Bridge chart for VS forms

Bridge chart for VS Forms 16-25 16-26 16-28 and 16-29 20180508.docx

Highly Pathogenic Avian Influenza, All Subtypes, and Newcastle Disease;Additional Restrictions

Bridge chart for VS forms

OMB: 0579-0245

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Current Form Number/Title:

VS 16-25 Application for Approval of Report of Inspection of Establishment Handling Restricted Animal Byproducts or Controlled Materials

VS 16-26 Agreement for Handling Restricted Imports of Animal Byproducts and Controlled Materials

Updated Form Number/Title:

VS 16-28 Approved Warehouse Request and Agreement to Handle Restricted Animal Byproducts

VS 16-29 Approved Establishment Request and Agreement to Handle Restricted Animal Byproducts

Current Form

Box #/Title

Corresponding Item Box #/Tile

Updated Form

VS 16-25

VS 16-26

Current Agreement Date

Date of Agreement

1. Date of agreement

VS 16-28

VS 16-29

VS 16-25

7. Inspections

2. Agreement type

2. Agreement type

VS 16-28

VS 16-29

VS 16-25

8. Truck or rail shipping address

5. Physical address of warehouse

5. Physical address of establishment

VS 16-28

VS 16-29

VS 16-25


9. Name and mailing address of establishment, Telephone number

4. Name of approved establishment

6. Mailing address of establishment

7. Phone number of establishment

VS 16-29

VS 16-28

VS 16-26

Mailing address of establishment

6. Mailing address of establishment

6. Mailing address of warehouse

VS 16-29

VS 16-28

VS 16-26

Name and address of establishment

4. Name of approved establishment

5. Physical address of establishment

4. Name of approved warehouse

5. Physical address of warehouse

VS 16-29


VS 16-28

VS 16-25



VS 16-26

12A. Name of contact at establishment

12B. Title of contact person at establishment

Typed Name and Title of Establishment Officer

9. Name and title of authorized establishment official

9. Name and title of authorized warehouse official

VS 16-29


VS 16-28

VS 16-25


VS 16-26

13. Name each restricted product, byproduct, or material to be handled

Kind of byproducts or materials

11. Specific restricted trophies to be handled

VS 16-29

VS 16-25

14. Methods used for sewage and effluent disposal

24. What method was used to clean and disinfect

12. Briefly describe disposal methods for any damaged packing

14. Briefly describe disposal methods for water and waste . . .

VS 16-28


VS 16-29

VS 16-25

19. If separate storage facilities are maintained, describe capacity and construction material

10. Storage capabilities

12. Storage before treatment

VS 16-28

VS 16-29

VS 16-25

20. Describe in detail, processing and/or disinfection of the restricted material

21. Methods used to control procedure in item 20


11. Specific restricted trophies to be handled (check all applicable processing methods to be used)


VS 16-29

VS 16-25

23. What disinfectant was used on car, truck, etc.?

24. What method was used to clean and disinfect?

11. List products used to clean and disinfect contaminated areas per written protocol

13. List products used to clean and disinfect contaminated areas per written protocol

VS 16-28



VS 16-29

VS 16-25

22. What persons supervised the work in item 20 or conducted tests

10. Name and title of person responsible for treating restricted trophies

VS 16-29

VS 16-25

VS 16-26

26-32 (signatures and dates)

Signatures and dates

15-18 (signatures and dates)

17-20 (signatures and dates)

VS 16-28

VS 16-29

VS 16-26

For all restricted animal products, byproducts, etc…….

13. I understand the following conditions

15. I understand the following conditions

VS 16-28

VS 16-29



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHolliday, Markus J - APHIS
File Modified0000-00-00
File Created2021-01-21

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