ࡱ > bjbjcTcT L > > A p G G G [ [ [ [ $ \ [ * . ) ) ) f* h* h* h* h* h* h* + . H h* G ) % L ) ) ) h* }* ) ) ) ) @ G f* ) ) f* ) ) ) T [ N) p ) R* * 0 * ) . ) . ) . G ) ) ) ) ) ) ) ) ) h* h* ) ) ) ) * ) ) ) ) . ) ) ) ) ) ) ) ) ) : Producer Affidavit & Market Lamb Health Record C1052E Youth Producer: Name: Address: Premise ID (if available): Phone: QA Certification #: Fair: Fair Tag #: Sale Date: Producer Affidavit and Animal Information (Obtain from producer): Flock Tag #:____________________ Scrapie ID#: Birth Date:_________________ Breed:__________________________ Sex: I (original producer) attest through first-hand knowledge, normal business records, or producer affidavit(s) that the animal referenced to by this document is of ___________ (country) origin, and is delivered to _____________________________________________________________ (Youth Producer). Date Purchased: ______________ Premise ID (if available): Purchased From (Farm Name): ______________________________ Office Phone: Address: __________________________________ City, State, Zip: Producer Signature: _____________________________ Print Name: Youth producers only list treatments administered while under your care. Do NOT list treatments administered prior to purchase. If you need additional space for treatments or medicated feeds, use supplemental health form pageavailable at animalag.wsu.edu-Youth Producers. Treatments & Dewormers (Date & Time)Associated Condition(s) Being Treated Estimated WeightTreatment Administered (Medication dispensed, amount, and route of administration) Drug Lot NumberName (Person giving treatment)Withdrawal Time (Instructed)Withdrawal Complete (Date & Time)For prescription or extra label drug use, list the veterinarians name, address, and phone. Medicated Feeds: Remember to document ALL medicated feeds and withdrawal times. Give Subcutaneous (Sub-Q) injections under loose skin of neck or front flanks, using the tented method. Give Intra-muscular (IM) injections in the neck. If label indicates a choice, use Sub-Q (under the skin) injections over IM. Dates Fed Medication Name (Medication included in feed and approximate amount of medication) Withdrawal Time (Instructed)Withdrawal Complete (Date & Time) Produce healthy and safe lamb products by being a knowledgeable and responsible producer. NEVER inject into the leg or the loin area. I certify that I produced this animal, it was not fed any prohibited mammalian protein (i.e. meat & bone meal), per FDA regulation, CFR Title 21, and I have listed ALL products and treatments they received while in my care and all withdrawal times have been met. I attest that the animal referred to by this document is of _______________(country) origin and raised in _________________ (country). Youth Signature:_____________________________________________________Date:___________ Guardian Signature:__________________________________________________Date:___________ Authors: Sarah M. Smith, Jean Smith, and Jan Busboom. C1052E revised November 2008. WSU Extension programs and employment are available to all without discrimination. Evidence of discrimination may be reported through your local WSU Extension Office. The information given herein is for educational purposes only. References to commercial products or trade names are made with the understanding that no discrimination is intended and no endorsement by WSU Extension is implied. " ( * + 3 4 5 ; = > ? @ A V o p q u v x y P ʸة}xl hY hv 6CJ \ hv 5 hAd) CJ hAd) hAd) 5 h_g 5h'Zn h:l 5h6,A hM[ hAd) CJ, \aJ, hM[ hAd) CJ, aJ, h5 j hE}5 UmH nH u h j h6,A UmH nH u h1 j h[ hE}5 UmH nH u $j h6,A h6,A CJ UmH nH u) # $ % ! |^|` $, |^| % & ' ( + 4 5 = A p q x y ! gd:l $a$gdM[ # P F ) * A O u v $$If a$gdAd) $$If a$ $$If a$ `'gdY `'x gdY `'gdv d`'gdY `'gdY j 5 C F T U ` & ' ) * A M O & ҿ곿~xq~k~~q~ h! CJ hAd) 5CJ hAd) CJ hAd) CJ h! 56CJ \] hAd) 56CJ \] h6,A h! hAd) hY hAd) 56\h4> hv 6CJ aJ hAd) 5\ hY hAd) 6CJ \ hAd) 5hv 5CJ \ hY hv 6CJ hv 5\ hv hv 5 hv \ *v ' I ! $If Ffn $If Ffk $$If a$ $$If a$ & ' : ; H I M q ! " # ( G ( ) < > V W Y [ \ a b c 乭䡛ĕ hAd) 5CJ h! CJ h! CJ hAd) CJ hAd) CJ h hAd) 5CJ aJ h hAd) CJ aJ hAd) CJ h! 6CJ hAd) 6CJ hAd) 5CJ hAd) 5h6,A hAd) 5CJ hAd) CJ hAd) 5CJ hAd) 5 FfDx Ff+u Ffr $If " # ) > $$If a$ $If $$If a$ ! Z T T T T $If kd>z $$If l l\ M" O 0 2 H 2 V 4 4 l a ` Z Z Z Z $If kd{ $$If l h\ M" O 0 4 4 l ayt5 ` Z Z Z Z $If kd{ $$If l h\ M" O 0 4 4 l ayt5 Y Z [ \ b ` Z X V X X X T X ! kd| $$If l h\ M" O 0 4 4 l ayt5 t ! # $a$gd $a$ $a$ dh ! dh x ! % ־֪֦ h1 hs he. hAd) 56CJ aJ hAd) CJ h! CJ h\ CJ h! CJ hAd) CJ h6,A hAd) hAd) CJ h4> hAd) 6CJ hAd) 5CJ h4> hAd) 6aJ 9 &P 1h0:p1 = /!"##$#% n; >bnZkPNG IHDR U m gAMA |Q pHYs + IDATx]W} 3;l)l,(@ l"P-$m*bD@ s#9RVy j ĸHHCAbQ
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