Version 1.0 1
CSAT Agriculture Survey
Questions Guide July 2010 Version 1.0
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security i
Table of Contents 1. General.................................................................................................................. 1 2. Facility Screening Information ................................................................................ 2 3. Agricultural Facility Customers .............................................................................. 3 4. COI Identification ................................................................................................... 7 5. COI-Containing Pesticide Products ...................................................................... 32 6. COI-Containing Fertilizer Products ...................................................................... 42 7. Other COI-Containing Products ........................................................................... 52 8. Finish ................................................................................................................... 62
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 1
1. General • The Agriculture Survey will collect information from the facilities being surveyed
about Chemicals of Interest (COI) and COI-containing products provided to their agricultural production customers as well as certain information, where available, about those customers’ use and handling of COI-containing products.
• Where information is requested for COI listed in Appendix A to 6 CFR Part 27, or for COI-containing product mixtures or blends (hereafter "COI-containing products"), please provide information for all COI or COI-containing products that meet or exceed the lowest applicable minimum concentration level established for that COI in Appendix A--whether or not the amount(s) of the COI(s) possessed by the facility exceed the applicable Screening Threshold Quantity(ies) in Appendix A--and that the facility sells, transfers, or commercially applies to agricultural facilities for agricultural activities. Facilities should not include COI or COI-containing products which are used exclusively as fuels in answering this questionnaire.
• For the purpose of this questionnaire:
o Agricultural activities means (1) preparation for the treatment of crops, feed, land, livestock (including poultry), or other areas of an agricultural facility; or (2) application to or treatment of crops, feed, land, livestock (including poultry), or other areas of an agricultural facility.
o Agricultural facility includes farms (e.g., crop, fruit, nut, and vegetable); ranches and rangeland; poultry, dairy, and equine facilities; turfgrass growers; golf courses; nurseries; floricultural operations; and public and private parks.
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2. Facility Screening Information Does your facility sell, transfer, or commercially apply COI-containing products directly for use by an agricultural facility in the preparation for the treatment of crops, feed, land, livestock (including poultry) or other areas of an agricultural facility? [Q:1.0-23756]
Yes No
Does your facility sell, transfer, or commercially apply COI-containing products directly for use by an agricultural facility during application to or treatment of crops, feed, land, livestock (including poultry) or other areas of an agricultural facility? [Q:1.0-23757]
Yes No
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3. Agricultural Facility Customers
NAICS Codes Using the U.S. Census Bureau's North American Industry Classification System (NAICS) codes, identify all of your agricultural facility customers - specifically, your agricultural facility customers (other than chemical distribution facilities or commercial chemical application services) to whom you sell, transfer or commercially apply COI for use in agricultural activities:
• In preparation for the treatment of crops, feed, land, livestock (including poultry) or other areas of an agricultural production facility; or
• During application to or treatment of crops, feed, land, livestock (including poultry) or other areas of an agricultural production facility.
Such customers may include farms (e.g., crop, fruit, nut and vegetable); ranches and rangeland; poultry, dairy and equine facilities; turfgrass growers; golf courses; nurseries; floricultural operations; and public and private parks.
Below are the NAICS codes that DHS believes relate to agricultural activities. You may have others. Each NAICS code title links to the definition of the specific code at the NAICS website.
NAICS Code
Customer Type Does this NAICS code describe your agricultural facility customers? [Q:2.0-23861]
1111 Oilseed and Grain Farming Yes No
1112 Vegetable and Melon Farming Yes No
1113 Fruit and Tree Nut Farming Yes No
1114 Greenhouse, Nursery, and Floriculture Production
Yes No
1119 Other Crop Farming Yes No
112111 Beef Cattle Ranching and Farming Yes No
112112 Cattle Feedlots Yes No
112120 Dairy Cattle and Milk Production Yes No
112130 Dual-Purpose Cattle Ranching and Farming
Yes No
112210 Hog and Pig Farming Yes No
1123 Poultry and Egg Production Yes No
1124 Sheep and Goat Farming Yes No
11251 Aquaculture Yes No
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NAICS Code
Customer Type Does this NAICS code describe your agricultural facility customers? [Q:2.0-23861]
1129 Other Animal Production Yes No
113110 Timber Tract Operations Yes No
113210 Forest Nurseries and Gathering of Forest Products
Yes No
11511 Support Activities for Crop Production (includes Soil Preparation, Planting, & Cultivation)
Yes No
11521 Support Activities for Animal Production
Yes No
11531 Support Activities for Forestry Yes No
53131 Real Estate Property Managers Yes No
54171 Research and Development in the Physical, Engineering, and Life Sciences
Yes No
611 Educational Services Yes No
711310 Promoters of Performing Arts, Sports, and Similar Events with Facilities
Yes No
712130 Zoos and Botanical Gardens Yes No
712190 Nature Parks and Other Similar Institutions
Yes No
712120 Historical Sites Yes No
713110 Amusement and Theme Parks Yes No
713910 Golf Courses and Country Clubs Yes No
Add other NAICS codes not listed above.
If you have agricultural facility customers that do not fit one of the descriptions/definitions in the above section, please click here which will take you to the NAICS website where you can identify the appropriate NAICS code(s) to list in the text field below. After typing in each NAICS code, click the "Add" button to add it to the list of additional NAICS codes describing your customers.
NAICS Code [Q:2.0-24819] NAICS Code Description [Q:2.0-23864]
Have you listed all NAICS codes that describe your agricultural facility customers? [Q:2.0-23858]
Add
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Yes No
Facility/Customer Relations Does your facility transfer possession of any COI-containing product(s) to any of your agricultural facility customers (e.g., the COI-containing product leaves your facility with a customer and there is no delivery or commercial application by your facility)? [Q:2.1-24423]
Yes No
Does your facility commercially apply any COI-containing product(s) to any of your agricultural facility customers? [Q:2.1-24424]
Yes No
Does your facility deliver any COI-containing product(s) to any of your agricultural facility customers? [Q:2.1-24426]
Yes No
Does your facility place security-related conditions or restrictions (e.g., voluntary company, association, or industry customer and/or purchaser verification programs) on the sale of any of the COI-containing product(s) to any of your agricultural facility customers? [Q:2.1-24427]
Yes No
Are any of the COI-containing product(s) that you commercially apply stored at your agricultural facility customers' facilities before, during, or after commercial application? [Q:2.2-24822]
Yes No
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Customer Activities To the best of your knowledge, do any of your agricultural facility customers ship any COI-containing product(s)? [Q:2.3-24400]
Yes No Don’t Know
To the best of your knowledge, do any of your agricultural facility customers resell any COI-containing product(s)? [Q:2.3-24401]
Yes No Don’t Know
To the best of your knowledge, do any of your agricultural facility customers implement security measures for any COI-containing product(s)? [Q:2.3-24402]
Yes No Don’t Know
To the best of your knowledge, do any of your agricultural facility customers participate in any mandatory or voluntary security programs (e.g., voluntary company, association, or industry programs or state or territorial programs) for any COI-containing product(s)? [Q:2.3-24403]
Yes No Don’t Know
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4. COI Identification
Chemicals of Interest Identify each COI in COI-containing products at or above the lowest Appendix A minimum concentration, regardless of the screening threshold quantity, that you sell, transfer or commercially apply to agricultural facilities.
The COI that your facility identified in its Top-Screen are listed in the table below. The minimum concentration provided is the lowest from Appendix A and may be lower than those applicable to your facility's Top-Screen. For each COI in column 1 that you sell, transfer, or commercially apply to agricultural facilities, indicate whether the COI functions as:
• a pesticide (including active ingredients, fumigants, sterilants and COI used in food preparation/preservation);
• a fertilizer (including as a fertilizer ingredient); or
• any other agriculture-related purpose.
If a COI performs different functions in different products, click all that apply (e.g., a COI that functions as a pesticide in one product but a fertilizer in another).
Chemical of Interest
CAS# Min. Conc.
Pesticide [Q:2.5-24039]
Fertilizer [Q:2.5-24033]
Other [Q:2.5-24034]
Chemical X XXX-X XXX% Yes No Yes No Yes No
Do you possess any other COI-containing products at or above the lowest Appendix A minimum concentration - regardless of the Appendix A screening threshold quantity - that you sell, transfer or commercially apply to agricultural facilities? [Q:2.5-24048]
Yes No
The remaining Appendix A COI are listed in the table below. For each of COI in column 1 that you sell, transfer, or commercially apply to agricultural facilities indicate whether the COI functions as:
• a pesticide (including active ingredients, fumigants, sterilants and COI used in food preparation/preservation);
• a fertilizer (including as a fertilizer ingredient); or
• any other agriculture-related purpose.
If a COI performs different functions in different products, click all that apply (e.g., a COI that functions as a pesticide in one product but a fertilizer in another).
