First Receiver and Shorebased Processor Economic Data Co

OMB Control No. 0648-#### Expiration Date: ##/##/####

WEST COAST FIRST RECEIVER AND
SHOREBASED PROCESSOR QUESTIONNAIRE
2011
NOAA Fisheries – Northwest Fisheries Science Center
Retain a completed copy of this questionnaire for your records.

I. Facility Characteristics and Ownership
1. Our records indicate that this entity or facility is a first receiver of limited entry trawl caught groundfish. The buyer
identification numbers issued by the state fish and game agencies associated with this entity or facility are reported
below. If the same buyer identification numbers reported below deliver directly to alternative physical locations, a
separate questionnaire must be completed for each facility. If the information on record is incorrect or there are
additional buyer identification numbers that deliver directly to this facility please provide that information in the
Corrections/Additions column.

Processor/Buyer IDs on Record

Corrections/Additions

Washington Dept. of Fish and Wildlife
___________________
___________________

___________________
___________________

Oregon Dept. of Fish and Game
___________________
___________________

___________________
___________________

California Dept. of Fish and Game
___________________
___________________

___________________
___________________

2. Provide the following information about the receiving or processing facility.
Name of facility

First Receiver License Number

Physical location of the receiving or processing facility (street address, city, state, zip code)

This form can be downloaded from http://www.nwr.noaa.gov.
If you have any questions, please contact us at (###) ###-#### or First.Last@noaa.gov.
Submit by 9/1/12 to EDC Program, FRAM Division, Northwest Fisheries Science Center, 2725 Montlake Blvd E, Seattle, WA 98112.

3. Provide the contact information for the owner of the first receiver site license. For baseline survey this question will
be changed to collect contact information for the buyer ID issued by state fish and game agencies.
Name of Company, Partnership, or Other Business Entity
Business Mailing Address
Street / PO Box

Business Phone

(

)

Business Fax

(
City

State

Zip Code

)

Business Email

4. Individual completing this report. If your address, phone, and email are provided in the Owner information above,
you do not need to repeat them here but please provide your name and title.

Name

Title

Business Mailing Address
Street / PO Box

Business Phone

(

)

Business Fax

(
City

State

Zip Code

)

Business Email

5. Did you receive or process any fish at this facility during the 2011 calendar year?

Yes

Complete and submit the entire questionnaire for your 2011 fiscal year.

No

Complete and submit the questionnaire through this page only.

6. Read the following statement and sign and date the box below.
I certify under penalty of perjury that I have reviewed all the information in this questionnaire and that it is
true and complete to the best of my knowledge.
Signature

Date signed

_____/_____/_________
mm

dd

yyyy

[ Page 2 ]

7. Appraised value of facility

What was the year of this facility's last appraisal?

_________
yyyy

What was the market value of this facility from the appraisal,
rounded to the nearest 100 dollars?

$ ________________

What was the replacement value of the facility from the appraisal,
rounded to the nearest 100 dollars?
Did the survey values given above include the value of all processing
equipment contained on-site?

8.

$ ________________
Yes

No

For the remainder of this survey, please answer all questions for the 2011 fiscal year. On what date did your 2011
fiscal year begin?
_____/_____
mm dd

Please report values from your 2011 fiscal year for the remainder of this survey.

II. Capitalized Investments
9. Provide the 2011 capitalized expenditures associated with each of the following categories for this facility. Round
all answers to the nearest 100 dollars.
CAPITAL EXPENDITURE CATEGORY
Capitalized expenditures on buildings (exclude land, but include
building improvements)
Capitalized expenditures on new and used machinery and
equipment (include only equipment used to process, transport
on-site, or store fish on-site)*

TOTAL CAPITALIZED
EXPENDITURE
$
$

*This should include all equipment present at this physical location that is used for the following: canning seafood; smoking,
salting, and drying seafood; eviscerating fresh fish by removing heads, fins, scales, bones, or entrails; and production of
marine fats and oils. It should also include equipment present at this physical location for packaging and freezing of seafood.
It should also include transportation equipment such as trucks, forklifts, etc. used to transport equipment within this physical
location. Do not include transportation equipment such as trucks or cars used to transport products or supplies into or away
from this physical location.

