HomeMy WebLinkAboutAnimal Inspection Form , _ �
� � The Commonwealth of Massachusetts
� DEPARTMENT OF AGRINLTURAL RESOURCES '
; DIVISION OF ANIMAL HEALTH
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� (Owner's Name) (Farm Name)
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� (A dress where�animals are kept-streei number and name)
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(Town) (Zip code) (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)
4. Swine: Breeders
Feeders
5. Llamas/Alpacas
6. Equines: Horses/Ponies
Donkeys/Mules
Stable use: Private_Boarding_Training_Rental_Lessons_
s 7. Poultry: Chickens ��_Turkeys
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Ratites(Ostrich,Emu) Waterfowl Gamebirds
8. Rabbits
E 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 �,_�, pecto " Animals(signature)
� Form74 yyhiteCopy-State'sCopy /�PinkCopy-Owner'sCopy / YellowCopy-Inspector'sCopy
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