| Instructions for "ROUNDWOOD RECEIVED FOR PROCESSING, Composite-Fuel" | 
	
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		| This instruction sheet is provided to help you fill out the "ROUNDWOOD RECEIVED FOR PROCESSING, Composite-Fuel" survey form. | 
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		| This form has been designed to determine the location, size, and composition of the primary wood-using mills in your State, | 
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		| the volume of roundwood harvested by product, species, and geographic location, and the volume and disposition of wood | 
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		| residues generated during primary processing for the calendar year indicated. Your cooperation completing this form for your | 
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		| mill will make the results of this survey comprehensive, accurate, and timely. All information is held in confidentiality and | 
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		| used only for statistical reports. No individual mill production data will be released. Your cooperation is appreciated. | 
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		| ROUNDWOOD is defined as any log, bolt, or other round section (including chips from roundwood) | 
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		| cut from trees for industrial or consumer use. This includes  saw logs, veneer logs, cooperage logs | 
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		| and bolts, pilings, poles, posts, hewn ties, and various other round, split, or hewn products. | 
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		| Page 1 -- Mill Information (This page only needs to be completed once per mill location.) | 
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		| *  Fill in the Business/Company name and mailing address. Also record the name and phone number of the owner, manager, | 
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 | or person that can be contacted if there are any questions concerning the information on the survey form. | 
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		| *  Record the address of the actual mill location if different from the business/company mailing address. | 
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		| *  Record the name of the County in which the mill is located. If Latitude and Longitude of mill location are available, | 
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 | they may be entered. | 
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		| *  If the mill is part of a larger, Parent company, record the Parent company name and address. | 
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		| *  Check the box if No wood was received at this mill location during the calender year of the survey. | 
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 | If no wood was received, no further information is needed. Please return the form in the enclosed envelope. | 
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		| *  Check the box under "Type of Roundwood Processed" that indicates the type of roundwood received at the mill | 
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 | for processing. If the mill processes more than one type of roundwood, complete a separate form for each. | 
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		| *  Enter the annual capacity of the mill when operating at full capacity, and indicate the unit of measure. | 
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		| *  Enter the number of employees, when the mill was established, and the mill status during the survey year. | 
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		| *  Check the box if you want the mill name and address to be withheld from "Regional/Statewide Industry" directories. | 
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		| *  Check the box to be to notified about the report resulting from this study. | 
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		| Page 2 -- SECTION 2. ORIGINS AND SPECIES OF ROUNDWOOD PROCESSED | 
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		| (This page should be completed for each 'Type of Roundwood Processed' in section 2.1) | 
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		| *  Check the box under "Type of Roundwood Processed" that indicates the type of roundwood received at the mill | 
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 | for processing. If the mill processes more than one type of roundwood, complete a separate form for each. | 
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		| *  Enter the total volume of roundwood received at the mill for the 'Type of Roundwood Processed' checked in Section 2.1, | 
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 | the unit of measure for softwood and hardwood, and the average log length and top diameter of logs processed | 
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 | at the mill. If the Unit of Mearsure is a weight measurement, please indicate the conversion factor the mill uses | 
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 | for pounds per board foot or cord. | 
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		| *  Indicate if the mill processes any logs from cities or towns (urban areas), and if so, what percent of the reported | 
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 | total volume of roundwood received came from cities or towns (urban areas). | 
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		| *  Indicate what percent of the reported of the total volume of roundwood received came from salvaged dead trees. | 
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		| *  Enter the amount or percent of each species group processed at the mill for the Raw Material (Logs/Roundwood) | 
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 | checked in Section 2.1. Break out the amount/percent by Roundwood, Whole tree chips or In-woods-chips (WTC), | 
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 | and peeled roundwood or peeled and chipped. Enter "W" in the 'Roundwood, WTC (W), Peeled (P)' colume for the | 
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 | amount/percent of wood that is whole tree chips or in-woods-chips. Enter "P" for the amount/percent that is peeled | 
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 | or peeled and chipped. Leave blank for bark on roundwood logs. Across the columns at the top of the table, enter the | 
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 | State and county, and foreign Country that the Raw Material (Logs/Roundwood) came from. Then fill in the table | 
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 | entering the amount or percent of each species that came from each county. If the species is not listed, enter it into | 
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 | the last three rows labeled "Other:" A species list is at the bottom of page. If you need more space, | 
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 | please duplicate this form. | 
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 | (Continued on next page.) | 
	
