P&SP-4500-i Page 1 of 2

Instructions to Complete 

Hopper Scale Test Report 

Form P&SP-4500 

Mail the completed form to the appropriate regional office of the Packers and Stockyards 

Program as listed below. The states covered by each regional office are listed below its address. 

Regional Offices of the Packers and Stockyards Program 

Grain Inspection, Packers and Stockyards Administration

Eastern Regional Office 

Suite 230 

75 Spring Street 

Atlanta, GA 30303-3308 

Telephone: (404) 562-5840 

FAX: (404) 562-5848 

e-mail: 

PSPAtlantaGA.GIPSA@usda.gov

Western Regional Office 

3950 Lewiston St., Suite 200 

Aurora, CO 80011-1556 

Telephone: (303) 375-4240 

FAX: (303) 371-4609 

e-mail: 

PSPDenverCO.GIPSA@usda.gov

Midwestern Regional Office 

Room 317 

210 Walnut Street 

Des Moines, IA 50309-2110 

Telephone: (515) 323-2579 

FAX: (515) 323-2590 

e-mail: 

PSPDesMoinesIA.GIPSA@usda.gov

States Covered States Covered States Covered 

AL, AR, CT, DC, DE, FL, GA, 

LA, MA, MD, ME, MS, NC, 

NH, NJ, NY, PA, RI, SC, TN, 

VA, VT, WV

AK, AZ, CA, CO, HI, ID, KS, 

MT, NM, NV, OK, OR, TX, UT, 

WA, WY

IA, IL, IN, KY, OH, MI, MO, 

MN, ND, NE, SD, WI

If you have any questions regarding this form, please contact the regional office of the Packers 

and Stockyards Program listed above. 

Line 

Number 

Subject Instruction 

1 Page Number The page number is normally 1 of 1. If additional space is 

needed or when testing multiple indicator/platform 

installations, number pages identifying the current page 

number and the total number of pages. For example, page 2 

of 3. 

2 Testing Agency Enter the name, address, city, state, zip code, phone number, 

and e-mail address of the testing agency. 

3-7 Scale Owner Enter the name of the scale owner, and the owner’s address, 

city, county, and state. 

8-12 Scale Location Enter the full address where the scale is located. 

13 Verification Date Enter the date the test weights were last verified. 

14 Scale Test Date Enter the date of the scale test. 

15 Last Test Date Enter the date the scale was last tested. 

16 Scale Availability Enter the days of the week and times during the day when the 

scale is available for testing. 

17 Scale Capacity Enter the scale capacity (maximum nominal capacity), in 

pounds. 

18 Scale Class Check the appropriate box to indicate the class of scale 

(Marked III or Not Marked). 

Expires 11-30-2017
P&SP-4500-i Page 2 of 2

Line 

Number 

Subject Instruction 

19 Model Number Enter the model number of the indicator found on the I.D. 

plate. 

20 Scale Division Enter the minimum scale division (or graduation), in pounds. 

21 Manufacturer Enter the name of the manufacturer of the beam, dial, or 

digital indicator. 

22 Indicator Type Check the appropriate box to indicate if the type of indicator 

is: Beam, Dial, Digital, or Printer 

23 Computer Check the appropriate box to indicate if the scale is connected 

to a computer. 

24 Serial Number Enter the serial number of the indicator found on the 

manufacturer’s ID plate. 

25 Sensitivity 

Response 

Enter the sensitivity response (SR) on beam scales or the 

discrimination on dial and digital scales, in pounds, at zero 

and maximum test loads. 

26 Condition Enter the maintenance condition of the scale as found. 

27 Zero Balance Enter the zero balance as found. 

28 Corner Test Data For each corner tested, enter, in pounds, the balance weights, 

test weight, weight indication, volume in pounds of error 

weights removed for the test, and the amount of error. 

NOTE: The weight shown on the indicator after removing the 

error weights is NOT entered on the form. The amount of the 

error will be the difference between column c and the amount 

shown on the indicator after removing the error weights. 

29 

a 

through 

e 

Increasing Load 

Test Data 

For the increasing load test, enter, in pounds, the weight of 

feed used, balance weights, test weights, weight indication, 

error weights, and error. 

NOTE: The weight shown on the indicator after removing the 

error weights is NOT entered on the form. The amount of the 

error will be the difference between column d and the amount 

shown on the indicator after removing the error weights. 

30 

a 

through 

f 

Accuracy Check the appropriate box to indicate if errors are or are not 

within the accuracy requirements specified in the NIST 

Handbook 44. 

31 Repairs To be completed by the State or scale testing company. Enter 

any repairs, adjustments, or changes made during the scale 

test. 

32 Recommendations To be completed by the State or scale testing company. Enter 

your recommendations for repair, replacement, or other action 

for the scale. 

33 Acknowledgement Sign to acknowledge receipt of the completed test report. 

34 Signature The scale inspector must sign the form. 

Expires 11-30-2017