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Acetaldehyde 75-07-0 1.00% Yes No Yes No Yes No
Acetone cyanohydrin, stabilized 75-86-5 ACG Yes No Yes No Yes No
Acetyl bromide 506-96-7 ACG Yes No Yes No Yes No
Acetyl chloride 75-36-5 ACG Yes No Yes No Yes No
Acetyl iodide 507-02-8 ACG Yes No Yes No Yes No
Acetylene [Ethyne] 74-86-2 1.00% Yes No Yes No Yes No
Acrolein [2-Propenal or Acrylaldehyde] 107-02-8 1.00% Yes No Yes No Yes No
Acrylonitrile [2-Propenenitrile] 107-13-1 1.00% Yes No Yes No Yes No
Acrylyl chloride [2-Propenoyl chloride] 814-68-6 1.00% Yes No Yes No Yes No
Allyl alcohol [2-Propen-1-ol] 107-18-6 1.00% Yes No Yes No Yes No
Allylamine [2-Propen-1-amine] 107-11-9 1.00% Yes No Yes No Yes No
Allyltrichlorosilane, stabilized 107-37-9 ACG Yes No Yes No Yes No
Aluminum (powder) 7429-90-5 ACG Yes No Yes No Yes No
Aluminum bromide, anhydrous 7727-15-3 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Aluminum chloride, anhydrous 7446-70-0 ACG Yes No Yes No Yes No
Aluminum phosphide 20859-73-8 ACG Yes No Yes No Yes No
Ammonia (anhydrous) 7664-41-7 1.00% Yes No Yes No Yes No
Ammonia (conc. 20% or greater) 7664-41-7 20.00% Yes No Yes No Yes No
Ammonium nitrate, [with more than 0.2 percent combustible substances, including any organic substance calculated as carbon, to the exclusion of any other added substance]
6484-52-2 ACG Yes No Yes No Yes No
Ammonium nitrate, solid [nitrogen concentration of 23% nitrogen or greater]
6484-52-2 33.00% Yes No Yes No Yes No
Ammonium perchlorate 7790-98-9 ACG Yes No Yes No Yes No
Ammonium picrate 131-74-8 ACG Yes No Yes No Yes No
Amyltrichlorosilane 107-72-2 ACG Yes No Yes No Yes No
Antimony pentafluoride 7783-70-2 ACG Yes No Yes No Yes No
Arsenic trichloride [Arsenous trichloride] 7784-34-1 1.00% Yes No Yes No Yes No
Arsine 7784-42-1 1.00% Yes No Yes No Yes No
Barium azide 18810-58-7 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
1,4-Bis(2-chloroethylthio)-n-butane 142868-93-7 Yes No Yes No Yes No
Bis(2-chloroethylthio)methane 63869-13-6 Yes No Yes No Yes No
Bis(2-chloroethylthiomethyl)ether 63918-90-1 Yes No Yes No Yes No
1,5-Bis(2-chloroethylthio)-n-pentane 142868-94-8 Yes No Yes No Yes No
1,3-Bis(2-chloroethylthio)-n-propane 63905-10-2 Yes No Yes No Yes No
Boron tribromide 10294-33-4 ACG Yes No Yes No Yes No
Boron trichloride [Borane, trichloro] 10294-34-5 1.00% Yes No Yes No Yes No
Boron trifluoride [Borane, trifluoro] 7637-07-2 1.00% Yes No Yes No Yes No
Boron trifluoride compound with methyl ether (1:1) Yes No Yes No Yes No
[Boron, trifluoro [oxybis (methane)]-,T-4-] 353-42-4 1.00% Yes No Yes No Yes No
Bromine 7726-95-6 1.00% Yes No Yes No Yes No
Bromine chloride 13863-41-7 9.67% Yes No Yes No Yes No
Bromine pentafluoride 7789-30-2 ACG Yes No Yes No Yes No
Bromine trifluoride 7787-71-5 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Bromotrifluorethylene [Ethene, bromotrifluoro-] 598-73-2 1.00% Yes No Yes No Yes No
1,3-Butadiene 106-99-0 1.00% Yes No Yes No Yes No
Butane 106-97-8 1.00% Yes No Yes No Yes No
Butene 25167-67-3 1.00% Yes No Yes No Yes No
1-Butene 106-98-9 1.00% Yes No Yes No Yes No
2-Butene 107-01-7 1.00% Yes No Yes No Yes No
2-Butene-cis 590-18-1 1.00% Yes No Yes No Yes No
2-Butene-trans [2-Butene, (E)] 624-64-6 1.00% Yes No Yes No Yes No
Butyltrichlorosilane 7521-80-4 ACG Yes No Yes No Yes No
Calcium hydrosulfite [Calcium dithionite] 15512-36-4 ACG Yes No Yes No Yes No
Calcium phosphide 1305-99-3 ACG Yes No Yes No Yes No
Carbon disulfide 75-15-0 1.00% Yes No Yes No Yes No
Carbon oxysulfide [Carbon oxide sulfide (COS); carbonyl sulfide]
463-58-1 1.00% Yes No Yes No Yes No
Carbonyl fluoride 353-50-4 12.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Carbonyl sulfide 463-58-1 56.67% Yes No Yes No Yes No
Chlorine 7782-50-5 1.00% Yes No Yes No Yes No
Chlorine dioxide [Chlorine oxide, (ClO2)] 10049-04-4 ACG Yes No Yes No Yes No
Chlorine monoxide [Chlorine oxide] 7791-21-1 1.00% Yes No Yes No Yes No
Chlorine pentafluoride 13637-63-3 4.07% Yes No Yes No Yes No
Chlorine trifluoride 7790-91-2 9.97% Yes No Yes No Yes No
Chloroacetyl chloride 79-04-9 ACG Yes No Yes No Yes No
2-Chloroethylchloro-methylsulfide 2625-76-5 Yes No Yes No Yes No
Chloroform [Methane, trichloro-] 67-66-3 1.00% Yes No Yes No Yes No
Chloromethyl ether [Methane, oxybis(chloro-)] 542-88-1 1.00% Yes No Yes No Yes No
Chloromethyl methyl ether [Methane, chloromethoxy-]
107-30-2 1.00% Yes No Yes No Yes No
1-Chloropropylene [1-Propene, 1-chloro-] 590-21-6 1.00% Yes No Yes No Yes No
2-Chloropropylene [1-Propene, 2-chloro-] 557-98-2 1.00% Yes No Yes No Yes No
Chlorosulfonic acid 7790-94-5 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Chromium oxychloride 14977-61-8 ACG Yes No Yes No Yes No
Crotonaldehyde [2-Butenal] 4170-30-3 1.00% Yes No Yes No Yes No
Crotonaldehyde, (E)- [2-Butenal], (E)-] 123-73-9 1.00% Yes No Yes No Yes No
Cyanogen [Ethanedinitrile] 460-19-5 1.00% Yes No Yes No Yes No
Cyanogen chloride 506-77-4 1.00% Yes No Yes No Yes No
Cyclohexylamine [Cyclohexanamine] 108-91-8 1.00% Yes No Yes No Yes No
Cyclohexyltrichlorosilane 98-12-4 ACG Yes No Yes No Yes No
Cyclopropane 75-19-4 1.00% Yes No Yes No Yes No
DF [Methyl phosphonyl difluoride] 676-99-3 Yes No Yes No Yes No
Diazodinitrophenol 87-31-0 ACG Yes No Yes No Yes No
Diborane 19287-45-7 1.00% Yes No Yes No Yes No
Dichlorosilane [Silane, dichloro-] 4109-96-0 1.00% Yes No Yes No Yes No
N,N-(2-diethylamino)ethanethiol 100-38-9 30.00% Yes No Yes No Yes No
o,o-Diethyl S-[2-(diethylamino)ethyl] phosphorothiolate
78-53-5 30.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Diethyl methylphosphonite 15715-41-0 30.00% Yes No Yes No Yes No
N,N-Diethyl phosphoramidic dichloride 1498-54-0 30.00% Yes No Yes No Yes No
Diethyldichlorosilane 1719-53-5 ACG Yes No Yes No Yes No
Diethyleneglycol dinitrate 693-21-0 ACG Yes No Yes No Yes No
Difluoroethane [Ethane, 1,1-difluoro-] 75-37-6 1.00% Yes No Yes No Yes No
Dimethylamine [Methanamine, N-methyl-] 124-40-3 1.00% Yes No Yes No Yes No
N,N-(2-diisopropylamino)ethanethiol [N,N-diisopropyl-β-aminoethane thiol]
5842-07-9 30.00% Yes No Yes No Yes No
N,N-Diisopropyl phosphoramidic dichloride 23306-80-1 30.00% Yes No Yes No Yes No
N,N-(2-dimethylamino)ethanethiol 108-02-1 30.00% Yes No Yes No Yes No
N,N-Dimethyl phosphoramidic dichloride [Dimethylphosphoramido-dichloridate]
677-43-0 30.00% Yes No Yes No Yes No
N,N-(2-dipropylamino)ethanethiol 5842-06-8 30.00% Yes No Yes No Yes No
N,N-Dipropyl phosphoramidic dichloride 40881-98-9 30.00% Yes No Yes No Yes No
Dimethyldichlorosilane [Silane, dichlorodimethyl-] 75-78-5 ACG Yes No Yes No Yes No
1,1-Dimethylhydrazine [Hydrazine, 1, 1-dimethyl-] 57-14-7 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
2,2-Dimethylpropane [Propane, 2,2-dimethyl-] 463-82-1 1.00% Yes No Yes No Yes No
Dingu [Dinitroglycoluril] 55510-04-8 ACG Yes No Yes No Yes No
Dinitrogen tetroxide 10544-72-6 3.80% Yes No Yes No Yes No
Dinitrophenol 25550-58-7 ACG Yes No Yes No Yes No
