Form Fv-251 - Imported Pistachios - Rework & Failed Lot Disposition Report printable pdf download

REPRODUCE LOCALLY – Include form number and date on all republications

OMB No. 0581-0215

USDA – Fruit and Vegetable Program

Marketing Order and Agreement Division

1400 Independence Avenue SW, Stop 0237

Washington, D.C. 20250-0237

Phone: (202) 720-2491; Fax: (202) 720-5698

Form FV-251 – Imported Pistachios – Rework & Failed Lot Disposition Report

Section A: Importers should complete and submit the following information for the failed lot within 10 days after

rework or other disposition is completed. Send the original to the U.S. Customs and Border Protection office

overseeing importation of this lot, send one copy to the Marketing Order and Agreement Division, and retain a copy

for your records.

Customs entry number: ____________________________

Lot description: ______________________ Lot ID marks: ___________________________

Weight: _________________ Lbs. Container size/description: _______________________

Importer name: ______________________________________________________________

Address: ______________________ City: _____________ State:_____ Zip code: ________

Aflatoxin Certificate number: ___________________ Date: __________________________

Is this an inshell lot? (circle one): Yes or No

If answer is yes, has it failed aflatoxin testing more than once? (circle one): Yes or No

Note: Inshell lots can be reworked only once for aflatoxin. Upon second rejection they must be shelled, sold as

export, or sold for non-human consumption.

Section B – Rework: Complete this section if rework of the failed lot is elected.

Total Pounds Reworked:_________ Pounds Accepted:_________ Pounds Rejected:_________

Location of rework: _____________________________________________________________

Address: ______________________ City:_____________ State:_____ Zip code:__________

Description of rework process:_____________________________________________________

New lot description:_________________________ New lot ID:_________________________

New container / size description:___________________________________________________

If reworked for aflatoxin, did the lot pass retest? (Circle one): Yes or No Cert #:___________

Aflatoxin Results: Test 1:______ppb Test 2:______ppb

Average of Tests 1 and 2:______ppb

Section C – Shelling: Complete this section if shelling was performed prior to reworking.

Pounds shelled:_________________ Name of sheller:_________________________________

Address:______________________ City:_______________ State:_____ Zip code:_________

FV-251 (Rev. 05/2014. Destroy previous editions)

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Form Fv-251 - Imported Pistachios - Rework & Failed Lot Disposition Report