qualified by a defect(s) being a factor of condition, the 

percentage of grade defects and the percentage of each condition defect (including 

decay whether present or not) must be shown along with the percentage of offsize. 

Size statements will be made under "'DESCRIPTION OF PRODUCT' when 

applicable. If a size statement is made in conjunction with a grade statement, it will 

not be necessary to repeat it under this heading unless a statement is being made 

as to the percentage of offsize or if the applicant requests a more detailed size 

statement. 

8 
(13) GRADE 

Under this heading a grade statement must be entered when applicable. 

Individual commodity handbooks give full instructions for writing grade statements 

along with any complementary size statements when required . If a product is being 

inspected that has no standard, enter "No established U.S. grade" (see Example 

No. 2). 

Under this heading, the vertical lines on either side are dotted. This allows 

for any unused space immediately on either side to be used when there is not 

adequate space between the lines. 

(14) Blank Heading 

The blank heading on the far right side of the certificate, next to the "GRADE" 

column, is intended to be used to show the hundredweight or State or Country of 

origin for the State programs that wish to provide this information. 

If hundredweight is.being provided, enter "CWT'' in the blank box in the 

heading and enter the hundredweight in the column below beside each lot (see 

Examples No. 1 and No. 4) . 

. 

' If State or Country of origin is being provided, enter "Origin" in the blank box 

and enter the State or Country of origin in the column below beside each lot. 

Use of this heading is optional. If this heading is not being used, the space 

under this heading should be used as additional space for the grade statement. 

(15) ABOVE ~RODUCTS MEET REQUIREMENTS OF MARKETING ORDER ... 

If a product(s) is being certified under a marketing order, and the product(s) 

meets the requirements of the marketing order, the marketing order number must be 

entered in the box directly to the right of this statement (see Example No. 3). If a 

certificate is being written on a product(s) that fails to meet requirements of a 

marketing order, the certificate must show this by drawing a line through the word 

"meet" and adding the word "fail" directly above and entering the marketing order 

number in the box directly to the right of the statement. 

(16) REMARKS 

The "REMARKS" section will be used-to enter PU or other ID when adequate 

space was not available in the appropriate blocks on the upper portion of the 

9 
certificate. The "REMARKS" section may also be used for any other information for 

which a heading or block was not provided. If adequate space is not available 

under "REMARKS," any unused portion of the body of the certificate may be used 

beginning with the term "REMARKS:." 

(17) INSPECTOR'S SIGNATURE 

This block is provided for the inspector's signature. The person signing the 

certificate must be one of the following: 1) The inspector who performed the 

inspection; 2) Another employee of the Inspection Service who has been given 

power of attorney by the inspector and has been authorized by the AMS 

Administrator to affix the inspector's signature. to an inspection certificate; or 3) 

Another employee of the Inspection Service who has been authorized to act in a 

supervisory capacity. 

A supervising inspector should only sign a certificate for another inspecto·r 

when, for whatever reason, the inspector is not available to sign the certificate and it 

would be impratical to have the applicant wait until the inspector is available. 

When a superving inspector signs a certificate for another inspector the name 

of the inspector that performed the inspection shall be printed in ALL ~CAPITAL 

LETTERS in the upper portion of the "INSPECTOR'S SIGNATURE" block with the 

$Upervising inspector's signature in the bottom portion of the block preceded by the 

the word "By" and followed by "Supervising Inspector' which may be abbreviated as 

"Supv. lnsp." (see Example No. 4) 

(18) DATE·ISSUED 

• 

In this block enter th~ date the certificate is actually issued which may not 

necessarily be the date the inspection was performed. Abbreviations or numbers 

may be used to indicate the month unless your supervisor instructs otherwise. 

(19) FEE BLOCK 

Your State program will provide instructions for assessing the fee. Lines 

have been provided for the fee, overtime (OT) and expenses (EXP). 

(20) ESTIMATED TOTAL 

The total fee shall be entered in this block which includes any overtime, 

expenses or other assessments that are being pharged to the applicant. Although 

this is headed as an estimated total, this total should be as accurate as possible. 

10 
-----

Certifying Product for Se Import Requirements or 

Government Purchases 

When certifying product for Be import requirements, a statement must be 

made under "REMARKS" as to whether the lot passes or fails as follows (See 

Examples No. 5 and No. 6): 

REMARKS: Meets (or Fails) U.S. Import Requirements 

For Government purchases, a statement must be made under "REMARKS" 

as follows (see Example No. 2): 

REMARKS: Meets the requirements of Announcement FV- ,. 

Invitation No. _ , Ammendment No. (if ammended) _. 

The above lot was personally counted by the undersigned. 

Contract No. 

---- Notice of Delivery No. _____ _ 

Delivery Order No. _____ _ 

, Reminder: Any unsused portion of the body of the certificate may be used 

when adequate space is not available in the "REMARKS" section. 