Dinitroresorcinol 519-44-8 ACG Yes No Yes No Yes No
Diphenyldichlorosilane 80-10-4 ACG Yes No Yes No Yes No
Dipicryl sulfide 2217-06-3 ACG Yes No Yes No Yes No
Dipicrylamine [or] Hexyl [Hexanitrodiphenylamine] 131-73-7 ACG Yes No Yes No Yes No
Dodecyltrichlorosilane 4484-72-4 ACG Yes No Yes No Yes No
Epichlorohydrin [Oxirane, (chloromethyl)-] 106-89-8 1.00% Yes No Yes No Yes No
Ethane 74-84-0 1.00% Yes No Yes No Yes No
Ethyl acetylene [1-Butyne] 107-00-6 1.00% Yes No Yes No Yes No
Ethyl chloride [Ethane, chloro-] 75-00-3 1.00% Yes No Yes No Yes No
Ethyl ether [Ethane, 1,1-oxybis-] 60-29-7 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Ethyl mercaptan [Ethanethiol] 75-08-1 1.00% Yes No Yes No Yes No
Ethyl nitrite [Nitrous acid, ethyl ester] 109-95-5 1.00% Yes No Yes No Yes No
Ethyl phosphonyl difluoride 753-98-0 Yes No Yes No Yes No
Ethylamine [Ethanamine] 75-04-7 1.00% Yes No Yes No Yes No
Ethyldiethanolamine 139-87-7 80.00% Yes No Yes No Yes No
Ethylene [Ethene] 74-85-1 1.00% Yes No Yes No Yes No
Ethylene oxide [Oxirane] 75-21-8 1.00% Yes No Yes No Yes No
Ethylenediamine [1,2-Ethanediamine] 107-15-3 1.00% Yes No Yes No Yes No
Ethyleneimine [Aziridine] 151-56-4 1.00% Yes No Yes No Yes No
Ethylphosphonothioic dichloride 993-43-1 30.00% Yes No Yes No Yes No
Ethyltrichlorosilane 115-21-9 ACG Yes No Yes No Yes No
Fluorine 7782-41-4 1.00% Yes No Yes No Yes No
Fluorosulfonic acid 7789-21-1 ACG Yes No Yes No Yes No
Formaldehyde (solution) 50-00-0 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Furan 110-00-9 1.00% Yes No Yes No Yes No
Germane 7782-65-2 20.73% Yes No Yes No Yes No
Germanium tetrafluoride 7783-58-6 2.11% Yes No Yes No Yes No
Guanyl nitrosaminoguanylidene hydrazine ACG Yes No Yes No Yes No
Hexaethyl tetraphosphate and compressed gas mixtures
757-58-4 33.37% Yes No Yes No Yes No
Hexafluoroacetone 684-16-2 15.67% Yes No Yes No Yes No
Hexanitrostilbene 20062-22-0 ACG Yes No Yes No Yes No
Hexolite [Hexotol] 121-82-4 ACG Yes No Yes No Yes No
Hexyltrichlorosilane 928-65-4 ACG Yes No Yes No Yes No
HMX [Cyclotetramethylenetetranitramine] 2691-41-0 ACG Yes No Yes No Yes No
HN1 (Nitrogen Mustard-1) [Bis(2-chloroethyl)ethylamine]
538-07-8 Yes No Yes No Yes No
HN2 (Nitrogen Mustard-2) [Bis(2-chloroethyl)methylamine]
51-75-2 Yes No Yes No Yes No
HN3 (Nitrogen Mustard-3) [Tris(2-chloroethyl)amine] 555-77-1 Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Hydrazine 302-01-2 1.00% Yes No Yes No Yes No
Hydrochloric acid (conc. 37% or greater) 7647-01-0 37.00% Yes No Yes No Yes No
Hydrocyanic acid 74-90-8 1.00% Yes No Yes No Yes No
Hydrofluoric acid (conc. 50% or greater) 7664-39-3 50.00% Yes No Yes No Yes No
Hydrogen 1333-74-0 1.00% Yes No Yes No Yes No
Hydrogen bromide (anhydrous) 10035-10-6 95.33% Yes No Yes No Yes No
Hydrogen chloride (anhydrous) 7647-01-0 ACG Yes No Yes No Yes No
Hydrogen cyanide [Hydrocyanic acid] 74-90-8 4.67% Yes No Yes No Yes No
Hydrogen fluoride (anhydrous) 7664-39-3 1.00% Yes No Yes No Yes No
Hydrogen iodide, anhydrous 10034-85-2 95.33% Yes No Yes No Yes No
Hydrogen peroxide (concentration of at least 35%) 7722-84-1 35.00% Yes No Yes No Yes No
Hydrogen selenide 7783-07-5 0.07% Yes No Yes No Yes No
Hydrogen sulfide 7783-06-4 1.00% Yes No Yes No Yes No
Iodine pentafluoride 7783-66-6 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Iron, pentacarbonyl- [Iron carbonyl (Fe(CO)5), (TB5-11)-]
13463-40-6 1.00% Yes No Yes No Yes No
Isobutane [Propane, 2-methyl] 75-28-5 1.00% Yes No Yes No Yes No
Isobutyronitrile [Propanenitrile, 2-methyl-] 78-82-0 1.00% Yes No Yes No Yes No
Isopentane [Butane, 2-methyl-] 78-78-4 1.00% Yes No Yes No Yes No
Isoprene [1,3-Butadiene, 2-methyl-] 78-79-5 1.00% Yes No Yes No Yes No
Isopropyl chloride [Propane, 2-chloro-] 75-29-6 1.00% Yes No Yes No Yes No
Isopropyl chloroformate [Carbonochloridic acid, 1-methylethyl ester]
108-23-6 1.00% Yes No Yes No Yes No
Isopropylamine [2-Propanamine] 75-31-0 1.00% Yes No Yes No Yes No
Isopropylphosphonothioic dichloride 1498-60-8 30.00% Yes No Yes No Yes No
Isopropylphosphonyl difluoride 677-42-9 Yes No Yes No Yes No
Lead azide 13424-46-9 ACG Yes No Yes No Yes No
Lead styphnate [Lead trinitroresorcinate] 15245-44-0 ACG Yes No Yes No Yes No
Lewisite 1 [2-chlorovinyldichloroarsine] 541-25-3 Yes No Yes No Yes No
Lewisite 2 [Bis(2-chlorovinyl)chloroarsine] 40334-69-8 Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Lewisite 3 [Tris(2-chlorovinyl)arsine] 40334-70-1 Yes No Yes No Yes No
Lithium amide 7782-89-0 ACG Yes No Yes No Yes No
Lithium nitride 26134-62-3 ACG Yes No Yes No Yes No
Magnesium (powder) 7439-95-4 ACG Yes No Yes No Yes No
Magnesium diamide 7803-54-5 ACG Yes No Yes No Yes No
Magnesium phosphide 12057-74-8 ACG Yes No Yes No Yes No
MDEA [Methyldiethanolamine] 105-59-9 80.00% Yes No Yes No Yes No
Mercury fulminate 628-86-4 ACG Yes No Yes No Yes No
Methacrylonitrile [2-Propenenitrile, 2-methyl-] 126-98-7 1.00% Yes No Yes No Yes No
Methane 74-82-8 1.00% Yes No Yes No Yes No
2-Methyl-1-butene 563-46-2 1.00% Yes No Yes No Yes No
3-Methyl-1-butene 563-45-1 1.00% Yes No Yes No Yes No
Methyl chloride [Methane, chloro-] 74-87-3 1.00% Yes No Yes No Yes No
Methyl chloroformate [Carbonochloridic acid, methyl ester]
79-22-1 1.00% Yes No Yes No Yes No
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U.S. Department of Homeland Security 21
Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Methyl ether [Methane, oxybis-] 115-10-6 1.00% Yes No Yes No Yes No
Methyl formate [Formic acid Methyl ester] 107-31-3 1.00% Yes No Yes No Yes No
Methyl hydrazine [Hydrazine, methyl-] 60-34-4 1.00% Yes No Yes No Yes No
Methyl isocyanate [Methane, isocyanato-] 624-83-9 1.00% Yes No Yes No Yes No
Methyl mercaptan [Methanethiol] 74-93-1 1.00% Yes No Yes No Yes No
Methyl thiocyanate [Thiocyanic acid, methyl ester] 556-64-9 1.00% Yes No Yes No Yes No
Methylamine [Methanamine] 74-89-5 1.00% Yes No Yes No Yes No
Methylchlorosilane 993-00-0 20.00% Yes No Yes No Yes No
Methyldichlorosilane 75-54-7 ACG Yes No Yes No Yes No
Methylphenyldichlorosilane 149-74-6 ACG Yes No Yes No Yes No
Methylphosphonothioic dichloride 676-98-2 30.00% Yes No Yes No Yes No
2-Methylpropene [1-Propene, 2-methyl-] 115-11-7 1.00% Yes No Yes No Yes No
Methyltrichlorosilane [Silane, trichloromethyl-] 75-79-6 ACG Yes No Yes No Yes No
O-Mustard (T) [Bis(2-chloroethylthioethyl)ether] 63918-89-8 Yes No Yes No Yes No
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U.S. Department of Homeland Security 22
Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Nickel Carbonyl 13463-39-3 1.00% Yes No Yes No Yes No
Nitric acid 7697-37-2 68.00% Yes No Yes No Yes No
Nitric oxide [Nitrogen oxide (NO)] 10102-43-9 1.00% Yes No Yes No Yes No
Nitrobenzene 98-95-3 ACG Yes No Yes No Yes No
5-Nitrobenzotriazol 2338-12-7 ACG Yes No Yes No Yes No
Nitrocellulose 9004-70-0 ACG Yes No Yes No Yes No
Nitrogen mustard hydrochloride [Bis(2-chloroethyl)methylamine hydrochloride]
55-86-7 30.00% Yes No Yes No Yes No
