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pdfInstructions For KC-334
PRELIMINARY/FINAL DISCHARGE/DELIVERY SURVEY
SUMMARY (FOR CCC-CONTRACTED SURVEYS)
Form used by CCC-contracted surveyors to provide preliminary or final cargo
survey information.
Submit the preliminary form by e-mail (tony.holland@kcc.usda.gov) to the
appropriate FSA servicing office and the final form with the survey report to the
appropriate FSA servicing office. For questions or assistance, contact
Tony Holland, International Procurement Division, Procurement Support Branch,
Kansas City Commodity Office, 816-926-6577.
Features for transmitting the form electronically are available to those customers
with access credentials only. If you would like to establish online access credentials
with USDA, follow the instructions provided at the USDA eForms web site.
Surveyors must complete all applicable items.
Fld Name /
Item No.
Survey
Company Name
Name of
Subcontractor
Person(s) Who
Performed
Survey:
Vessel
Name/Voyage
Number
CCC Reference
Number
Destination
Country
Discharge Port
or Inland
Destination
Vessel Arrival
Date
Vessel
Discharge
Page 1 of 5
Instruction
Enter your company name.
Enter your subcontractor’s name, if applicable.
Enter the name of the person or persons who performed the survey.
Enter the vessel name and voyage number.
Enter the reference number provided by Kansas City Commodity
Office.
Enter the destination country.
Enter the discharge port or inland destination, as applicable.
Enter the date the vessel arrived.
Enter the date the vessel discharge commenced or completed, as
applicable.
Fld Name /
Item No.
Commenced/
Completed
Delivery to
Final
Destination
Commenced/
Completed
Destuffing of
Containers
Commenced/
Completed
Commodity/
Pack Size
Manifested
Units
Manifested
Weight
(Kgs/lbs)
Quantity
Discharged
Sound units
Quantity
Discharged
Sound accepted
weight in
Kgs/lbs.
(includes
reconstituted/
sound)
Torn/Slack/
Leaking units
Torn/Slack/
Leaking units
accepted weight
in kgs/lbs.
(includes
reconstituted/
sound)
Torn/Slack/
Leaking units
weight loss in
kgs/lbs (includes
Page 2 of 5
Instruction
Enter the date the delivery commenced or completed, as applicable
Enter the date destuffing of containers commenced or completed.
Enter the commodity and pack size.
Enter the manifested units.
Enter the manifested weight in kgs/lbs.
Enter the number of sound units discharged.
Enter the accepted weight of sound units discharged in kgs/lbs.
Includes reconstituted/sound.
Enter the number of torn, slack, or leaking units.
Enter the accepted weight of torn, slack or leaking units in kgs/lbs.
Includes reconstituted/sound.
Enter the weight loss of torn, slack, or leaking units in kgs/lbs.
Includes unfit losses.
Fld Name /
Item No.
unfit losses)
Discharged
Empty Units
Discharged
Empty weight
loss in kgs/lbs
(includes unfit
losses)
Wet Units
Wet accepted
weight in
kgs/lbs (includes
reconstituted/
sound)
Wet weight loss
in kgs/lbs
(includes unfit
losses)
Infested Units
Infested
accepted weight
in kgs/lbs
(includes
reconstituted/
sound)
Infested weight
loss in kgs/lbs
(includes unfit
losses)
Moldy Units
Moldy accepted
weight in
kgs/lbs (includes
reconstituted/
sound)
Moldy weight
loss in kgs/lbs
(includes unfit
losses)
Other Unfit
Units (i.e.,
contaminated/
Page 3 of 5
Instruction
Enter the number of units discharged empty.
Enter the weight loss of discharged empty units in kgs/lbs. Includes
unfit losses.
Enter the number of wet units.
Enter the accepted weight of wet units in kgs/lbs. Includes
reconstituted/sound.
Enter the weight loss of wet units in kgs/lbs. Includes unfit losses.
Enter the number of infested units.
Enter the accepted weight of infested units in kgs/lbs. Includes
reconstituted/sound.
Enter the weight loss of infested units in kgs/lbs. Includes unfit losses.
Enter the number of moldy units.
Enter the accepted weight of moldy units in kgs/lbs. Includes
reconstituted/sound.
Enter the weight loss of moldy units in kgs/lbs. Includes unfit losses.
Enter the number of other unfit units (for example, contaminated,
caked, or stained units).
Fld Name /
Item No.
caked/stained)
Other (i.e.,
contaminated/
caked/stained)
accepted weight
in kgs/lbs
(includes
reconstituted/
sound)
Other unfit
weight losses
(i.e.,
contaminated/
caked/stained)
in kgs/lbs)
TOTAL
QUANTITY
DISCHARGED
units
TOTAL
QUANTITY
DISCHARGED
accepted weight
in kgs/lbs
(includes
reconstituted/
sound)
TOTAL
QUANTITY
DISCHARGED
weight loss in
kgs/lbs (includes
unfit losses)
Short Landed
units
Short Landed
weight loss in
kgs/lbs (includes
unfit losses)
Excess Landed
units
Excess Landed
Page 4 of 5
Instruction
Enter the accepted weight of other unfit units in kgs/lbs (for example,
contaminated, caked, or stained units). Includes reconstituted/sound.
Enter the weight loss of other unfit units in kgs/lbs (for example,
contaminated, caked, or stained).
Enter the total units discharged.
Enter the total accepted weight in kgs/lbs. Includes
reconstituted/sound.
Enter the total weight loss in kgs/lbs. Includes unfit losses.
Enter the number of short landed units.
Enter the weight loss of short landed units in kgs/lbs. Includes unfit
losses.
Enter the number of excess landed units.
Enter the accepted weight of excess landed units in kgs/lbs. Includes
Fld Name /
Item No.
accepted weight
in kgs/lbs
(includes
reconstituted/
sound)
Sound/
recovered
Sweepings
accepted weight
in kgs/lbs
(includes
reconstituted/
sound)
Additional
Comments
Tally Sheets
3 day notice to
Vessel or Agent
of loss
Short Landing
Certificate
Unfit
Certificates /
Lab Analysis
Confirmation of
Attendance
Photographs
Disposition
Documentation
Printed Name of
Preparer
Signature of
Preparer
Date
Page 5 of 5
Instruction
reconstituted/sound.
Enter the accepted weight of sweepings in kgs/lbs. Includes
reconstituted/sound.
Enter any additional comments, as necessary.
Check this box if tally sheets are attached to this form.
Check this box if three-day notice to vessel or agent of loss is attached
to this form.
Check this box if short landing certificate is attached to this form.
Check this box if unfit certificates or lab analysis are attached to this
form.
Check this box if confirmation of attendance is attached to this form.
Check this box if photographs are attached to this form.
Check this box if disposition documentation is attached to this form
and indicate whether disposition is sold, donated, or
destroyed/dumped. If no documentation, explain disposition in
comments.
Print the name of the preparer.
Preparer signs this block.
Date the form is signed.
File Type | application/pdf |
File Title | Microsoft Word - KC0334instr.doc |
File Modified | 2007-01-04 |
File Created | 2007-01-04 |