VS 9-8 Flock Inspection and Check Testing Report

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0007. The time required to complete this information collection is estimated to average .20 hours 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.

OMB Approved 0579-0007

UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE NATIONAL POULTRY IMPORVEMENT PLAN FLOCK INSPECTION AND CHECK-TESTING REPORT

1. CLASSIFICATION

2. FLOCK OWNER (Name and address)

3. SUPPLY FLOCK FOR (Name and address of l1atcllery or dealer)

4. SELECTED BY

5. TESTED BY

6. BREED, STOCK OR TRADE NAME

MALE

FEMALE

7. NO. BIRDS IN FLOCK (Males)

(Females)

8. HAS REPLACEMENT STOCK BEEN PURCHASED YES NO

IF YES, GIVE SOURCE

SAT.

UNSAT

SAT.

UNSAT

EGG HANDLING (Cont'd)

SAT.

UNSAT

Flock separated from other fowl

Surrounding area kept clean

Dirty eggs kept separate

Other fowl tested

Animal kept out of poultry area

Cleanliness of hatching eggs

Reactors and cults removed

Limited access by visitors

Egg grading

Health of flock

Egg room temperature

Condition of litter

Egg room humidity

Location of equipment

EGG HANDLING

Egg room sanitation

Condition of equipment

Condition of nests

Windows screened

Condition of containers

Rodent control

Frequency of collecting

9. NO.BIRDS CHECK TESTED

NO. REACTORS

10. RESULTS OF INSPECTION AND CHECK-TESTING

11. REMARKS

12. SIGNATURE OF STATE INSPECTOR

DATE

VS FORM 9-8 Previous edition may be used

OCT 2012