Nitrogen trioxide 10544-73-7 3.83% Yes No Yes No Yes No
Nitroglycerine 55-63-0 ACG Yes No Yes No Yes No
Nitromannite [Mannitol hexanitrate, wetted] 15825-70-4 ACG Yes No Yes No Yes No
Nitromethane 75-52-5 ACG Yes No Yes No Yes No
Nitrostarch 9056-38-6 ACG Yes No Yes No Yes No
Nitrosyl chloride 2696-92-6 1.17% Yes No Yes No Yes No
Nitrotriazolone 932-64-9 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Nonyltrichlorosilane 5283-67-0 ACG Yes No Yes No Yes No
Octadecyltrichlorosilane 112-04-9 ACG Yes No Yes No Yes No
Octolite 57607-37-1 ACG Yes No Yes No Yes No
Octonal 78413-87-3 ACG Yes No Yes No Yes No
Octyltrichlorosilane 5283-66-9 ACG Yes No Yes No Yes No
Oleum (Fuming Sulfuric acid) [Sulfuric acid, mixture with sulfur trioxide]
8014-95-7 1.00% Yes No Yes No Yes No
Oxygen difluoride 7783-41-7 0.09% Yes No Yes No Yes No
1,3-Pentadiene 504-60-9 1.00% Yes No Yes No Yes No
Pentane 109-66-0 1.00% Yes No Yes No Yes No
1-Pentene 109-67-1 1.00% Yes No Yes No Yes No
2-Pentene, (E)- 646-04-8 1.00% Yes No Yes No Yes No
2-Pentene, (Z)- 627-20-3 1.00% Yes No Yes No Yes No
Pentolite 8066-33-9 ACG Yes No Yes No Yes No
Peracetic acid [Ethaneperoxic acid] 79-21-0 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Perchloromethylmercaptan [Methanesulfenyl chloride, trichloro-]
594-42-3 1.00% Yes No Yes No Yes No
Perchloryl fluoride 7616-94-6 25.67% Yes No Yes No Yes No
PETN [Pentaerythritol tetranitrate] 78-11-5 ACG Yes No Yes No Yes No
Phenyltrichlorosilane 98-13-5 ACG Yes No Yes No Yes No
Phosgene [Carbonic dichloride] or [carbonyl dichloride]
75-44-5 0.17% Yes No Yes No Yes No
Phosphine 7803-51-2 0.67% Yes No Yes No Yes No
Phosphorus 7723-14-0 ACG Yes No Yes No Yes No
Phosphorus oxychloride [Phosphoryl chloride] 10025-87-3 ACG Yes No Yes No Yes No
Phosphorus pentabromide 7789-69-7 ACG Yes No Yes No Yes No
Phosphorus pentachloride 10026-13-8 ACG Yes No Yes No Yes No
Phosphorus pentasulfide 1314-80-3 ACG Yes No Yes No Yes No
Phosphorus trichloride 7719-12-2 ACG Yes No Yes No Yes No
Picrite [Nitroguanidine] 556-88-7 ACG Yes No Yes No Yes No
Piperidine 110-89-4 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Potassium chlorate 3811-04-9 ACG Yes No Yes No Yes No
Potassium cyanide 151-50-8 ACG Yes No Yes No Yes No
Potassium nitrate 7757-79-1 ACG Yes No Yes No Yes No
Potassium perchlorate 7778-74-7 ACG Yes No Yes No Yes No
Potassium permanganate 7722-64-7 ACG Yes No Yes No Yes No
Potassium phosphide 20770-41-6 ACG Yes No Yes No Yes No
Propadiene [1,2-Propadiene] 463-49-0 1.00% Yes No Yes No Yes No
Propane 74-98-6 1.00% Yes No Yes No Yes No
Propionitrile [Propanenitrile] 107-12-0 1.00% Yes No Yes No Yes No
Propyl chloroformate [Carbonchloridic acid, propylester]
109-61-5 1.00% Yes No Yes No Yes No
Propylene [1-Propene] 115-07-1 1.00% Yes No Yes No Yes No
Propylene oxide [Oxirane, methyl-] 75-56-9 1.00% Yes No Yes No Yes No
Propyleneimine [Aziridine, 2-methyl-] 75-55-8 1.00% Yes No Yes No Yes No
Propylphosphonothioic dichloride 2524-01-8 30.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Propylphosphonyl difluoride 690-14-2 Yes No Yes No Yes No
Propyltrichlorosilane 141-57-1 ACG Yes No Yes No Yes No
Propyne [1-Propyne] 74-99-7 1.00% Yes No Yes No Yes No
QL [o-Ethyl-o-2-diisopropylaminoethyl methylphosphonite]
57856-11-8 Yes No Yes No Yes No
RDX [Cyclotrimethylenetrinitramine] 121-82-4 ACG Yes No Yes No Yes No
RDX and HMX mixtures 121-82-4 ACG Yes No Yes No Yes No
Sarin [o-Isopropyl methylphosphonofluoridate] 107-44-8 Yes No Yes No Yes No
Selenium hexafluoride 7783-79-1 1.67% Yes No Yes No Yes No
Sesquimustard [1,2-Bis(2-chloroethylthio)ethane] 3563-36-8 Yes No Yes No Yes No
Silane 7803-62-5 1.00% Yes No Yes No Yes No
Silicon tetrachloride 10026-04-7 ACG Yes No Yes No Yes No
Silicon tetrafluoride 7783-61-1 15.00% Yes No Yes No Yes No
Sodium azide 26628-22-8 ACG Yes No Yes No Yes No
Sodium chlorate 7775-09-9 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Sodium cyanide 143-33-9 ACG Yes No Yes No Yes No
Sodium hydrosulfite [Sodium dithionite] 7775-14-6 ACG Yes No Yes No Yes No
Sodium nitrate 7631-99-4 ACG Yes No Yes No Yes No
Sodium phosphide 12058-85-4 ACG Yes No Yes No Yes No
Soman [o-Pinacolyl methylphosphonofluoridate] 96-64-0 Yes No Yes No Yes No
Stibine 7803-52-3 0.67% Yes No Yes No Yes No
Strontium phosphide 12504-16-4 ACG Yes No Yes No Yes No
Sulfur dioxide (anhydrous) 7446-09-5 1.00% Yes No Yes No Yes No
Sulfur Mustard (Mustard gas (H)) [Bis(2-chloroethyl)sulfide]
505-60-2 Yes No Yes No Yes No
Sulfur tetrafluoride [Sulfur fluoride (SF4), (T-4)-] 7783-60-0 1.00% Yes No Yes No Yes No
Sulfur trioxide 7446-11-9 1.00% Yes No Yes No Yes No
Sulfuryl chloride 7791-25-5 ACG Yes No Yes No Yes No
Tabun [o-Ethyl-N,N-dimethylphosphoramido-cyanidate]
77-81-6 Yes No Yes No Yes No
Tellurium hexafluoride 7783-80-4 0.83% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Tetrafluoroethylene [Ethene, tetrafluoro-] 116-14-3 1.00% Yes No Yes No Yes No
Tetramethyllead [Plumbane, tetramethyl-] 75-74-1 1.00% Yes No Yes No Yes No
Tetramethylsilane [Silane, tetramethyl-] 75-76-3 1.00% Yes No Yes No Yes No
Tetranitroaniline 53014-37-2 ACG Yes No Yes No Yes No
Tetranitromethane [Methane, tetranitro-] 509-14-8 1.00% Yes No Yes No Yes No
Tetrazene [Guanyl nitrosaminoguanyltetrazene] 109-27-3 ACG Yes No Yes No Yes No
1H-Tetrazole 288-94-8 ACG Yes No Yes No Yes No
Thiodiglycol [Bis(2-hydroxyethyl)sulfide] 111-48-8 30.00% Yes No Yes No Yes No
Thionyl chloride 7719-09-7 ACG Yes No Yes No Yes No
Titanium tetrachloride [Titanium chloride (TiCl4) (T-4)-]
7550-45-0 ACG Yes No Yes No Yes No
TNT [Trinitrotoluene] 118-96-7 ACG Yes No Yes No Yes No
Torpex [Hexotonal] 67713-16-0 ACG Yes No Yes No Yes No
Trichlorosilane [Silane, trichloro-] 10025-78-2 ACG Yes No Yes No Yes No
Triethanolamine 102-71-6 80.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Triethanolamine hydrochloride 637-39-8 80.00% Yes No Yes No Yes No
Triethyl phosphite 122-52-1 80.00% Yes No Yes No Yes No
Trifluoroacetyl chloride 354-32-5 6.93% Yes No Yes No Yes No
Trifluorochloroethylene [Ethene, chlorotrifluoro] 79-38-9 1.00% Yes No Yes No Yes No
Trimethyl phosphite 121-45-9 80.00% Yes No Yes No Yes No
Trimethylamine [Methanamine, N,N-dimethyl-] 75-50-3 1.00% Yes No Yes No Yes No
Trimethylchlorosilane [Silane, chlorotrimethyl-] 75-77-4 ACG Yes No Yes No Yes No
Trinitroaniline 26952-42-1 ACG Yes No Yes No Yes No
Trinitroanisole 606-35-9 ACG Yes No Yes No Yes No
Trinitrobenzene 99-35-4 ACG Yes No Yes No Yes No
Trinitrobenzenesulfonic acid 2508-19-2 ACG Yes No Yes No Yes No
Trinitrobenzoic acid 129-66-8 ACG Yes No Yes No Yes No
Trinitrochlorobenzene 88-88-0 ACG Yes No Yes No Yes No
Trinitrofluorenone 129-79-3 ACG Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Trinitro-meta-cresol 602-99-3 ACG Yes No Yes No Yes No
Trinitronaphthalene 55810-17-8 ACG Yes No Yes No Yes No
Trinitrophenetole 4732-14-3 ACG Yes No Yes No Yes No
Trinitrophenol 88-89-1 ACG Yes No Yes No Yes No
Trinitroresorcinol 82-71-3 ACG Yes No Yes No Yes No
