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-XXXX. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collected. Send comments regarding this burden statement or any other aspect of this information collection, including suggestions for reducing this burden, to [email protected]. |
OMB Approved 0579-XXXX
EXP: XX/20XX |
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UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE VETERINARY SERVICES NATIONAL ANIMAL HEALTH MONITORING SYSTEM 2150 CENTRE AVE, BLDG B FORT COLLINS, CO 80526 |
NAHMS site inspection checklist |
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Printed Name: _________________________________
Organization: _________________________________ Phone: ___________________________________
Email: _________________________________ Date: __________________________________
Instructions: Complete the field with the requested information or mark each security question as appropriate. Any “NO” response requires a comment.
Workplace Description |
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Is the workplace in a home or an office? |
☐ Home ☐ Office |
Location within the building (floor number, room number, etc.) |
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Physical Security |
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Workplace is not located in a “high traffic” area. |
☐ Yes ☐ No Comments: |
Workplace is isolated from public areas within the building. |
☐ Yes ☐ No Comments: |
Workplace is only accessible by authorized individuals. |
☐ Yes ☐ No Comments: |
Workplace is located inside a lockable room. |
☐ Yes ☐ No Comments: |
Computer monitor is not readily visible from external facing windows or doors. |
☐ Yes ☐ No Comments: |
Confidentiality |
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The applicant is aware that any form of screen capture, such as screen prints, taking pictures, or otherwise transferring data from the enclave in any way other than the approved export process is prohibited. |
☐ Yes ☐ No Comments: |
Machine Information |
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Manufacturer |
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Model number |
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Serial number |
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IP address |
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NAHMS Inspector Printed Name: ___________________________ Signature: _________________________
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Quatrano, Christopher B - APHIS |
| File Modified | 0000-00-00 |
| File Created | 2025-01-16 |