11 
EXAMPLES 

The following examples are intended only as guides. Since each State 

program may have it's own unique concerns and priorities, a certificate written in 

one State may look somewhat different than one written in another State. Any 

information included on the following example certificates that is not specifically 

addressed in this handbook is provided for informational purposes only and :is not 

intended to set precedent over instructions that have been issued by your 

supervisor or included in any of the commodity handbooks. 

12 
u.a. DfPNnMUIT o,. AQNCULTI.Rl Example No. 1 A.GR.ICU. YURAL. MNW(£TIHG SUNICE 

AIUIT ,.,,0 V(Gn Ml..£ OMSION 

FEDERAL-STATE INSPECTION CERTIFICATE 

.,. ····• »<~::IMCB1l1RCATE .. UMll90 '· I I ,--------,-,-- I ., I -

r"· --------·--------------- . N'f'UiNri , . , , .. 

. 2, I . I _I 

·· ,oli~ f -1 I cwr -· '· '.\ , MOORS _ , ~------ ----,..----- -------- --

1.-- ------"--. '1?:,~ .R-:i'.''.Zt ~; '"". _-. _.___. _ _.I,, 1, ,,-U.•. und_, rsiJp)d,d,. .• ·duly,_ ~rizfjHI' insp~ orJJf ,fhi'.. Un(t,hi ~ taras 

:J ;<,;T(J':'.";q , o.,,~!'·r :, ~f A'g,ii:u/1.ura, ,cdp T'1Jt1rtiby,. c_Htify ,that{ ~ ~ , of ·.rh• 1,.._.....__._.........___,__. __ , ............ ~ - han,in dascribad ptodui:t w...-11 inspacrad and "'rh• "1/ffldr.; as -;shown 

INSPEC1EO '" ''. '· -~=-:1 I by.said ·sMnp/as wera as ' harein ·stated. BY 

·~.r . .:.., I 

.-!::=:::===== 

FU: l,D. 0 0 

O.T., $ ___ __ 1 

EJt.P.: $ £/, 7 ~ 

~~ INSPECTOR'S SIGNATURE 

(STIMAT£0 TOTAL 

DATE ISSUEO 

$ ~4.1S-
Example No. 2 u.a. OO'Nn'M&ff CW AONCtA:tu.q 

"""'CUI.TUIW.. M""'(£11NG R>\\/IC( 

""UIT N<O vt:G<TMll.£ OMSIOO< 

FEDERAL-STATE INSPECTION CERTIFICATE 0 SUBLOT 

FOR DATA ENTRY ONLY 

. :;o...,,.,, ::::CTS ,v., ... CSITIFIICAT£HIJMBEA 

~1 I I I I I - " . ; 

.21 j N'PUCNIT 

CWT :i:=·1 I 

O.T: .... ::1 

INSPECTED TRAva' MIU:S I 8Y 

O.T,ev.,II 

I 

I 

I 

I 

-00 

I, . th'1 undMsignad, B duly °llluthorizN irtspiictor of dis ,.'Uriitsd SCBlflS 

OflParrm.nr : ~f AgricultiJr_•, .,~ '\tu,:·•by c~" tiiar ~,impies 'of d>e 

hsrein dttScrilH-d produ,;( 'w .rs,,~pected and, the grades as shown 

by ssid ii:emples wer• as ·,-,,Mein '~tale/I. 

DATE ISSUED 

..... 

FU: '3.2. 00 

O.T.: $·------1 

EXP.: $ '1,SO EST I MA TEn TOl "'-

-
Example No. 3 U.&. DIP.MTM&IT Of: Ami.cut.~ 

AGfUCUl. TUfVJ.. MAFUl;.rnNG SO.'\AC( 

MUtT" AHO V£Ci£T"8l.E. Of.VISION 

FEDERAL-STATE INSPECTION CERTIFICATE 0 SUBLOT 

INSPECTOR"S SIGNATURE 

EXP., $ 

ESTIMATU> TOT Al 

0~12~/q::, 

OATE ISSUED 
Example No. 4 UA. 00-NffM8ilf oF "4lfl¥:Ul.TU'U: 

ACRICU.T~ M/1,M.CTtNG SE.'RV'IC( 

ffUJIIT AHO V'(CC'l' A8Lf 0.Vl5'0N 

FEDERAL-STATE INSPECTION CERTIFICATE 0 SUBLOT 

.,<Qf.-f!lmOuct•:•:NK>.-8ffl'~~~EIIS(•:ol\E PI\OW>£D.IIX:•mEN'f:UCN<T..;~~OJ'8~G e&mf'lm;-8Y.·:ntE~SP£CTOR UNLESS O'.fHEBWISEMOTlD ;::•.'· 

REMARKS: 

..._...____,___.!1-------,---------- --- ---.-------1 

I /,.>lit,, und•rsign•d~ · .• -duly authoriz,id' insp&etoi of .tl>IJ Ulllt#d Steru 2,.00 . oepsrtm.nr ,,,. . Agricu1,uri,, _ do \ ,,.,,.,;./5 ~f;i,. rii.,. siJ.mp1n of ·the 

h1Y11i11 described product wt1re JnspKC!fd ivid die · gredu as · -shown I by O.T.: ----- --< said sempies: w~r· as h,,re;;, .~,.,ei:!. 