Tritonal 54413-15-9 ACG Yes No Yes No Yes No
Tungsten hexafluoride 7783-82-6 7.10% Yes No Yes No Yes No
Vinyl acetate monomer [Acetic acid ethenyl ester] 108-05-4 1.00% Yes No Yes No Yes No
Vinyl acteylene [1-Buten-3-yne] 689-97-4 1.00% Yes No Yes No Yes No
Vinyl chloride [Ethene, chloro-] 75-01-4 1.00% Yes No Yes No Yes No
Vinyl ethyl ether [Ethene, ethoxy-] 109-92-2 1.00% Yes No Yes No Yes No
Vinyl fluoride [Ethene, fluoro-] 75-02-5 1.00% Yes No Yes No Yes No
Vinyl methyl ether [Ethene, methoxy-] 107-25-5 1.00% Yes No Yes No Yes No
Vinylidene chloride [Ethene, 1,1-dichloro-] 75-35-4 1.00% Yes No Yes No Yes No
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Chemical of Interest CAS# Min. Conc. Pesticide [Q:2.6-24053]
Fertilizer [Q:2.6-24054]
Other [Q:2.6-24055]
Vinylidene fluoride [Ethene, 1,1-difluoro-] 75-38-7 1.00% Yes No Yes No Yes No
Vinyltrichlorosilane 75-94-5 ACG Yes No Yes No Yes No
VX [o-Ethyl-S-2-diisopropylaminoethyl methyl phosphonothiolate]
50782-69-9 Yes No Yes No Yes No
Zinc hydrosulfite [Zinc dithionite] 7779-86-4 ACG Yes No Yes No Yes No
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5. COI-Containing Pesticide Products
Identify Pesticide Products For each COI that you identified previously as a pesticide, identify each pesticide product that you sell, transfer or commercially apply to agricultural facilities.
In responding to this question, include all COI-containing pesticide products that your facility has sold, transferred or commercially applied in the past year and all that your facility anticipates selling, transferring, or commercially applying in the coming year. Do not include pesticides that are no longer available in commerce (e.g., pesticides without an active registration).
If the pesticide product is shown in the table below, select the EPA Pesticide Registration Number and corresponding product name which appear on the pesticide label. If your product's name is not shown in this table, you will need to add the EPA registration number and the different product name in the section farther down on this page.
In the text fields below, enter in the EPA Registration Number and pesticide product name of any other pesticide products which are not listed in the previous table. Provide only the numbers on each side of the first hyphen of the EPA Registration Number (e.g., 123-456-798). Click "Add" to add the pesticide product to the list.
EPA Registration Number
[Q:3.0-24183] Pesticide Product
[Q:3.0-23881]
Have you listed all COI-containing pesticide products that you sell, transfer, or commercially apply to agricultural facilities? [Q:3.0-23870]
Yes No
All Pesticide Products Click "Describe" to provide the requested information for each pesticide product.
EPA Registration Number – Product Name [Q:3.1-23898]
XXX-XXX-XXX – Product X
Add
Describe: XXX-XXX-XXX – Product X
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Have you described all pesticide products listed above? [Q:3.1-24268]
Yes No
Pesticide Product Ingredients Indicate the percent by weight of all COI present in XXX-XXX-XXX - Product X
Confirm Appendix A COI present in the pesticide product at or above the lowest Appendix A minimum concentration by clicking Yes if the percent by weight provided is correct for the COI listed on the pesticide label. If the COI is correct and the percent by weight is wrong, click "Yes" and correct the percent by weight. Click "Yes" and add the percent by weight for any additional COI in the pesticide product at or above the lowest Appendix A minimum concentration. (The percent by weight of active ingredients is listed on the pesticide product label.) If percent by weight must be rounded, enter values that are rounded to two decimal places.
Chemical of Interest CAS# Min. Conc.
COI present in Pesticide? [Q:3.2-24041]
Percent by Weight [Q:3.2-24042]
Chemical X XXX-X XXX% Yes No
Pesticide Product Containers Add an entry for each type of container that you sell, transfer, or commercially apply of XXX-XXX-XXX – Product X, using the net weight or net content listed on the pesticide label. Express the net weight in the Amount column as the largest applicable unit, rounding, if necessary, to two decimal places (i.e., express 5 pounds, 4 ounces as 5.25 pounds). Click "Add" to add the container type to the list.
Container [Q:3.25-23944]
Amount [Q:3.25-23945]
Unit [Q:3.25-23946]
Add
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Customer Types for COI-Containing Pesticide Products Identify the customer type(s) to whom you sell, transfer, or for whom you commercially apply XXX-XXX-XXX – Product X.
Customer Types [Q:3.3-23942]
Do you sell, transfer, or commercially apply the pesticide to this customer type? [Q:3.3-23943]
Customer Type X Yes No
Customers for COI-Containing Pesticide Products Click "Provide" to provide the requested information for each customer type with regards to XXX-XXX-XXX – Product X.
Customer Types [Q:3.4-23921]
Customer Type X
Have you answered the questions for all customer types associated with this pesticide? [Q:3.4-23949]
Yes No
Facility/Customer Relations for Pesticide/Customer Pairs In the Facility Information section, you answered a number of questions about your facility and customer relations. Based on those responses, you will be directed to answer specific questions about each COI-containing product and customer combination. Click Next to continue.
Do you transfer possession of XXX-XXX-XXX – Product X to Customer Type X customers (e.g., the COI-containing product leaves your facility with a customer and there is no delivery or commercial application by your facility)? [Q:3.41-24942]
Yes No
Provide Customer Type X Detail Information
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Do you commercially apply XXX-XXX-XXX – Product X to Customer Type X customers and the product is stored at the customer facilities before, during or after commercial application? [Q:3.41-24943]
Yes No
Do you deliver XXX-XXX-XXX – Product X to Customer Type X customers? [Q:3.41-24944]
Yes No
Pesticide Products Transferred to Agricultural Facility Customers If you transfer possession of XXX-XXX-XXX – Product X consistently throughout the year, enter the number of containers you typically transfer each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If you transfer possession of XXX-XXX-XXX – Product X on an as needed basis, leave the text box blank.
Container Types [Q:3.6-23976]
Amount [Q:3.6-23992]
Units [Q:3.6-23994]
Year Round [Q:3.6-23941]
Container X XX XX
If the number of containers you transfer is not consistent throughout the year, enter the number of containers you typically transfer each month for each container type in the column corresponding to each month below. If you do not typically transfer possession of XXX-XXX-XXX – Product X during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If you transfer possession of XXX-XXX-XXX – Product X on an as needed basis, leave the text box blank.
