HomeMy WebLinkAboutAnimal Inspection Form , _
� The Commonwealth of Massachusetts
DEPARTMENT OF AGRICULTURAL RESOURCES
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DIVISION OF ANIMAL HEALTH
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(Owner's�l lame) (Farm Name)
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(A dress where animals re ept-street number and nameJ
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� (Tov�irt�;`� ����Z p ode) (Phone number)
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Dealer. Yes� NoQ
; 1. Cattle(Adult=2 years&over) Adult Young �
� Dairy
� Beef
Steers/Oxen �_
2. Goats(Adult=1 year&over) �_
! 3. Sheep(Adult=1 year&over) �_
� 4. Swine: Breeders
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� Feeders
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5. Llamas/Alpacas
6. Equines: Horses/Ponies
f Donkeys/Mules �_
Stable use: Private�Boarding_Training_Rental_Lessons_
� 7. Poultry: Chickens \� Turkeys
� Ratites(Ostrich,Emu) Waterfowl Gamebirds �
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' 8. Rabbits
` 9. Other
� 10. Do animals listed appear to be free from contagious disease?�
11. Are accommodations adequate with reference to situation,cleanliness,
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 -� , ,pectorofAnimals(signature)
Form 74 yyhite Copy-State's eopy / Pink Copy-Owner's Copy / Yellow Copy-Inspector's Copy