,E (XP.: $ 

ESTIMATED TOl"'-

~...,,: ~~ ~ S."1f"'· I"'Sf 0 ":>/~/qs s 2. 7. oo 

INSPECTOR'S SIGNATURE DATE ISSUED 
U.&.09'_0F __ Example No. 5 G -CUI.T.-_ MNU<(TtNG $81\/IC£ 

MlJIT AHO WGETAalE OMSION 

FEDERAL-STATE INSPECTION CERTIFICATE 0 SUBLOT 

.,IIOUIIS .!--1 --"-~-1--+..L.:o'---sF--'-===ae...:..,~-F~:..:..:....L..-- - ~x';r::_· .. t~~ , .. ~ ;T. ~,l'.l 

....... _._~__.___.___. r':i'· -::-:~~I ====~ ,,, '."IA ve.. IMl.f$ . ..... __.__..__-..J 

O.T. tw..:1..j 

--------.----------i 

fU: 

O.T.: ---

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EXP.: $ -

ESTIM,.TEO TOT"1. 

O'ffe'f/ct"( $ 

DATE ISSUED / I q · 00 
t-~===~~===:==:=:=====~ r aMf4 A i.s: 

Example No. 6 U C. DEP'""TM9'f M AQllllteut.TIM( 

l"GRIC4.A.1U't\A&. M-""'C£r .... C S0.vtC£ 

n.UtT N«J Vt:Gf"l'MlC OtVl'SlON 

FEDERAL-STATE INSPECTION CERTIFICATE 0 SUBLOT 

'.-,)~-:-:-,:;.:;.;,.,:1'NltlY~ffl.QOUCT,>N«>-,E!\ ~~OKTNNEJIS)AAE PIIO\/IO(J).IT:~£~'.·MD' ffQJ,'8EING CERT11!9) BYJ'>'EINSE't:CTOfl UH\.£$$ o;ll4B1W1S'E NOTII) : ··, ·:. 

-~Mf-or+ Re.q.~~-m..e..~.t...s. ·-·---·--

1-=~;:;:;;:;:;;::::::;:;::;:;::~=;::===---IJ.:la.r.; .Ce.s~ 4.~e!1.±r-¥~ • 8"2 - ooo l.~.S.!:i.:.'---·--

' A\ C ~ ~ ll # 7 2_:l_q_£J~~1-~1!.L ______ --

.___..__-=--_.I 1------------- --------,------ ---1 /; the uride;Si{ltled, " duly authorind it1Spector of du1 ·United :Statlis I . Dopsrrm,,nt 'Of Agricultur11, do ,·~11raby c~fy that semples of the 

- - - her11in d,ucrib,,d product w .... ,, inspected end the grades llS -shown I by s aid samples were as her1tin :stateil. 

O.T. -.1 , I . .___ ........ _ _.___, ·~· l~---O!:ll<:::-11'=- ~=-==--:.~ . .. O'{/.,v('I'( $ j I DAf;tSSUEO 

F£l: 

O.T.: $~------1 - (KP.: 

(STIMA 

$ -

TOJ TOT A.l.. 

s / <" '-({) 

t:)...::»' 
-~ 

• • REMARKS "A I I ( I (. ~ J 

.-=s..;.;..:;a,;.==-=--=c:.=====--, n.' ~f(2. ic0,t1+ Sfu 'tt!5,-tA.!:?!?v"1- ci+ 4-o b-e. og~- -

=====:::::::::::;::::=--j_~_.__-=Sc_.=_-=$;._attt_~('..Lq_J_~c_e-1.ii~c lv' o Ck.A..,.5 

1 · fr• d."<c..e. ~ J./oVl,f) Ko~§-·----

.___.__.,___,! ~------- -----------....-------! ~---~ I, · th• und•rs!Jlfl•d, • duly surhoriz•d inspflt:tor of di• Unit.d .St~tn 

• j D~nr o,f Agrlcultur•. ?lo h~•by c~fy dlsr ·samplflS of tlu, 

~- h•r•in dfl$ctib8d product w•re inspect•d and ihe gn,d.s ;as shown I .___.__._J _ _. by said ~11mp/1,s were as herein stated. 

FEE: Cf:too 

O.T.: ~------1 / .7 - EkP,: $ b 

Example No. 7 UA. OU"MT'M9ff OF A,,QNCUI.~ 

AGNCut. TURAL MAIUCE'TING SU\VIC£ 

MOIT NlO VfG(TA&L( OtVISIOH 

FEDERAL-STATE INSPECTION CERTIACATE 0 SUBLOT 

'-=~"":;: _·.;.=·-=.,,,:;: :,, = .. ;:: . 

·:zq ,: 

·cwt. ' ,-,, 

o .T. CMJ 

..__.__,__..__.......__.. !--:~::-~==::·:::: . TIIAlla 'iNs'!vCTED : Milts 

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