Form QID Annual Colony Loss Inquiry - January 2016

ANNUAL COLONY LOSS INQUIRY - January 2016
			OMB No. 0535-1 Approval Expires: 2/14/2015 Project Code:       QID:       SMetaKey: 3782
				United States Department of Agriculture
				NATIONAL AGRICULTURAL STATISTICS SERVICE

Please make corrections to name, address, and Zip Code, if necessary.	USDA/NASS National Operations Division 9700 Page Avenue, Suite 400 St. Louis, MO  63132-1547 Phone: 1-888-424-7828 Fax: 1-855-515-1328 E-mail: nass@nass.usda.gov
The information you provide will be used for statistical purposes only. In accordance with the Confidential Information Protection provisions of Title V, Subtitle A, Public Law 107–347 and other applicable Federal laws, your responses will be kept confidential and will not be disclosed in identifiable form to anyone other than employees or agents. By law, every employee and agent has taken an oath and is subject to a jail term, a fine, or both if he or she willfully discloses ANY identifiable information about you or your operation.  Response is voluntary.
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 number is 0535-1. The time required to complete this information collection is estimated to average 10 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.

SECTION 1 - APIARIES

1. Between January 1, 2015 and December 31, 2015, did this operation own or control any apiaries?
	2705	1 Yes – Continue 3 No – Go to Section 10

SECTION 2 – JANUARY THROUGH MARCH 2015

	None	Colonies
2. On January 1, 2015, how many total colonies did this operation own, regardless of location?	27601	xxx
3. Between January 1, 2015 and March 31, 2015, how many:
a. Colonies were completely lost/dead out? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760
b. Colonies were requeened and/or received nucs/packages? (Exclude colonies that were completely lost/dead out in Item 2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761
c. New colonies did you add? (Include splits, newly created, and replacements of lost/dead out colonies. Exclude colonies that were requeened and/or received nucs/packages in Item 2b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2762

SECTION 3 – APRIL THROUGH JUNE 2015

	None	Colonies
4. On April 1, 2015, how many total colonies did this operation own, regardless of location?	27601	xxx
5. Between April 1, 2015 and June 31, 2015, how many:
a. Colonies were completely lost/dead out? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760
b. Colonies were requeened and/or received nucs/packages? (Exclude colonies that were completely lost/dead out in Item 2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761
c. New colonies did you add? (Include splits, newly created, and replacements of lost/dead out colonies. Exclude colonies that were requeened and/or received nucs/packages in Item 2b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2762

SECTION 4 – JULY THROUGH SEPTEMBER 2015

	None	Colonies
6. On July 1, 2015, how many total colonies did this operation own, regardless of location?	27601	xxx
7. Between July 1, 2015 and September 30, 2015, how many:
a. Colonies were completely lost/dead out? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760
b. Colonies were requeened and/or received nucs/packages? (Exclude colonies that were completely lost/dead out in Item 2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761
c. New colonies did you add? (Include splits, newly created, and replacements of lost/dead out colonies. Exclude colonies that were requeened and/or received nucs/packages in Item 2b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2762

SECTION 5 – OCTOBER THROUGH DECEMBER 2015
	None	Colonies
8. On October 1, 2015, how many total colonies did this operation own, regardless of location?	27601	xxx
9. Between October 1, 2015 and December 31, 2015, how many:
a. Colonies were completely lost/dead out? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760
b. Colonies were requeened and/or received nucs/packages? (Exclude colonies that were completely lost/dead out in Item 2a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761
c. New colonies did you add? (Include splits, newly created, and replacements of lost/dead out colonies. Exclude colonies that were requeened and/or received nucs/packages in Item 2b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2762

SECTION 6 – COLONIES ADDED IN 2015

10. Between January 1, 2015 and December 31, 2015, how many new colonies were added using the following methods?
	None	Colonies
a. Purchased package (with or without queen) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760	2760
b. Purchased nuc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761	2761
c. Purchased queen/queen cell only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2762	2762
d. Self-created queen/queen cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2763	2763
e. Captured swarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2764	2764

SECTION 7 – LOSS IN 2015

11. Of the total colonies lost between January 1, 2015 and December 31, 2015, did any colonies experience all of the following symptoms?

Little to no build-up of dead bees in the hive or at the hive entrance Rapid loss of adult bee population despite the presence of queen, capped brood, and food reserves Absence or delayed robbing of the food reserves Loss not attributable to Varroa or Nosema loads
	2770 1Yes - Continue 3No - Go to Section 9 4No Loss - Go to Section 9 2Don't Know - Go to Section 9
		Colonies
12. How many colonies did you lose that experienced all of the symptoms in Item 1? . . . . . . . . . . . . .		2771

SECTION 8 – COLONY HEALTH IN 2015

13. Of the total colonies owned between January 1, 2015 and December 31, 2015, how many colonies were affected by the following, but not necessarily lost? Note: The total of rows a through f, may exceed the total number of colonies.
	None	Colonies
a. Varroa Mites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2760
b. Other Pests and Parasites1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	2761
c. Diseases2 (Specify: ____________________________________________) . . . .	2762
d. Pesticides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	27642
e. Other3 (Specify: _______________________________________________) . . . .	27641
f. Unknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	27643

1/ Includes Tracheal Mites, Nosema, Hive beetle, Wax moths, etc.

2/ Includes American and European foulbrood, Chalkbrood, Stonebrood, Paralysis (acute and chronic), Kashmir, Deformed Wing, Sacbrood, IAPV, Lake Sinai II, etc.

3/ Includes weather, starvation, insufficient forage, queen failure, hive damage/destroyed, etc.

SECTION 7 – COMMENTS

1000

SECTION 8 - CHANGE IN OPERATION

1. Has the operation named on the label been sold or turned over to someone else?

Yes – Identify the new operator(s) No – Go to Section 9

Operation Name:

Operator Name:

Address:

City: State: Zip:

Phone: ( ) -

SECTION 9 - CONCLUSION

1. Do you make any day-to-day decisions for any other apiaries?
		Yes – List other operations: ____________________________________________________________________
	No – (Continue) (need radio varnames)
THANK YOU FOR YOUR COOPERATION

Respondent Name: _________

9911 Phone: ( ) ______________

9910 MM DD YY Date: __ __ __ __ __ __

Response

Respondent

Mode

Enum.

Eval.

Office Use for POID

1-Comp 2-R 3-Inac 4-Office Hold 5-R – Est 6-Inac – Est 7-Off Hold – Est 8-Known Zero

9901

1-Op/Mgr 2-Sp 3-Acct/Bkpr 4-Partner 9-Oth

9902

1-Mail 2-Tel 3-Face-to-Face 4-CATI 5-Web 6-e-mail 7-Fax 8-CAPI 19-Other

9903

098

100

789 __ __ __ - __ __ __ - __ __ __

Optional Use

407

408

9906

9916

S/E Name