AMS-24 State and Tribal Hemp Disposal Report

REPRODUCE LOCALLY. STATE AND TRIBAL DISPOSAL AND REMEDIATION REPORT.

OMB No. 0581-0318

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
USDA DOMESTIC HEMP PRODUCTION PROGRAM
STATE AND TRIBAL DISPOSAL AND REMEDIATION REPORT
Reporting Period: ______________ to ______________
State or Tribe Name: ___________________________ Date Submitted: _______________
States and Tribes must submit this information to USDA when conducting on-farm disposal or
remediation as a result of a non-compliant test result exceeding the acceptable hemp THC level.
States and Tribes must submit this report by the 1st day of each month. If this date falls on a holiday or
weekend, the report is due on the next business day. If no disposals or remediations occurred during
the reporting cycle, check the box indicating there were no changes during the reporting cycle.
Below is a description of each data point needed:
•
•
•

Farm Number, Tract Number, Field Number, Subfield Number: This information is
provided as part of the USDA Farm Service Agency (FSA) registration process.
Location Type: Greenhouse/Indoor production or Outdoor/Field
Size: This is the total growing area expressed in Acres for outdoor/field or Square Feet for
greenhouse/indoor. If outdoor land area is less than one acre, estimate land area and present
this figure as a decimal (1/2 acre = .5, 1/4 acre = .25, etc.)

Disposals:
•
•

Disposal Type: Check the appropriate box for the type of disposal completed in each growing
location. Plow under, Mulch, Disk, Burial, Burn, Chop, Other
Date of Disposal: This is the date the disposal was completed. Include a range, if needed.

Remediations:
•
•

•
•
•

Note: All remediated material must be resampled and retested.
Remediation Type: Check the appropriate box for the type of remediation that was completed
in each growing location. 1.) Separate and dispose of floral material or 2.) Blended biomass
Both options require a new THC compliance test to ensure that the remediated material
is compliant.
Date of Remediation: This is the date the remediation was completed. Include a range, if
needed.
Date of Remediation Sample: This is the date the remediated product was sampled for
compliance. An official sampling agent must be used.
Certificate of Analysis (COA) Attached:
o For a Disposal: An official COA from a laboratory compliance test result must be
attached showing a non-compliant test result.
o For a Remediation: An official COA from a laboratory compliance test result showing
the initial non-compliant test result and an official COA from a laboratory compliance
test result showing the follow-up, compliant test result of the remediated material must
be attached.

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REPRODUCE LOCALLY. STATE AND TRIBAL DISPOSAL AND REMEDIATION REPORT.

OMB No. 0581-0318

Please complete the chart(s) below if there were any disposals or remediation during the month.
If there were no disposals or remediations during this reporting cycle check this box: ☐
This form shall be submitted to the USDA using a digital format compatible with USDA’s
information sharing systems, whenever possible. All information submitted must be accurate,
legible, and complete. If submission through the information sharing system is not possible,
please submit form to:
By Mail:
USDA/AMS/Specialty Crops Program
Hemp Branch
470 L’Enfant Plaza S.W.
Post Office Box 23192
Washington, D.C. 20026

Or via Email at:
Forms.Hemp@usda.gov

Or via Fax at:
(202) 720-8938

The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. § 552a) and the
Paperwork Reduction Act of 1995. The authority for requesting this information to be supplied on this form
is the 7 CFR Part 990 Domestic Hemp Program (Program). The purpose of collecting this information is for
USDA to administer the Program and the information provided on this form will be used to monitor
Program participants. Failure to provide the information requested on this form may result in ineligibility to
participate in the Program.
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 OMB 0581-0318. The time required to complete this
information collection is estimated to average 60 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.
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and
employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex,
gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance
program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all
programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language,
etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at
(800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination complaint, complete the
USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a
letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit
your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue,
SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.

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REPRODUCE LOCALLY. STATE AND TRIBAL DISPOSAL AND REMEDIATION REPORT.

OMB No. 0581-0318

Disposals
List all licensees and locations where a disposal took place during this reporting cycle.
Name of
Licensee

License or
Authorization
Identifier

Farm
Number

Tract
Number

Field
Number

Subfield
Number
(If
applicable)

Location
Type
(Greenhouse/,
Indoor, or
Field/
Outdoor)

Size (Acres or
Sq Ft.)

Disposal Type

(Plow under, Mulch,
Disk, Burial, Burn,
Chop, Other)

Date of
Disposal

Attached
COA (Yes)

_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft

Use additional line as necessary.

AMS-24 (XX/20XX) Exp XX/20XX

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REPRODUCE LOCALLY. STATE AND TRIBAL DISPOSAL AND REMEDIATION REPORT.

OMB No. 0581-0318

Remediations
List all licensees and locations where a remediation took place during this reporting cycle.
Name of
Licensee

License or
Authorization
Identifier

Farm
Number

Tract
Number

Field
Number

Subfield
Number
(If
applicable)

Location Type
(Greenhouse/
Indoor, or
Field/Outdoor)

Size (Acres, or
Sq Ft.)

Remediation Type

Separate and
dispose of floral
material. Or
Blend biomass.

Date of
Remediation
(List range, if
necessary)

Date
Remediation
Sample was
Taken

Attached
COA (Yes)

_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft
_______
Acres
or
_______
Sq Ft

Use additional line as necessary.

AMS-24 (XX/20XX) Exp XX/20XX

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