[ Page 3 ]

III. Employees and Payroll
Provide the following information about the number of employees and wages. Include full and part-time employees and
temporary employees working at this facility. The information is requested separately for production employees and all
other employees, which are defined below.
10. Provide the number of production workers in the following table. Production workers include those workers at
this facility (up through and including the line-supervisor level) engaged in fabricating, processing, assembling,
inspecting, receiving, packing, warehousing, shipping, maintenance, repair, janitorial, product development, or
transporting product on-site.
For the week including

Number of employees (full
time, part time, and
temporary)

Total Hours Worked

January 12

___________workers

____________hrs

February 12

___________workers

____________hrs

March 12

___________workers

____________hrs

April 12

___________workers

____________hrs

May 12

___________workers

____________hrs

June 12

___________workers

____________hrs

July 12

___________workers

____________hrs

August 12

___________workers

____________hrs

September 12

___________workers

____________hrs

October 12

___________workers

____________hrs

November 12

___________workers

____________hrs

December 12

___________workers

____________hrs

11. Provide the number of all other employees in the following table. All other employees includes those involved in
supervision above line-supervisor level, sales, advertising, credit, collection, installation, cafeteria, recordkeeping,
clerical and routine office functions, guard services, executive, purchasing, finance, and legal.

For the week including
March 12

Number of employees
(full time, part time, and
temporary)

Total Hours Worked

___________workers

____________hrs

[ Page 4 ]

12. Labor expenses for production and all other employees (include wages, bonuses, benefits, payroll taxes, and
unemployment insurance)

Expense Category

2011 Total
Expenditure

Production employee (see definition in Question 10 above)

$

All other employee (see definition in Question 11 above)

$

IV. Selected Expenses and Depreciation
13. Quota Expenses
Expense Category
Purchases of quota pounds

2011 Total Expenditure
$

Leasing of quota share

$

Purchases of quota share

$

14. Utilities
Expense Category
Electricity

2011 Total Expenditure
$

Natural gas

$

Propane gas

$

Water

$

Sewer and waste disposal

$

15. Rental or Lease Payments
Expense Category
Rental or lease of buildings, job-site trailers and other
structures (include land)
Rental or lease of processing machinery or equipment

2011 Total Expenditure
$
$

[ Page 5 ]

16. Maintenance and Depreciation
Expense Category

2011 Total
Expenditure

Repair and maintenance on buildings and equipment* (expensed in
2011)

$

Depreciation charges for all building, equipment, and improvement
capital investments (equipment includes all equipment used to process,
transport on-site, or store fish on-site)*

$

*This should include all equipment present at this physical location that is used for the following: canning seafood;
smoking, salting, and drying seafood; eviscerating fresh fish by removing heads, fins, scales, bones, or entrails; and
production of marine fats and oils. It should also include equipment present at this physical location for packaging and
freezing of seafood. It should also include transportation equipment such as trucks, forklifts, etc. used to transport
equipment within this physical location. Do not include transportation equipment such as trucks or cars used to transport
seafood into or away from this physical location.

17. Please provide the following information on custom processing performed for you by another processor outside of
this facility in 2011.
Total weight of fish supplied to
custom processors

2011 Custom Processing
Fees Paid

Groundfish

________________lbs

$

Whiting

________________lbs

$

Other

________________lbs

$

18. Other Expenses
Expense Category

2011 Total
Expenditure

Shoreside monitoring costs

$

Production supplies (boots, smocks, hair nets, knives ,etc.)

$

Packing materials

$

Freight costs for supplies to the facility

$

Non-fish ingredients (additives)

$

Off-site product freezing and storage

$

Insurance payments (property and workers compensation)

$

Other Specify_______________________________

$

Other Specify_______________________________

$

[ Page 6 ]

19. Fish Purchases
For each type of fish listed, provide the amount of fish used as an input in this processing facility in 2011. In the table
below Other Sources includes fish acquisitions from other processors, wholesale dealers, brokers, or aquaculture
producers. The gross cost of fish purchases includes the value of any taxes paid on behalf of delivering vessels.
Total weight of fish received but not paid for (for size or quality reasons) does not include fish received for
custom processing.
Total weight of fish purchased and Gross cost of fish purchases includes fish purchased by you that are custom
processed by another processor outside of this facility.
Please include any post-season adjustments.

Total weight of fish received
but not paid for
(for size or quality reasons)

Total weight of fish
purchased

Gross cost of fish
purchases

LE Trawl
Fixed Gear
Other Sources

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

LE Trawl
Fixed Gear
Other Sources
Thornyheads
LE Trawl
Fixed Gear
Other Sources
Sablefish
LE Trawl
Fixed Gear
Other Sources
Lingcod
LE Trawl
Fixed Gear
Other Sources
Rockfish
LE Trawl
Fixed Gear
Other Sources
English Sole
LE Trawl
Fixed Gear
Other Sources
Rex sole
LE Trawl
Fixed Gear
Other Sources
Petrale sole
LE Trawl

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs

_____________lbs

$

Type of Fish
Whiting

Dover sole

[ Page 7 ]

Type of Fish
Fixed Gear
Other Sources
Sharks, Skates, Rays
LE Trawl
Fixed Gear
Other Sources
Tuna
All Tuna
Pacific Halibut
All Pacific Halibut
California Halibut
All California Halibut
Herring
All Herring
Coastal Pelagic
All Other Coastal Pelagic
Salmon
All Salmon
Crab
All Crab
Shrimp
All Shrimp
Squid
All Squid
Echinoderms
All Echinoderms
Other Shellfish
All Other Shellfish
Other Species (please
list)
_______________
_______________
_______________