Container Types
[Q:3.6-23996]
Amount
[Q:3.6-23997]
Units
[Q:3.6-23998]
January
[Q:3.6-24000]
February
[Q:3.6-24001]
March
[Q:3.6-24002]
April
[Q:3.6-24003]
May
[Q:3.6-24004]
June
[Q:3.6-24005]
Container X XX XX
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Container Types
[Q:3.6-23991]
Amount
[Q:3.6-23993]
Units
[Q:3.6-23995]
July
[Q:3.6-
23970]
August
[Q:3.6-23971]
September
[Q:3.6-23972]
October
[Q:3.6-23973]
November
[Q:3.6-23974]
December
[Q:3.6-23975]
Container X XX XX
Pesticide Products Commercially Applied and Stored for Agricultural Facility Customers If you commercially apply XXX-XXX-XXX – Product X consistently throughout the year, enter the number of containers you typically store at the customer's site each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If XXX-XXX-XXX – Product X is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types [Q:3.7-24198]
Amount [Q:3.7-24199]
Units [Q:3.7-24200]
Year Round [Q:3.7-24201]
Container X XX XX
If the number of containers you store at the customer's site is not consistent throughout the year, enter the number of containers you typically store each month for each container type in the column corresponding to each month below. If you do not typically store XXX-XXX-XXX – Product X at the customer's site during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If XXX-XXX-XXX – Product X is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types
[Q:3.7-24202]
Amount
[Q:3.7-24203]
Units
[Q:3.7-24204]
January
[Q:3.7-24205]
February
[Q:3.7-24206]
March
[Q:3.7-24207]
April
[Q:3.7-24208]
May
[Q:3.7-24209]
June
[Q:3.7-24210]
Container X XX XX
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Container Types
[Q:3.7-24211]
Amount
[Q:3.7-24212]
Units
[Q:3.7-24213]
July
[Q:3.7-
24214]
August
[Q:3.7-24215]
September
[Q:3.7-24216]
October
[Q:3.7-24217]
November
[Q:3.7-24218]
December
[Q:3.7-24219]
Container X XX XX
Pesticide Products Delivered to Agricultural Facility Customers If you deliver XXX-XXX-XXX – Product X consistently throughout the year, enter the number of containers you typically deliver each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If XXX-XXX-XXX – Product X is delivered on an as needed basis, leave the text box blank.
Container Types [Q:3.8-24223]
Amount [Q:3.8-24224]
Units [Q:3.8-24225]
Year Round [Q:3.8-24226]
Container X XX XX
If the number of containers you deliver is not consistent throughout the year, enter the number of containers you typically deliver each month in the column corresponding to each month below. If you do not typically deliver the product during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If XXX-XXX-XXX – Product X is delivered on an as needed basis, leave the text box blank.
Container Types
[Q:3.8-24227]
Amount
[Q:3.8-24228]
Units
[Q:3.8-24229]
January
[Q:3.8-24230]
February
[Q:3.8-24231]
March
[Q:3.8-24232]
April
[Q:3.8-24233]
May
[Q:3.8-24234]
June
[Q:3.8-24235]
Container X XX XX
Container Types
[Q:3.8-24236]
Amount
[Q:3.8-24237]
Units
[Q:3.8-24238]
July
[Q:3.8-
24239]
August
[Q:3.8-24240]
September
[Q:3.8-24241]
October
[Q:3.8-24242]
November
[Q:3.8-24243]
December
[Q:3.8-24244]
Container X XX XX
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Security Restrictions Placed on Sale of Pesticide Products Do you place any security-related conditions or restrictions on the sale of this product to these customers? [Q:3.91-24496]
Yes No
Do you follow a company or facility policy/program? [Q:3.92-24478]
Yes No
Do you follow an industry/association program? [Q:3.92-24479]
Yes No
If Yes, please enter the association and program name. [Q:3.92-24480]
Do you follow a state security regulatory program? [Q:3.92-24481]
Yes No
If Yes, please identify the state of the regulatory program (select all that apply). [Q:3.92-24482]
If you place any other condition or restriction that is not listed above, please describe the security-related condition or restriction in this text field. [Q:3.92-24483]
Add
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Pesticide Customer Activities To the best of your knowledge, do any of these customers ship this product? [Q:3.925-24502]
Yes No Don’t Know
To the best of your knowledge, do any of these customers resell this product? [Q:3.925-24508]
Yes No Don’t Know
To the best of your knowledge, do any of these customers implement security measures for this product? [Q:3.925-24514]
Yes No Don’t Know
To the best of your knowledge, do any of these customers participate in any mandatory or voluntary security programs for this product? [Q:3.925-24520]
Yes No Don’t Know
Customer Security Measures Do you believe that any of these customers have access control measures in place? [Q:3.93-23952]
Yes No Don’t Know
Do you believe that any of these customers have physical security measures in place (e.g., locked or fenced storage enclosures, lighted storage areas, valve locks, motion detector lights, or alarms)? [Q:3.93-23953]
Yes No Don’t Know
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 40
Do you believe that any of these customers have inventory control measures in place? [Q:3.93-23954]
Yes No Don’t Know
Do you believe that any of these customers have security procedures in place (e.g., regular security inspection of storage area and security measures, transaction records/logs, procedures for reporting tampering or loss)? [Q:3.93-23955]
Yes No Don’t Know
Do you believe that any of these customers have security awareness measures in place (e.g., procedures for identifying and reporting suspicious behavior)? [Q:3.93-23956]
Yes No Don’t Know
Do you believe these customers have other security measures in place? If so, please describe the customer's security measures in this text field. [Q:3.93-23957]
Customer Security Programs Do you believe that any of these customers have a company or facility policy/program in place? [Q:3.94-23959]
Yes No Don’t Know
Do you believe that any of these customers follow an industry/association program? [Q:3.94-23965]
Yes No Don’t Know
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 41
If Yes, please enter the association and program name. [Q:3.94-23966]
Do you believe that any of these customers follow a state security regulatory program? [Q:3.94-23967]
Yes No Don’t Know
If Yes, please identify the state of the regulatory program (select all that apply). [Q:3.94-23977]
If you believe an agriculture facility customer follows some other security program not listed above, please describe the customer's security programs in this text field. [Q:3.94-23968]
Add
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U.S. Department of Homeland Security 42
6. COI-Containing Fertilizer Products
Identify Fertilizer Products For each COI that you identified previously as a fertilizer, identify each fertilizer product that you sell, transfer, or commercially apply to agricultural facilities.
In responding to this question, include all COI-containing fertilizer products that your facility has sold, transferred, or commercially applied in the past year and all that your facility anticipates selling, transferring, or commercially applying in the coming year.
List of COI Used in Fertilizers
The following list shows all COI that you have indicated are used as a fertilizer.
Chemical of Interest CAS# Min. Conc.
Chemical Y YYY-Y YYY%
In the text fields below, enter a unique product name for each fertilizer product that you sell, transfer, or commercially apply to agricultural facilities. Click "Add" to add the fertilizer product to the list and then click "Describe" to provide the requested information for each fertilizer product.
Fertilizer Name
[Q:4.0-23978]
Product Y
Have you described all COI-containing fertilizers that you sell, transfer, or commercially apply to agricultural facilities? [Q:4.0-24395]
Yes No
Describe: Product Y
Add
Delete
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U.S. Department of Homeland Security 43
Fertilizer Product Ingredients Indicate the percent by weight of all COI present in Product Y
Identify all Appendix A COI present in Product Y in an amount at or above the lowest Appendix A minimum concentration. (The percent by weight of active ingredients is available from the product label or MSDS.) Enter values that are rounded to two decimal places.
Chemical of Interest CAS# Min. Conc.
COI present in Fertilizer? [Q:4.2-24493]
Percent by Weight [Q:4.2-24494]
Chemical Y YYY-Y YYY% Yes No
Fertilizer Product Containers Add an entry for each size container that you sell, transfer, or commercially apply of Product Y, using the drop down box selections below. If you select "Flexible Intermediate Bulk Container (pounds)" or "Other Bulk Container (pounds)" enter the number of pounds in the "Additional Information" column. If you select ">55 gallons","Tank Truck (gallons)," or "Rail Car (gallons)" enter the number of gallons in the "Additional Information" column. Otherwise, leave the "Additional Information" column blank. Click "Add" to add the container size to the list.
Container Size [Q:4.25-24174]
Additional Information [Q:4.25-24175]
Customer Types for COI-Containing Fertilizer Products Identify the customer type(s) to whom you sell, transfer, or for whom you commercially apply Product Y.
Customer Types [Q:4.3-24260]
Do you sell, transfer, or commercially apply the fertilizer to this customer type? [Q:4.3-24261]
Customer Type Y Yes No
Add
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U.S. Department of Homeland Security 44
Customers for COI-Containing Fertilizer Products Click "Provide" to provide the requested information for each customer type with regards to Product Y.
Customer Types [Q:4.4-24264]
Customer Type Y
Have you answered the questions for all customer types associated with this fertilizer? [Q:4.4-24265]
Yes No
Facility/Customer Relations In the Facility Information section, you answered a number of questions about your facility and customer relations. Based on those responses, you will be directed to answer specific questions about each COI-containing product and customer combination. Click Next to continue.
