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HomeMy WebLinkAboutAnimal Inspection Form 5 � .. .. . . .. _
f � � The Commonwealth of Massachusetts
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� DEPARTMENT OF AGRINLTURAL RESOURCES
j DIVISION OF ANIMAL HEALTH
1
� � � —��'�r���
(Owners a� (Farm Name)
�'�t�����'� .. �:�- -�
(A�c dress where animals ar�kept-street number and name)
'� '1. , �`��'�''� �� ��t
(Town) (Zip code) �'(Phone number)
� Dealer: Yes� No�.Y
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 f Alpacas
6. Equines: Horses/Ponies
' Donkeys/Mules
Stable use: Private_Boarding_Training_Rental_Lessons_
; 7. Poultry: Chickens�� Turkeys
' Rati�es(Ostrich,Emu) Waterfowl Gamebirds
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 brieflyh;�_.�., -
� � .
i - �-�:-���.�
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� 1 hereby certify that I have this day inspected these animals and the
conditions under which they are ke t. �
�t ,�- F�1� � >'`� --
; Date ector of Animals(signature)
� Form�a yyhiteCopy-State's / PinkCopy-Owner'sCopy / YellowCopy-Inspector'sCopy
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