VS Form 10-6A Listing Agreement for a Slaughter Establishment Handling

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 0579-0212. The time required to complete this information collection is
estimated to average .5 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.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

OMB APPROVED
0579-0212
EXP. XX/XXXX

LISTING AGREEMENT FOR A SLAUGHTER
ESTABLISHMENT HANDLING LIVESTOCK, POULTRY, OR
CARCASSES IN INTERSTATE COMMERCE PURSUANT TO
TITLE 9, CODE OF FEDERAL REGULATIONS

SLAUGHTER ESTABLISHMENT (FSIS) NUMBER

NAME OF ESTABLISHMENT

ADDRESS OF ESTABLISHMENT

TELEPHONE NUMBER

I, _____________________________________________________, operator of _______________________________________________________,
(name of the person legally responsible for the day-to-day operations of the establishment)

(name of facility)

hereby agree to maintain and operate the slaughter establishment located at the address above in accordance with the applicable provisions of this
agreement and Title 9, Part 71.21, of the Code of Federal Regulations.
TYPE OF LIVESTOCK, POULTRY, AND CARCASSES BEING HANDLED (check all that apply)
BOVINE

BISON

PORCINE

OVINE

CAPRINE

EQUINE

CERVID

AVIAN

OTHER (specify): ___________________

Cooperation
The Animal and Plant Health Inspection Service (APHIS), Veterinary Services (VS), must be provided with a schedule of
the slaughter establishment’s days of operation, along with the types of animals that will be handled at the establishment
on the days of operation. The Assistant Director (AD) responsible for the State in which the establishment is located must
be informed of any changes to the hours of normal operation within 1 week prior to the implementation of the changes. In
emergency situations, such as large livestock or poultry losses due to weather, fire, or failure of ventilation equipment, the
AD will be notified of changed operating hours as soon as practical.
APHIS will provide the operator of the slaughter establishment advance notice when APHIS personnel or its representative
will be taking blood and/or tissue samples at the establishment. This notice may be in any form or by any means that the
AD reasonably believes will reach the operator of the slaughter establishment prior to the start of sample collection. The
notice will include the anticipated date and time sample collection will begin. The notice will also include the anticipated
ending date and time except that in cases of perpetual sampling the ending date may be stated as “ongoing.”
The slaughter establishment agrees to grant access to APHIS personnel or representatives during normal business hours
at the establishment to collect tissue samples and to evaluate whether the slaughter establishment and its operations are
in compliance with the applicable provisions of this agreement and 9 CFR 71.21.
The AD or his/her representative must be immediately notified if the slaughter establishment discovers, suspects, or has
reason to believe that any livestock, poultry, or carcasses presented at the slaughter establishment are either affected by,
exposed to, or show signs of possibly being affected by or exposed to any program, emerging, or foreign animal disease.
The slaughter establishment agrees to provide safe space, appropriate equipment, and access to the processing line within
the slaughter establishment for blood and tissue sample collection, and to allow and facilitate APHIS or its representatives
to collect blood and tissue samples from all livestock, poultry, or carcasses at the facility. There will be no cost to the United
States for the blood and/or tissue materials. The slaughter establishment agrees that this collection station must consist of
adequate unobstructed line space for each specimen collector to safely collect all samples needed.
The slaughter establishment agrees to provide adequate wash and sanitation facilities and supplies, including soap and
disinfectant for washing hands and sterilizing instruments. These facilities must be located next to the collection station
where practical.
The slaughter establishment agrees to allow APHIS personnel or representatives to record the identification of individual
animals and retain any external or internal identification devices.
The slaughter establishment agrees to provide adequate office and sample collection space, including necessary
furnishings, light, and heat rent free for use by APHIS personnel or representatives collecting samples for blood and tissue
testing.

VS FORM 10-6A
MAY 2017

NOTE: Some small slaughter establishments may not completely comply with the office space and collection area
requirements of this section. VS will be as flexible as possible in these cases as long as collector safety is ensured and
sample quality is maintained. For example, our regulations allow for offsite sample processing. It may be possible to collect
critical parts of livestock or poultry carcasses and transport them to a nearby facility for sample collection and preparation.
If such arrangements are made, they must be specified in writing and attached to the agreement. Correlation of the samples
and the animals’ identification devices must be maintained at all times. In all cases of noncompliance, efforts should be
made to minimize the slaughter establishment’s cost of complying.
Records
The slaughter establishment agrees that documents such as weigh tickets; sales slips; and records of origin, identification
and correlation to carcass identification, and destination that relate to livestock or carcasses that are in, or that have been
in, the slaughter establishment, will be maintained by the establishment for a period of 2 years for poultry and swine, and 5
years for cattle, bison, sheep, goats, cervid, and equines. APHIS personnel or representatives will be permitted to review
and copy those documents during normal business hours.
Identification
The slaughter establishment agrees that all livestock or poultry and carcasses will be officially identified in accordance with
the applicable regulations in 9 CFR, Parts 71, 75, 78, 79, and 85, at the time of, or before, entry into the establishment.
Cleaning and Disinfection
The slaughter establishment agrees that live animal handling facilities, including all yards, docks, pens, alleys, chutes,
scales, means of conveyance, and their associated equipment, must be maintained in a clean and sanitary condition. In
addition, it is agreed that the operator of the slaughter establishment is responsible for the cleaning and disinfection of the
slaughter establishment in accordance with 9 CFR, Parts 71, 75, 78, and 85, and for maintaining an adequate supply of
disinfectant and serviceable equipment for cleaning and disinfection.
Listing
Request to be listed:
The slaughter establishment requests approval for its facility to operate as a listed establishment for the classes of livestock,
poultry, or carcasses indicated in this agreement. The slaughter establishment also agrees to allow APHIS personnel or
representatives to take blood and tissue samples from all livestock, poultry, or carcasses at this slaughter establishment
without cost to the United States Government. The slaughter establishment specifically allows these personnel adequate,
safe access to the processing line for collection of blood and tissue specimens and allows these personnel to record and
retain all forms of internal and external individual animal identification devices.
The slaughter establishment acknowledges that it has been informed and understands that failure to abide by the provisions
of this agreement and the applicable provisions of 9 CFR, Parts 71, 75, 78, and 85, constitutes a basis to withdraw this
listing.

PRINTED NAME OF OPERATOR

SIGNATURE OF OPERATOR

DATE

PRE-LISTING INSPECTION OF SLAUGHTER FACILITY CONDUCTED BY:
PRINTED NAME OF APHIS REPRESENTATIVE
SIGNATURE OF APHIS REPRESENTATIVE
DATE

PRINTED NAME OF ASSISTANT DIRECTOR

VS FORM 10-6A (REVERSE)

RECOMMEND APPROVAL:
SIGNATURE OF ASSISTANT DIRECTOR

DATE