		| Instructions for "ROUNDWOOD RECEIVED FOR PROCESSING, Composite-Fuel" (continued) | 
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		| Page 3-- SECTION 3. Mill equipment,  wood process type, products produced, production amounts, | 
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 | and boiler/hog fuel, amounts. | 
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		| (This page only needs to be completed once per mill location.) | 
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		| *  Check the wood process type and mill equipment found at the mill. | 
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		| *  Enter the percent of the group for each type of product produced at the mill. | 
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		| *  Enter the total amount produced for each 'Type of Roundwood Processed' in section 2.1, the unit of measure,  and the | 
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 | amount of finished product exported out of the United States. | 
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		| *  If the mill receives mill residuses from other wood-using mills, enter the State or Foreign Country of origin. Whole tree | 
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 | chips or in-woods-chips should be entered on Page 2. Enter the amount of mill residues under the type of mill | 
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 | residue received from each State or Foreign Country by softwoods and hardwoods. | 
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 | Indicate the unit of measure reported in. | 
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		| *  If the mill receives roundwood, in-woods chips, whole-tree chips, and/or tops and limbwood used for Boiler/hog fuel/industrial | 
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 | fuel, record the total amount by State of origin, and softwoods and hardwood, and indicate the unit of measure. | 
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		| Pages 4 -- SECTION II. DISPOSAL OF BARK AND WOOD RESIDUES GENERATED | 
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		| (This page should be completed for each 'Type of Roundwood Processed' in section 2.1.) | 
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		| *  Check the box under "Type of Roundwood Processed" that indicates the type of roundwood received at the mill | 
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 | for processing. If the mill processes more than one type of roundwood, complete a separate form for each. | 
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		| *  Enter the amount of mill residues that were generated by processing the type of Raw Material (Logs/Roundwood) | 
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 | Section 4.1 for each type of mill residue and for Softwoods and Hardwoods. Indicate the "Unit of Measure." | 
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		| *  Enter the percent for each type of "USE OF MILL RESIDUE" by the type of mill residue, and Softwoods and Hardwoods. | 
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 | The columns should sum to 100%. | 
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		| FOREST SERVICE, U.S. DEPARTMENT OF AGRICULTURE | 
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 | Form Approved | 
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		| Northern Research Station | 
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 | OMB No. 0596-0010 | 
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		| 1992 Folwell Avenue | 
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 | Expires: date | 
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		| St. Paul, Minnesota 55108 | 
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		| ROUNDWOOD RECEIVED FOR PROCESSING, Composite-Fuel, STATE, year | 
	