Do you transfer possession of Product Y to Customer Type Y customers (e.g., the COI-containing product leaves your facility with a customer and there is no delivery or commercial application by your facility)? [Q:4.41-24956]
Yes No
Do you commercially apply Product Y to Customer Type Y customers and the product is stored at the customer facilities before, during or after commercial application? [Q:4.41-24957]
Yes No
Do you deliver Product Y to Customer Type Y customers? [Q:4.41-24958]
Yes No
Provide Customer Type Y Detail Information
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U.S. Department of Homeland Security 45
Fertilizer Products Transferred to Agricultural Facility Customers If you transfer possession of Product Y consistently throughout the year, enter the number of containers you typically transfer each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If you transfer possession of Product Y on an as needed basis, leave the text box blank.
Container Types [Q:4.6-24537]
Additional Weight Information [Q:4.6-24538]
Year Round [Q:4.6-24539]
Container Y YY
If the number of containers you transfer is not consistent throughout the year, enter the number of containers you typically transfer each month for each container type in the column corresponding to each month below. If you do not typically transfer possession of Product Y during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If you transfer possession of Product Y on an as needed basis, leave the text box blank.
Container Types
[Q:4.6-24541]
Additional Weight Information
[Q:4.6-24542]
January
[Q:4.6-24543]
February
[Q:4.6-24544]
March
[Q:4.6-24545]
April
[Q:4.6-24546]
May
[Q:4.6-24547]
June
[Q:4.6-24548]
Container Y YY
Container Types
[Q:4.6-24550]
Additional Weight Information
[Q:4.6-24551]
July
[Q:4.6-
24552]
August
[Q:4.6-24553]
September
[Q:4.6-24554]
October
[Q:4.6-24555]
November
[Q:4.6-24556]
December
[Q:4.6-24557]
Container Y YY
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U.S. Department of Homeland Security 46
Fertilizer Products Commercially Applied and Stored for Agricultural Facility Customers If you commercially apply Product Y consistently throughout the year, enter the number of containers you typically store at the customer's site each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If Product Y is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types [Q:4.7-24561]
Additional Weight Information [Q:4.7-24562]
Year Round [Q:4.7-24563]
Container Y YY
If the number of containers you store at the customer's site is not consistent throughout the year, enter the number of containers you typically store each month for each container type in the column corresponding to each month below. If you do not typically store Product Y at the customer's site during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If Product Y is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types
[Q:4.7-24565]
Additional Weight Information
[Q:4.7-24566]
January
[Q:4.7-24567]
February
[Q:4.7-24568]
March
[Q:4.7-24569]
April
[Q:4.7-24570]
May
[Q:4.7-24571]
June
[Q:4.7-24572]
Container Y YY
Container Types
[Q:4.7-24574]
Additional Weight Information
[Q:4.7-24575]
July
[Q:4.7-
24576]
August
[Q:4.7-24577]
September
[Q:4.7-24578]
October
[Q:4.7-24579]
November
[Q:4.7-24580]
December
[Q:4.7-24581]
Container Y YY
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U.S. Department of Homeland Security 47
Fertilizer Products Delivered to Agricultural Facility Customers If you deliver Product Y consistently throughout the year, enter the number of containers you typically deliver each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If Product Y is delivered to the customer’s site on an as needed basis, leave the text box blank.
Container Types [Q:4.8-24585]
Additional Weight Information [Q:4.8-24586]
Year Round [Q:4.8-24587]
Container Y YY
If the number of containers you deliver is not consistent throughout the year, enter the number of containers you typically deliver each month in the column corresponding to each month below. If you do not typically deliver Product Y during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If Product Y is delivered to the customer’s site on an as needed basis, leave the text box blank.
Container Types
[Q:4.8-24589]
Additional Weight Information
[Q:4.8-24590]
January
[Q:4.8-24591]
February
[Q:4.8-24592]
March
[Q:4.8-24593]
April
[Q:4.8-24594]
May
[Q:4.8-24595]
June
[Q:4.8-24596]
Container Y YY
Container Types
[Q:4.8-24598]
Additional Weight Information
[Q:4.8-24599]
July
[Q:4.8-
24600]
August
[Q:4.8-24601]
September
[Q:4.8-24602]
October
[Q:4.8-24603]
November
[Q:4.8-24604]
December
[Q:4.8-24605]
Container Y YY
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U.S. Department of Homeland Security 48
Security Restrictions Placed on Sale of Fertilizer Products Do you place any security-related conditions or restrictions on the sale of this product to these customers? [Q:4.91-24613]
Yes No
Do you follow a company or facility policy/program? [Q:4.92-24625]
Yes No
Do you follow an industry/association program? [Q:4.92-24626]
Yes No
If Yes, please enter the association and program name. [Q:4.92-24627]
Do you follow a state security regulatory program? [Q:4.92-24628]
Yes No
If Yes, please identify the state of the regulatory program (select all that apply). [Q:4.92-24629]
If you place any other condition or restriction that is not listed above, please describe the security-related condition or restriction in this text field. [Q:4.92-24630]
Add
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U.S. Department of Homeland Security 49
Fertilizer Customer Activities To the best of your knowledge, do any of these customers ship this product? [Q:4.925-24614]
Yes No Don’t Know
To the best of your knowledge, do any of these customers resell this product? [Q:4.925-24615]
Yes No Don’t Know
To the best of your knowledge, do any of these customers implement security measures for this product? [Q:4.925-24616]
Yes No Don’t Know
To the best of your knowledge, do any of these customers participate in any mandatory or voluntary security programs for this product? [Q:4.925-24617]
Yes No Don’t Know
Customer Security Measures Do you believe that any of these customers have access control measures in place? [Q:4.93-24633]
Yes No Don’t Know
Do you believe that any of these customers have physical security measures in place (e.g., locked or fenced storage enclosures, lighted storage areas, valve locks, motion detector lights, or alarms)? [Q:4.93-24634]
Yes No Don’t Know
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U.S. Department of Homeland Security 50
Do you believe that any of these customers have inventory control measures in place? [Q:4.93-24635]
Yes No Don’t Know
Do you believe that any of these customers have security procedures in place (e.g., regular security inspection of storage area and security measures, transaction records/logs, procedures for reporting tampering or loss)? [Q:4.93-24636]
Yes No Don’t Know
Do you believe that any of these customers have security awareness measures in place (e.g., procedures for identifying and reporting suspicious behavior)? [Q:4.93-24637]
Yes No Don’t Know
Do you believe these customers have other security measures in place? If so, please describe the customer's security measures in this text field. [Q:4.93-24638]
Customer Security Programs Do you believe that any of these customers have a company or facility policy/program in place? [Q:4.94-24641]
Yes No Don’t Know
Do you believe that any of these customers follow an industry/association program? [Q:4.94-24642]
Yes No Don’t Know
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 51
If Yes, please enter the association and program name. [Q:4.94-24643]
Do you believe that any of these customers follow a state security regulatory program? [Q:4.94-24644]
Yes No Don’t Know
If Yes, please identify the state of the regulatory program (select all that apply). [Q:4.94-24645]
Add
If you believe an agriculture facility customer follows some other security program not listed above, please describe the customer's security programs in this text field. [Q:4.94-24646]
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U.S. Department of Homeland Security 52
7. Other COI-Containing Products
Identify Other Products For each COI that you identified previously as used for some purpose other than as a pesticide or fertilizer, identify each product that you sell, transfer, or commercially apply to agricultural facilities.
In responding to this question, include all COI-containing products (other than pesticides or fertilizers) that your facility has sold, transferred, or commercially applied in the past year and all that your facility anticipates selling, transferring, or commercially applying in the coming year.
List of COI Used in Other Products
The following list shows all COI that you have indicated are used as other products.
Chemical of Interest CAS# Min. Conc.
Chemical Z ZZZ-Z ZZZ%
In the text fields below, enter a unique name for each product (other than pesticides or fertilizers) that you sell, transfer, or commercially apply to agricultural facilities. Click "Add" to add the product to the list and then click "Describe" to provide the requested information for each product.
Product Name
[Q:5.0-24439]
Product Z
Have you described all COI-containing products (
Add
other than pesticides or fertilizers) that you sell, transfer, or commercially apply to agricultural facilities? [Q:5.0-24441]
Yes No
Describe: Product Z Delete
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U.S. Department of Homeland Security 53
Other Product Ingredients Describe the use of the product. [Q:5.2-24485]
Indicate the percent by weight of all COI present in Product Z
Identify all Appendix A COI present in Product Z in an amount at or above the lowest Appendix A minimum concentration. (The percent by weight of active ingredients may be available from the product label or MSDS.) Enter values that are rounded to two decimal places.
Chemical of Interest CAS# Min. Conc.
COI present in Product?
