HomeMy WebLinkAboutAnimal Inspecition Form i
� The Commonwealth of Massachusetts
DEPARTMENT OF AGRICULTURAL RESOURCES
DIVISION OF ANIMAL HEALTH
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(Owner's Name) arm Name)
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'� (A�c dress w�iere animals are kept-s reet number and name) �
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(Town� (Zip cocCe) (Phone number)
; Dealer: Yes� No�
1. Cattle(Adult=2 years&over) Adult Young
Dairy
Beef
Steers/Oxen
2. Goats(Adult=1 year&over)
3. Sheep(Adult=1 year&over)
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4. Swine: Breeders
� Feeders
5. Llamas/Alpacas
6. Equines: Horses/Ponies
; Donkeys/Mules
Stable use: Private_Boarding_Training_Rental_Lessons_
; 7. Poultry: Chickens�� Turkeys
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Ratites(Ostrich,Emu) Waterfowl Gamebirds
8. Rabbits
9. Other
; 10. Do animals listed appear to be free from contagious disease?�1 z�i--�-
� 11. Are accommodations adequate with reference to situation,cleanli sen s,
; light,ventilation and water supply?(explain briefly)
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' I hereby certify that I have this day inspected these animals and the
conditions under which they are kept.
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� Date ,,:>' Inspector of Animals(signature) �
� porm�a yyhite Copy-State's�/ Pink Copy-Owner's Copy / Yellow Copy-Inspector's Copy '�
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