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		| Section 1.1 | 
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 | Business/Company Name: | 
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 | Mailing Address: | 
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 | City/State/Zip code: | 
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 | Phone number: | 
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 | Fax number: | 
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 | Company website: | 
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 | Company e-mail: | 
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 | Contact Name and Title: | 
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 | Title: | 
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 | City/State/Zip code: | 
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 | Phone number: | 
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		| Mill physical location if different from mill mailing address | 
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 | Mill physical address: | 
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 | City/State/Zip code: | 
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		| County mill is located in: _____________________ | 
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 | Latitude of mill: _______________ | 
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 | Longitude of mill: _______________ | 
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		| Parent Company Name (if different from Mill Name): | 
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 | Mailing Address: | 
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 | City/State/Zip code: | 
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 | Phone number: | 
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 | Fax number: | 
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 | Check here if "NO" wood was processed during the calendar year and return form. No further information is needed. | 
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		| Instructions: This form is for reporting the quantities and types of logs received by this mill in, and the disposal of plant residues | 
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		| resulting from the manufacturing or processing of wood products. Please complete this form and return it promptly. If complete | 
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		| records are not available, please give your best estimates. Do not include logs or bolts sold or treansferred to another | 
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		| primary processing plant. Complete page 2 and 4 for each 'Type of Roundwood Processed' checked in Section 1.2 | 
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		| below. Only 1 page 1 and 3 need to be completed for each mill. This survey is voluntary. While you are not required to respond | 
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		| your cooperation is needed to make the results of the survey comprehensive, accurate, and timely. ALL VOLUMES REPORTED | 
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		| WILL BE HELD CONFIDENTIAL AND WILL ONLY BE USED TO AGGREGATE TO THE COUNTY AND STATE LEVEL. | 
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		| Section 1.2 | 
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		| Type of Roundwood Processed: | 
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 | Composite panel/Engineered wood product mill | 
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 | Industrial fuelwood/Biomass/energy plant | 
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		| Annual mill capacity (volume per year when operating at full capacity): _____________     Unit of measure: ___________________ | 
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		| Number of employees: __________          Year mill established: __________ | 
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		| Mill status (check one):  ____ Active        ____ New        ____ Idle        ____ Closed/Out of Business        ____ Dismantled | 
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		| 
 | Check here if you want the mill's name and address to be withheld from "Regional/Statewide Industry" directories. | 
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		| 
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		| For Official Use Only. | 
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		| 
 | Interviewer's Name and Title:__________________________________________     Phone: ___________________     Date of Interview: ___________ | 
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		| 
 | Interview type: mail _____     phone _____     personal contact _____     e-mail _____ | 
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		| 
 | MILL_NBR:_______     State:____     County:_____     Product:______     Total volume:_____________ | 
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		| Public reporting burden for this collection of information is estimated to average 50 minutes per response, including the time for reviewing instructions, searching existing | 
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		| data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden | 
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		| estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Agriculture, Clearance Officer, OIRM, | 
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		| Room 404-W. Washington, DC 20250; and to the Office of Management and Budget, Paperwork Reduction Project (OMB# 0596-0010), Washington, DC 20503. | 
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		| Section 2. ORIGINS AND SPECIES OF ROUNDWOOD PROCESSED | 
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		| ROUNDWOOD is defined as any log, bolt, or other round section (including chips from roundwood) cut from trees for industrial or consumer use. | 
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		| 
 | This includes saw logs, veneer logs, cooperage logs and bolts, pilings, poles, posts, hewn ties, and various other round, split, or hewn products. | 
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		| 2.1. Type of Roundwood Processed (check one). From Section 1.2 | 
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		| 
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 | Composite panel/Engineered wood product mill | 
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 | Industrial fuelwood/Biomass/energy plant | 
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		| 2.2. Amount of Roundwood received and processed at the mill. | 
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		| Enter the TOTAL amount of Raw Material (Logs/Roundwood) received and processed at the mill for the 'Type of Rooundwood Processed' checked in 2.1 above. | Softwood Unit of Measure (from list at right) | Hardwood Unit of Measure (from list at right) | If Unit of measure is a weight, enter Softwood Weight conversion factor | If Unit of measure is a weight, enter Hardwood Weight conversion factor | 
 | Average | 
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		| 
 | Log | 
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 | Log Top | 
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		| 
 | Length | 
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 | 21 - Standard cord (4' X 4' X 8') | 
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 | 43 - Thousand cubic feet | 
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		| 
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 | 22 - Lake States cord (4' X 4' X 100") | 
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 | 47 - Thousand cubic meters | 
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 | 31 - Green tons (short, 2,000 lbs) | 
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 | 99 - Other (specify):_____________________ | 
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		| Amount: ________________ | 
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 | _____lbs. per cord | 
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 | _____lbs. per cord | 
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 | 33 - Green metric tonnes | 
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		| Do you process any logs from cities or towns (urban areas) at your mill? | 
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 | YES | 
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 | If YES, what percent of the total roundwood received was urban wood in year? | 
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		| What percent of the total roundwood received was from salvaged dead trees from forested areas? | 
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		| 2.3.Species and Origin of roundwood received at mill. | 
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		| Please enter the amount or percent of roundwood received, broken out by roundwood, whole tree chips (WTC), and peeled roundwood or peeled and chipped roundwood. | 
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		| Enter "W" in the 'Roundwood, WTC (W), Peeled (P)' colume for amount of whole tree chips, and "P" for roundwood amounts that are peeled, including peeled and chipped. | 
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		| Please complete the matrix to the best of your knowledge. If you don't know the exact origin please give approximate values for the top counties within the mill's procurement zone | 
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		| 
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 | Provide county name as headings for column below. If out of state or foreign origin please specify state or Country. Add additional sheets as needed. | 
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		| Species Group Name | 
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 | Amount received by spp | Roundwood, WTC (W), Peeled (P) | 
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 | Total All Counties | 
	
		| Cedar/juniper | 
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 | 100% | 
	
		| Balsam fir | 
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 | 100% | 
	
		| Jack pine | 
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 | 100% | 
	
		| Red pine | 
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 | 100% | 
	
		| White pine | 
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 | 100% | 
	
		| Other pine | 
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 | 100% | 
	
		| Ash | 
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 | 100% | 
	
		| Aspen/balsam poplar | 
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 | 100% | 
	
		| Basswood | 
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 | 100% | 
	
		| Yellow birch | 
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 | 100% | 
	
		| White (paper) birch | 
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 | 100% | 
	
