Form P&SP-4500 Expires 11-30-2017 Page 1 of 2

 OMB Control No. 0580-0015 

U.S. DEPARTMENT OF AGRICULTURE

GRAIN INSPECTION, PACKERS AND 

STOCKYARDS ADMINISTRATION

PACKERS AND STOCKYARDS PROGRAM

HOPPER SCALE TEST REPORT

1 Page No.

2 Testing Agency (Name, address, city, state, zip code, telephone number, and 

e-mail address):

3 Scale Owner 

4 Address 

5 City 6 County 7 State 

8 Scale Location 

9 Address 

10 City 11 County 12 State 

13 Date Test Weights Were Last Verified 

14 Test Date 

(mm/dd/yyyy) 

15 Last Test Date 

(mm/dd/yyyy) 

16 List Times and Days When Scale Is Not In Use, and Available For Testing 17 Scale Capacity (lbs.) 

18 Class of Scale: 

 Marked III  Not Marked 

19 Model Number 20 Scale Division (lbs.)

21 Scale Manufacturer (Indicator) 22 Type of Indicator: 

 Beam  Dial  Digital  Printer

23 Is the Scale Connected to a Computer?

 Yes  No 

24 Serial Number 

TEST RESULTS 

25 SR (Sensitivity Response) Or Discrimination Test 

Zero Load = ______________ lb. Maximum Load = ______________ lb. 

26 Scale Condition As Found 27 Zero Balance As Found 

28 CORNER TEST 29 INCREASING LOAD TEST (continued)

Position (a) 

Balance 

Weights 

(b) 

Test 

Weight 

(c) 

Weight 

Indication 

(d) Error 

Weights 

(lbs.)

(e) 

Error 

(a) Feed (b) 

Balance 

Weights 

(c) 

Test 

Weights 

(d) 

Weight 

Indication 

(e) Error 

Weights 

(lbs.)

(f) 

Error 

Corner 1 

Corner 2 

Corner 3

Corner 4

29 INCREASING LOAD TEST

a Feed b Balance 

Weights 

c Test 

Weights 

d Weight 

Indication 

e Error 

Weights 

(lbs.)

f Error 

30 The errors indicated on this test report  ARE  ARE NOT within the accuracy requirements specified in National Institute of Standards and Technology 

(NIST) Handbook 44 as required by the regulations (9 CFR 201.71). (For more information, contact the Business Practices Unit of the Packers and Stockyards 

Program Regional Office.) 

31 Repairs, adjustments, or changes made at this time: 

32 Recommendations for repair, replacement, etc. (Continue on reverse side if necessary): 

33 Receipt of Report Acknowledged (Signature): 34 Scale Inspector (Signature): 

Response is required to assure that tests are made on feed scales, and to show accuracy of scales used to weigh feed when feed weight is a factor in determining payment or 

settlement for livestock or live poultry. ( 9 CFR 201.72.) Information held confidential (9 CFR 201.96). 
Form P&SP-4500 Expires 11-30-2017 Page 2 of 2

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 0580-0015. The time required to complete this 

information collection is estimated to average 45 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 individual’s 

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 USDA’s 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.