[Q:5.2-24468]
Percent by Weight [Q:5.2-24469]
Chemical Z ZZZ-Z ZZZ% Yes No
Other Product Containers Add an entry for each size container that you sell, transfer, or commercially apply of Product Z, using the drop down box selections below. If you select "Flexible Intermediate Bulk Container (pounds)" or "Other Bulk Container (pounds)" enter the number of pounds in the "Additional Information" column. If you select ">55 gallons","Tank Truck (gallons)," or "Rail Car (gallons)" enter the number of gallons in the "Additional Information" column. Otherwise, leave the "Additional Information" column blank. Click "Add" to add the container size to the list.
Container Size [Q:5.25-24452]
Additional Information [Q:5.25-24453]
Add
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U.S. Department of Homeland Security 54
Customer Types for Other COI-Containing Products Identify the customer type(s) to whom you sell, transfer, or for whom you commercially apply Product Z.
Customer Types [Q:5.3-24456]
Do you sell, transfer, or commercially apply the fertilizer to this customer type? [Q:5.3-24457]
Customer Type Z Yes No
Customers for Other COI-Containing Products Click "Provide" to provide the requested information for each customer type with regards to Product Z.
Customer Types [Q:5.4-24460]
Customer Type Z
Have you answered the questions for all customer types associated with this product? [Q:5.4-24461]
Yes No
Other Product Use by Customers In the Facility Information section, you answered a number of questions about your facility and customer relations. Based on those responses, you will be directed to answer specific questions about each COI-containing product and customer combination. Click Next to continue.
Do you transfer possession of Product Z to Customer Type Z customers (e.g., the COI-containing product leaves your facility with a customer and there is no delivery or commercial application by your facility)? [Q:5.41-24964]
Yes No
Provide Customer Type Z Detail Information
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 55
Do you commercially apply Product Z to Customer Type Z customers and the product is stored at the customer facilities before, during or after commercial application? [Q:5.41-24965]
Yes No
Do you deliver Product Z to Customer Type Z customers? [Q:5.41-24966]
Yes No
Other Products Transferred to Agricultural Facility Customers If you transfer possession of Product Z consistently throughout the year, enter the number of containers you typically transfer each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If you transfer possession of Product Z on an as needed basis, leave the text box blank.
Container Types [Q:5.6-24653]
Additional Weight Information [Q:5.6-24654]
Year Round [Q:5.6-24655]
Container Z ZZ
If the number of containers you transfer is not consistent throughout the year, enter the number of containers you typically transfer each month for each container type in the column corresponding to each month below. If you do not typically transfer possession of Product Z during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If you transfer possession of Product Z on an as needed basis, leave the text box blank.
Container Types
[Q:5.6-24657]
Additional Weight Information
[Q:5.6-24658]
January
[Q:5.6-24659]
February
[Q:5.6-24660]
March
[Q:5.6-24661]
April
[Q:5.6-24662]
May
[Q:5.6-24663]
June
[Q:5.6-24664]
Container Z ZZ
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Container Types
[Q:5.6-24666]
Additional Weight Information
[Q:5.6-24667]
July
[Q:5.6-
24668]
August
[Q:5.6-24669]
September
[Q:5.6-24670]
October
[Q:5.6-24671]
November
[Q:5.6-24672]
December
[Q:5.6-24673]
Container Z ZZ
Other Products Commercially Applied and Stored for Agricultural Facility Customers If you commercially apply Product Z consistently throughout the year, enter the number of containers you typically store at the customer's site each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If Product Z is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types [Q:5.7-24677]
Additional Weight Information [Q:5.7-24678]
Year Round [Q:5.7-24679]
Container Z ZZ
If the number of containers you store at the customer's site is not consistent throughout the year, enter the number of containers you typically store each month for each container type in the column corresponding to each month below. If you do not typically store Product Z at the customer's site during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If Product Z is stored at the customer’s site on an as needed basis, leave the text box blank.
Container Types
[Q:5.7-24681]
Additional Weight Information
[Q:5.7-24682]
January
[Q:5.7-24683]
February
[Q:5.7-24684]
March
[Q:5.7-24685]
April
[Q:5.7-24686]
May
[Q:5.7-24687]
June
[Q:5.7-24688]
Container Z ZZ
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Container Types
[Q:5.7-24690]
Additional Weight Information
[Q:5.7-24691]
July
[Q:5.7-
24692]
August
[Q:5.7-24693]
September
[Q:5.7-24694]
October
[Q:5.7-24695]
November
[Q:5.7-24696]
December
[Q:5.7-24697]
Container Z ZZ
Other Products Delivered to Agricultural Facility Customers If you deliver Product Z consistently throughout the year, enter the number of containers you typically deliver each month for each container type in the column marked "Year Round". Enter a value that has been rounded to the closest whole number. If Product Z is delivered to the customer’s site on an as needed basis, leave the text box blank.
Container Types [Q:5.8-24701]
Additional Weight Information [Q:5.8-24702]
Year Round [Q:5.8-24703]
Container Z ZZ
If the number of containers you deliver is not consistent throughout the year, enter the number of containers you typically deliver each month in the column corresponding to each month below. If you do not typically deliver Product Z during a particular month or for a particular container type, leave that field blank. Enter values that have been rounded to the closest whole number. If Product Z is delivered to the customer’s site on an as needed basis, leave the text box blank.
Container Types
[Q:5.8-24705]
Additional Weight Information
[Q:5.8-24706]
January
[Q:5.8-24707]
February
[Q:5.8-24708]
March
[Q:5.8-24709]
April
[Q:5.8-24710]
May
[Q:5.8-24711]
June
[Q:5.8-24712]
Container Z ZZ
Container Types
[Q:5.8-24714]
Additional Weight Information
[Q:5.8-24715]
July
[Q:5.8-
24716]
August
[Q:5.8-24717]
September
[Q:5.8-24718]
October
[Q:5.8-24719]
November
[Q:5.8-24720]
December
[Q:5.8-24721]
Container Z ZZ
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Security Restrictions Placed on Sale of Other Products Do you place any security-related conditions or restrictions on the sale of this product to these customers? [Q:5.91-24729]
Yes No
Do you follow a company or facility policy/program? [Q:5.92-24741]
Yes No
Do you follow an industry/association program? [Q:5.92-24742]
Yes No
If Yes, please enter the association and program name. [Q:5.92-24743]
Do you follow a state security regulatory program? [Q:5.92-24744]
Yes No
If Yes, please identify the state of the regulatory program (select all that apply). [Q:5.92-24745]
If you place any other condition or restriction that is not listed above, please describe the security-related condition or restriction in this text field. [Q:5.92-24746]
Add
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U.S. Department of Homeland Security 59
Describe Customer Use To the best of your knowledge, do any of these customers ship this product? [Q:5.925-24730]
Yes No Don’t Know
To the best of your knowledge, do any of these customers resell this product? [Q:5.925-24731]
Yes No Don’t Know
To the best of your knowledge, do any of these customers implement security measures for this product? [Q:5.925-24732]
Yes No Don’t Know
To the best of your knowledge, do any of these customers participate in any mandatory or voluntary security programs for this product? [Q:5.925-24733]
Yes No Don’t Know
Customer Security Measures Do you believe that any of these customers have access control measures in place? [Q:5.93-24749]
Yes No Don’t Know
Do you believe that any of these customers have physical security measures in place (e.g., locked or fenced storage enclosures, lighted storage areas, valve locks, motion detector lights, or alarms)? [Q:5.93-24750]
Yes No Don’t Know
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U.S. Department of Homeland Security 60
Do you believe that any of these customers have inventory control measures in place? [Q:5.93-24751]
Yes No Don’t Know
Do you believe that any of these customers have security procedures in place (e.g., regular security inspection of storage area and security measures, transaction records/logs, procedures for reporting tampering or loss)? [Q:5.93-24752]
Yes No Don’t Know
Do you believe that any of these customers have security awareness measures in place (e.g., procedures for identifying and reporting suspicious behavior)? [Q:5.93-24753]
Yes No Don’t Know
Do you believe these customers have other security measures in place? If so, please describe the customer's security measures in this text field. [Q:5.93-24754]
Customer Security Programs Do you believe that any of these customers have a company or facility policy/program in place? [Q:5.94-24757]
Yes No Don’t Know
Do you believe that any of these customers follow an industry/association program? [Q:5.94-24758]
Yes No Don’t Know
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 61
If Yes, please enter the association and program name. [Q:5.94-24759]
Do you believe that any of these customers follow a state security regulatory program? [Q:5.94-24760]
Yes No Don’t Know
If Yes, please identify the state of the regulatory program (select all that apply). [Q:5.94-24761]
If you believe an agriculture facility customer follows some other security program not listed above, please describe the customer's security programs in this text field. [Q:5.94-24762]
Add
CSAT Agriculture Survey Questions Guide
U.S. Department of Homeland Security 62
8. Finish
DHS Communications A letter acknowledging receipt of the Agriculture Survey will be sent to the Submitter.
Preparer Copy Do you want a copy of the letter acknowledging receipt of the Agriculture Survey to be sent to the Preparer in addition to the Submitter? [Q:9.9-24387]
Yes No
Submission Statement My statements in this submission are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that a knowing and willful false statement on this form can be punished by fine or imprisonment or both. (See section 1001 of title 18, United States Code).
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