		| Other birch | 
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 | 100% | 
	
		| Black cherry | 
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 | 100% | 
	
		| Black walnut | 
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 | 100% | 
	
		| Cottonwood | 
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 | 100% | 
	
		| Elm | 
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 | 100% | 
	
		| Hickory | 
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 | 100% | 
	
		| Hard maple | 
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 | 100% | 
	
		| Soft maple | 
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 | 100% | 
	
		| Yellow-poplar | 
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 | 100% | 
	
		| Red oak | 
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 | 100% | 
	
		| White oak | 
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 | 100% | 
	
		| Other: from list below ________________ | 
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 | 100% | 
	
		| Other: from list below ________________ | 
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 | 100% | 
	
		| 
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		| Other species | 
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		| 
 | Cypres | 
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 | Hemlock | 
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 | Ponderosa/Jeffrey pine | 
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 | Longleaf/slash pine | 
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 | Sugar pine | 
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 | Spruce | 
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 | Alder | 
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 | Beech | 
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 | Tupelo/black gum | 
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		| 
 | Douglas-fir | 
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 | Loblolly/shortleaf pine | 
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 | Lodgepole pine | 
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 | Lodgepole pine | 
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 | Tamarack/larch | 
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 | Redwood | 
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 | Sweetgum | 
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 | Sycamore | 
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 | Other hardwoods not listed | 
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		| Section 3 - Mill equipment, wood process type, products produced, production amounts, and boiler/hog fuel, amounts. | 
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		| 
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		| 3.1.  Check type of equipment in use. | 
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		| Wood process type | 
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 | Equipment | 
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 | Equipment | 
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		| 
 | Sulfite | 
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 | Slab chipper | 
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 | Firewood Processor | 
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		| 
 | Kraft | 
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 | Chipper | 
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 | Wood-fired boiler | 
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		| 
 | Groundwood/Mechanical | 
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 | Debarker | 
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 | Optimizer equipment | 
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		| 
 | Semichemical | 
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 | Dry kiln | 
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		| 
 | Kraft/Groundwood | 
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 | Treating equipment | 
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 | Other - specify _________________ | 
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		| 
 | Thermochemical | 
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 | Chip Canter | 
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		| 
 | Thermomecnanical | 
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 | Shaving machine | 
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		| 
 | Pelletizer | 
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 | Hammer mill | 
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 | Other - specify _________________ | 
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		| 
 | Other - specify _________________ | 
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		| 
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		| Section 3.2 -- Products produced from logs received in year. | 
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		| Enter the percent of the total for each group of products produced from logs, or chipped logs. | 
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		| 
 | Do not include products that are produced from mill residues such as bark, sawdust, planer shavings, slabs, etc. | 
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		| 
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		| Composite panel/Engineered wood products | 
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 | Bioenergy/Fuelwood | 
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 | Other miscellaneous products | 
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		| % | 401 - Oriented Strand Board (OSB) | 
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 | % | 500 - Industrial fuelwood (co-gen,steam,etc) | 
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 | % | 1101 - Mulch, soil additives, compost | 
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		| % | 402 - Particle board | 
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 | % | 501 - Industrial fuelwood - electricity/power | 
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 | % | 1102 - Chemical extractives | 
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		| % | 403 - Wafer board | 
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 | % | 502 - Industrial fuelwood - heat/steam | 
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 | % | 1105 - Shavings/excelsior (packing | 
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		| % | 404 - Hardboard | 
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 | % | 510 - Pellets | 
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 | material, bedding, etc.) | 
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		| % | 405 - Medium density fiber board (MDF) | 
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 | % | 511 - Pellets - Residential grade | 
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 | % | 1106 - Novelty | 
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		| % | 406 - Laminated veneer lumber (LVL) | 
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 | % | 512 - Pellets - Torrefied | 
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 | % | 1107 - Foreign Export logs | 
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		| % | 407 - Other engineered product - | 
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 | % | 513 - Pellets/briquettes - Industrial grade | 
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 | % | 1108 - Other - | 
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		| 
 | 
 | Specify:  ______________ | 
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 | % | 514 - Pellets - other(please specify) | 
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 | Specify:  _______________________ | 
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		| 
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 | % | 530 - Pressed/reconstituted logs (Presto) | 
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		| Charcoal | 
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 | % | 540 - Liquid fuels | 
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		| % | 520 - Charcoal/briquettes | 
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 | % | 541 - Liquid fuels - Ethanol | 
