Form VS 13-17 VS 13-17 Swine Health Protection Act

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 is 0579-0065. The time required to complete this information collection is estimated to average .083 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 0579-0065 EXP. Date XX/XXXX
SWINE HEALTH PROTECTION ACT
COMPLETE THIS FORM IF YOU BELIEVE FOOD SCRAPS ARE BEING TAKEN FROM FOOD SERVICE FACILITIES TO BE FED TO LIVESTOCK AND POULTRY IN VIOLATION OF ORS 600.010 TO 600.110. PLEASE PROVIDE ACCURATE INFORMATION AND RETURN THE SECOND COPY (POST CARD) OF THIS FORM.
FOOD SCRAPS FROM ___________________________________________________________ARE BEING TAKEN BY PERSONS OTHER THAN (FACILITY NAME) A LICENSED GARBAGE COLLECTION SERVICE. IT IS POSSIBLE THAT THESE FOOD SCRAPS ARE BEING FED TO LIVESTOCK AND POULTRY.
__________________________________________ ______________________ (FACILITY CONTACT PERSON) (DATE) __________________________________________ (telephone number)	PERSONS PICKING UP GARBAGE 1.__________________________________________ ____________________ (NAME) (TELEPHONE) ____________________________________________________________________ (ADDRESS) (CITY) (STATE)
USDA, APHIS, VETERINARY SERVICES 530 CENTER ST., NE, SUITE 335 SALEM, OREGON 97301 (503) 399-5871 (TEAR OFF TOP COPY FOR YOUR RECORDS)	2.__________________________________________ ____________________ (NAME) (TELEPHONE) ____________________________________________________________________ (ADDRESS) (CITY) (STATE)

VS FORM 13-17

JUN 2011