Total weight of fish received
but not paid for
(for size or quality reasons)

Total weight of fish
purchased

Gross cost of fish
purchases

_____________lbs
_____________lbs

_____________lbs
_____________lbs

$
$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs

_____________lbs

$

_____________lbs
_____________lbs
_____________lbs

_____________lbs
_____________lbs
_____________lbs

$
$
$

[ Page 8 ]

V. Annual Earnings
20. Provide the 2011 selling value f.o.b. plant (after discounts and allowances and excluding freight charges).
Include products made from custom processing performed for you, but do not include products you made from
fish owned by others (custom processing you performed for others).
Do not include any additional payment you received to cover any shipping, handling, or storage costs associated
with the sale beyond the plant.
Please include any post-season adjustments.
For products made during the survey year and held in inventory at the end of the year, estimate the value on the
basis of the average price received for similar products sold during the year.
Include products shipped to other establishments of your company.

Type of Fish

Total weight of production

Total value of production
(Include products shipped to other
facilities of your company)

Whiting
Surimi
H&G
Fillets
Roe
Frozen Whole
Unprocessed
other (specify)__________
other (specify)__________
Dover sole
Fresh
Frozen
Unprocessed
Other
Thornyheads
Fresh
Frozen
Unprocessed
Other
Sablefish
Fresh
Frozen
Unprocessed
Other
Lingcod
Fresh
Frozen
Unprocessed
Other
Rockfish
Fresh
Frozen
Unprocessed
Other

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
[ Page 9 ]

Type of Fish
English Sole
Fresh
Frozen
Unprocessed
Other
Rex sole
Fresh
Frozen
Unprocessed
Other
Petrale sole
Fresh
Frozen
Unprocessed
Other
Sharks, Skates, Rays
Fresh
Frozen
Unprocessed
Other
Tuna
Fresh
Frozen
Canned
Unprocessed
Other
Herring
Fresh
Frozen
Unprocessed
Other
Sturgeon
Fresh
Frozen
Canned
Unprocessed
Other
Pacific Halibut
Fresh
Frozen
Unprocessed
Other
California Halibut
Fresh
Frozen
Unprocessed
Other

Total weight of production

Total value of production
(Include products shipped to other
facilities of your company)

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
[ Page 10 ]

Type of Fish
Other Coastal Pelagic
Fresh
Frozen
Unprocessed
Other
Salmon
Fresh
Frozen
Smoked
Canned
Unprocessed
Other
Crab
Fresh
Frozen
Canned
Unprocessed
Other
Shrimp
Fresh
Frozen
Canned
Unprocessed
Other
Squid
Fresh
Frozen
Unprocessed
Other
Echinoderms
Fresh
Frozen
Unprocessed
Other
Other Shellfish
Fresh
Frozen
Unprocessed
Other
Other Species
(please list)
____________________
____________________
____________________
Other Non-Species
specific Products

Total weight of production

Total value of production
(Include products shipped to other
facilities of your company)

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs
_____________lbs

$
$
$
$

_____________lbs
_____________lbs
_____________lbs

$
$
$

[ Page 11 ]

Total value of production
(Include products shipped to other
facilities of your company)

Type of Fish

Total weight of production

Fish Meal

_____________lbs

$

Fish Oil

_____________lbs

$

Other products

_____________lbs

$

Other Earnings
21. Provide the revenue received for custom processing for others in 2011.
2011 Custom Processing Revenue
Groundfish

$

Whiting

$

Other

$

22. Provide the revenue received for quota sales and leasing in 2011.
Quota Category
Sale of quota pounds

$

2011 Total Revenue

Leasing of quota pounds

$

Leasing of quota share

$

Sale of quota share

$

[ Page 12 ]

Questionnaire Comments:

Public Reporting Burden Statement
Public reporting burden for this collection of information is estimated to take 8 hours per response, including time for reviewing
the instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding this burden to Todd Lee, National Marine Fisheries Service, Northwest
Fisheries Science Center, 2725 Montlake Blvd E, Seattle, WA 98112.
Additional Information
Before completing this form, please note the following: 1) Notwithstanding any other provision of the law, no person is required to
respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the
requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control
Number; 2) This information is mandatory and is required to manage commercial fishing efforts under 50 CFR part 660 and under
section 402(a) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.); 3) Responses to this information request are confidential
under 402(b) of the Magnuson-Stevens Act (16 U.S.C. 1801, et seq.). They are also confidential under NOAA Administrative
Order 216-100, which sets forth procedures to protect the confidentiality of fishery statistics.

[ Page 13 ]