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		| 
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 | % | 542 - Liquid fuels - Other (aviation fuel,etc) | 
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		| 
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 | % | 550 - Other energy products - | 
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		| 
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 | Specify:  ______________ | 
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		| 
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		| Section 3.3 -- Volume of product produced from Raw Material (Logs/Roundwood) Processed in year. | 
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		| Please enter amount of mill product produced in year from each type of RAW MATERIAL (Logs/roundwood) by softwoods and hardwoods. | 
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		| 
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		| 
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 | Amount | Unit of Measure (codes at right) | 
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 | Units of Measure | 
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		| 
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 | 31 - Green tons | 
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		| Product Produced | 
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 | 32 - Dry tons | 
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		| Composite panel/ Engineered wood products | 
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 | 72 - Thousand Square Feet | 
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		| Bioenergy/Fuelwood | 
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 | 99 - Other (specify): | 
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		| Other - specify: ___________
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		| 
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		| Do you export finished product out of the Country? ____ NO     ____YES. Percent of finished product exported out of the United States: ________%. | 
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		| Section 3.4 -- PLANT BYPRODUCTS RECEIVED FOR USE IN PRODUCTION OF COMPOSITE PANELS OR INDUSTRIAL FUELWOOD | 
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		| Instructions: Select the unit of measure the volume is reported in. Indicate the State of origin, plant byproduct, and the volume each species group received. | 
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		| 
 | Wood chips are chips from coarse mill residues. Whole tree chip volumes should be recorded as roundwood on page 2. | 
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		| 
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 | Origin of byproduct | 
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		| Check only one | 
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 | ST code (office use) | Wood chips | Sawdust | Other byproducts | 
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		| Unit of Measure | 
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 | State or | 
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		| 
 | XX | 
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 | foreign Country | 
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 | Softwood | 
 | Hardwood | 
 | Softwood | 
 | Hardwood | 
 | Softwood | 
 | Hardwood | 
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		| 
 | Standard cord | 
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 | Dry tons | 
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 | Green tons | 
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		| 
 | Other (specify): | 
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		| 
 | ________________ | 
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		| Section 3.5 -- Volume of hog fuel/industrial fuelwood received in year. (Composite panel/Engineered wood product mills only) | 
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		| Please record the volume/amount of in-woods chips, whole-tree chips, and/or tops and limbwood used for Boiler/hog fuel/industrial fuelwood | 
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 | that you received at the mill in year. | 
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 | State or | 
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 | ST code (office use) | Boiler/hog fuel volume | 
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 | foreign Country | 
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 | Softwood | Hardwood | 
 | Check the unit of Measure used (only one) | 
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 | Thousand cu. ft. | 
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 | Other (specify): | 
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		| Section 4—MILL RESIDUE and MILL RESIDUE USE for (year) | 
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		| Check if no residues are produced, everything goes into product. If no residues are produced. Skip sections 4.1, 4.2, and 4.3.   | 
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		| 4.1. Type of Roundwood Processed (check one). From Section 1.2 | 
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		| Composite panel/Engineered wood product mill | 
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   | Industrial fuelwood/Biomass/energy plant | 
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		| 4.2. Please enter the amount of mill residue produced by this mill. | 
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 | Softwood | Hardwood | Unit of Measure (example: green tons, dry tons, thousand cubic feet, etc.)
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		| Type of Residue | 
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		| Bark | 
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		| Coarse (chips, slabs, edgings, trims, cores, etc.) | 
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		| Fine - Shavings (Planer or Lathe) | 
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		| Fine - Sawdust | 
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		| Whole logs or short sections chipped or not processed as mills primary product | 
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		| 4.3. Disposal of mill residues | 
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		| Instructions: | For each type of wood residue generated at your mill, enter the percentage that was disposed of by | 
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 | the various means. Each column should sum to 100% for each species group recorded. | 
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 | BARK | COARSE (chips, slabs, edgings, trims, cores, etc.)
 | FINE | WHOLE LOGS/SHORT SECTIONS | 
	
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 | Shavings (Planer or Lathe)
 | Sawdust | 
	
		| Disposal of | Softwood | Hardwood | Softwood | Hardwood | Softwood | Hardwood | Softwood | Hardwood | Softwood | Hardwood | 
	
		| Mill Residues | % | % | % | % | % | % | % | % | % | % | 
	
		| Manufacture of fiber/composite products | 
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		| Small dimension and other sawn products | 
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		| Charcoal or chemical wood | 
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		| Industrial fuel at this plant (on-site) | 
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		| Industrial fuel at other plants | 
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		| Bio-energy pellets | 
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		| Other Bio-energy products (biodiesel,etc) | 
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		| Residential fuelwood | 
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		| Mulch/Soil additive (includes biochar) | 
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		| Animal bedding | 
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		| Other misc. uses- please specify:  _______________ | 
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		| NOT USED (land fill, burned, etc.) | 
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		| TOTAL | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% | 100% |