VS 5-19 A Flock Inspection and Epidemnity Report Initial Flock Ins

Scrapie in Sheep and Goats; Interstate Movement Restrictions and Indemnity Program

VS 5-19A Mar 2010

Private Sector

OMB: 0579-0101

Document [doc]
Download: doc | pdf

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 0579-0101. The time required to complete this information collection is estimated to average 2 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

0579-0101

EXP DATE XX/XXXX

UNITED STATES DEPARTMENT OF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

VETERINARY SERVICES

FLOCK INSPECTION AND EPIDEMIOLOGY REPORT

Initial Flock Inspection for Complete or Export Monitored Status

In the Scrapie Flock Certification Program

Flock ID

Flock Name and Address



Flock Location if Different

PIN

Telephone

Inspector



Inspector ID

County

Inspection Date



Latitude

Longitude

Type of Flock

__________ Purebred

__________ Commercial

__________ Feeder

__________ Other __________________


SHEEP

­­­­­









INVENTORY

Adult Males

Adult Females

Yearling Males

Yearling Females

Female Lambs/Kids

Male Lambs/Kids

Castrated Males

Total

GOATS









Veterinary Practitioner Name


Species

Predominant Breed

Yes

No

INSPECTION CHECKLIST



Sheep and goats inspected and found free of clinical signs of scrapie.



Sheep and goats inspected and those over 1 year of age are officially identified.



Discussed procedure for reporting of both scrapie suspect animals and the submission of samples.

Written or computer records reviewed and contain the following information:



Official and Secondary Identification Type of official ID ___________________________




Sex.



Breed.



Copy of Flock Inventory Attached.

Does the producer understand the following records will need to be kept in the future?



Date of Birth for future natural additions to the flock.



Sire and Dams official and secondary identification for future natural additions.



Progeny Official and secondary identification and sex.



Flock of Origin (including SFCP status) and date of acquisition for purchased animals.



Animal deaths – date died and cause of death.



Purpose, reason, date, and buyer name and address for animals which are sold.



Records of 1 year old sheep sold as breeding animals and official ID replaced

Does the owner anticipate any of the following activities to occur over the next year? If so discuss the implications of the activities on his/her flock status.



Commingling of sheep with another producer’s sheep.



Purchase of ewes from another producer.



Purchase of rams from another producer.



Use of semen and embryos.

Comments















Flock Owner Signature

Yes

No

Application Form Completed (VS Form 5-22)

Inspector Signature

Yes

No

Received Copy of SFCP Standards

Yes

No

Meets Program Standards

VS 5-19A

MAR 2010

File Typeapplication/msword
File TitleAccording to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond
AuthorGovernment User
Last Modified Bysmharris
File Modified2011-12-14
File Created2010-02-04

© 2024 OMB.report | Privacy Policy