U.S. USDA Form usda-ccc-560
This form is available electronically.
CCC-560
(08-22-03)
A. LEAVE BLANK - FOR CCC USE ONLY
2. Contract No.
3. Warehouse Code No.
1. Date Approved
U.S. DEPARTMENT OF AGRICULTURE
Commodity Credit Corporation
(MM-DD-YYYY)
APPLICATION FOR APPROVAL OF WAREHOUSE
(Processed Commodities)
RETURN TO:
KANSAS CITY COMMODITY OFFICE
DAIRY AND DOMESTIC OPERATIONS DIVISION
P. 0. BOX 419205 - STOP 8718
KANSAS CITY, MO 64141-6205
(See Page 2 for Privacy Act and Public Burden Statements)
Prepare an application for each building. On all but the initial application, omit items 8 through 14 and other items not appropriate.
B. MANAGEMENT
C. FACILITIES (Continued)
4. Type of Storage:
16. Warehouse is:
Dry
Cooler
Freezer
Owned
5. Legal Name of Operating Entity
If Leased, answer
Items 17 through 21.
Leased
17. Name of Lessor
NO
YES
6. Main Office Address of Operating Entity
18. Written lease?
19. Will you guarantee 120-day notice if lease is canceled?
20. Renewal option?
7a. Telephone No. (Include Area Code) 7b. FAX No. (Include Area Code)
21. Expiration Date (MM-DD-YYYY)
7c. E-Mail Address
22. No. Floors (Include basement)
8. Type of Operating Entity:
a. Corporation
CHECK
b. General Partnership
23. Area of each type of
Storage (Square Feet)
a. Dry
b. Cooler
c. Freezer
24. Type of construction:
c. Individual
CHECK
a. Concrete
b. Brick
d. Limited Partnership
c. Iron clad
e. Other: (Specify)
9. If corporation, does purpose clause of articles of
incorporation authorize "public warehouse business?''
YES
NO
d. Wood frame
a. Basement
b. Ground Floor
c. Other Floors
d. Walls
e. Roof
26. Age of Warehouse
27. Is Building (for dry storage only)
25. Material Used For:
10. If a Partnership, list names of partners (Indicate by " * " those authorized to
bind Partnership.)
Heated
Insulated
28. Original use for which building was intended
11. If a Corporation, list names or titles of all authorized to execute contract
(Attach either an excerpt from the by-laws or a copy of resolution of the
board of directors giving this authority.)
YES
NO
29. If cooler, can 28 degrees F to 32 degrees F and 50
percent to 70 percent humidity be maintained?
12. Name of Warehouse Manager or Superintendent
30. If freezer, can 0 degrees F or lower be maintained?
13. Warehouse Operated As:
Public
Private
31. Is auxiliary equipment available for maintaining
temperature in event of breakdown? (Items 29 and 30)
14. License No. (If applicable)
a. State
D. MATERIAL HANDLING EQUIPMENT
b. U.S. Warehouse Act
C. FACILITIES OFFERED
15. Name and Location of Warehouse (if different than above)
32. Palletized system? (Explain "NO" in item 64)
33. Are gasoline powered vehicles equipped with approved
spark arrestors and extinguishers?
34. No. Handtrucks
35. No. Gasoline Tractors 36. No. Electric
Tractors
37. No. Trailers
38. No. Gasoline Lift or
Fork Trucks
Check if propane.
39. No. Electric Lift
or Fork Trucks
CCC-560 (08-22-03) Page 2
E. HANDLING CAPACITY
YES
G. FIRE PROTECTION
54. Source of Water Supply
NO
40. Does building have a car door level loading platform?
55a. Is automatic sprinkler system YES NO
installed (or present)?
41. Does building have a truck bed level loading dock?
42. In an 8-hour day, number of cars, trucks, and pounds that can be:
a. Cars
b. Trucks
55b. If ''YES''
c. Pounds
Loaded
Wet
a. Cars
b. Trucks
Dry
SIZE/TYPE
NO.
56. Outdoor water hydrant system?
c. Pounds
Unloaded
57. Chemical fire extinguishers?
YES
F. TRANSPORTATION FACILITIES
NO
58. Are public fire fighting facilities available?
43. Railroads serving warehouse (Indicate railroad which spots cars)
H. OTHER PROTECTION
59a. Security service provided?
44. Are reciprocal switching privileges available?
(If "YES", identify number and list names of RR in
Item 53.)
45. Is storage in transit available? (If ''YES'' identify by number
and list commodities in Item 53.)
YES
59b. If ''YES'', describe system (include inclusive hours
and by whom). (If more space is needed, use
''Remarks'' section.)
NO
46. Railroad siding immediately adjacent to warehouse?
47. Do you have exclusive use of this siding?
48. If team track, are commodities moved to and from
warehouse in covered or insulated trucks?
49. Frequency of switch
50. Maximum number of cars spotted
at one time
59c. If ''NO'', describe protection afforded the warehouse
during non-operating hours.
60a. Insect control program provided?
60b. If ''YES'', by
51. Maximum number cars worked at
one time
52. If no siding, indicate distance
to nearest track (miles)
53. Information from Items 44 and 45
Commercial Contract
Warehouse Personnel
60c. Name of Firm (If applicable)
61a. Rodent control program provided?
61b. If ''YES'', by
Commercial Contract
Warehouse Personnel
61c. Name of Firm (If applicable)
62. If ''NO'', in Items 60a and 61a, are you willing to
institute an insect and rodent control program as
recommended by USDA?
63. Are records kept of control measures taken?
64. REMARKS
NOTE: The authority for collecting the following information is Pub. L. 107-171. This authority allows for the collection of information without prior OMB approval mandated by the Paperwork Reduction Act
of 1995. 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.
The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a). The authority for requesting the following information is 15 U.S.C. 714 and regulations promulgated
thereunder (7 CFR Parts 1423 and 1403). The information will be used to complete the terms of an agreement between the warehouse operator and CCC. Furnishing the requested information is
voluntary, however, without it, eligibility to enter into an agreement with CCC cannot be determined. This information may be provided to other agencies, IRS, Department of Justice, or other State
and Federal Law enforcement agencies, and in response to a court magistrate or administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 371, 641, 651,
1001; 15 USC 714m; and 31 USC 3729, may be applicable to the information provided. RETURN THIS COMPLETED FORM TO THE KANSAS CITY COMMODITY OFFICE, P.O. BOX 419205,
STOP 8718, KANSAS CITY, MO 64141-6205..
The applicant certifies that all statements made herein are true and correct to the best of his or her knowledge and belief.
65. Legal name of operating entity (warehouse operator)
66. By (Authorized Official)
67. Title
68. Date (MM-DD-YYYY)
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race color, national origin gender, religion age disability, political beliefs sexual orientation, and
marital or family status. (Not all prohibited bases apply to all programs ) Persons with disabilities who require alternative means for communication' of program information (Braille large print, audiotape etc.)
should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination write USDA Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence
Avenue, SW, Washington, D. C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.