Del I: Opplysninger om forsendelsen

Transkript

1 I.1. Avsender Sertifikat til bruk ved handel innenfor Fellesskapet I.2. Sertifikatets referansenummer I.2.a. Lokalt referansenummer: I.3. Vedkommende sentrale myndighet Del I: Opplysninger om forsendelsen I.4. Vedkommende lokale myndighet Land I.5. Mottaker I.6. Nr. på tilhørende originalsertifikat(er) Nr. på følgedokument(er) I.7. Forhandler Land I.8. Opprinnelsesland I.9. Opprinnelsesregion Kode I.10. Mottakerstat I.11. Bestemmelsesregion Kode I.12. Opprinnelsessted/fangststed I.13. Bestemmelsessted Driftsenhet Oppsamlingssentral Lokalene til en forhandler Driftsenhet Oppsamlingssentral Lokalene til en forhandler Godkjent organ Sædstasjon Godkjent akvakulturanlegg Godkjent organ Sædstasjon Godkjent akvakulturanlegg Embryogruppe Virksomhet Annet Embryogruppe Virksomhet Annet I.14. Lastested I.15. Avgangsdato og -klokkeslett I.16. Transportmiddel Fly Skip Jernbanevogn Veitransport Annet Identifikasjon:: Nummer: I.21 Temperatur i produktene Omgivelses- Kjølt Fryst I.23. Containernummer/plombenummer I.17. Transportør I.20. Antall/mengde I.22. Antall kolli I.25. Dyr sertifisert til / produkter sertifisert til: Kunstig reproduksjon I.26. Transitt gjennom tredjestat I.27. Transitt gjennom medlemsstater Utførselssted Kode Innførselssted GKS-nr. I.28. Eksport I.29. Forventet transporttid Utførselssted Kode I.30. Reiseplan Ja Nei I.31. Identifikasjon av dyrene Art Rase Kategori Identifikasjon av donordyr Innsamlingsdato(er) et til gruppa Mengde nw 1/ 5

2 2010/470 Porcine ova/embryos - Part A II. Helseinformasjon II.a. Sertifikatets referansenummer II.b. Lokalt referansenummer: Del II: Attestering I, the undersigned official veterinarian, hereby certify that the ova / embryos (1) described above: II.1 were produced / collected (1), processed and stored by an approved embryo collection/production(1) team(2) approved and supervised in accordance with Chapter I(III) of Annex D to Directive 92/65/EEC; II.2 meet the requirements of Chapter III(II) of Annex D to Directive 92/65/EEC; II.3 come from donor females of the porcine species which meet the requirements of Chapter IV(2) of Annex D to Directive 92/65/EEC; (1)either [II.4 are in vivo derived embryos which: II.4.1 were conceived as a result of artificial insemination with semen meeting the requirements of Directive 90/429/EEC, II.4.2 originate from a Member State or region thereof: (1)or [listed in Annex II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I to Decision 2008/185/EC and have been washed with trypsin;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I or II to Decision 2008/185/EC and have been washed with trypsin;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or regions thereof not listed in Annex I or II to Decision 2008/185/EC;] ;] (1)or [II.4 are in vitro produced / micromanipulated (1) embryos which: II.4.1 were conceived as a result of in vitro fertilisation with semen meeting the requirements of Directive 90/429/EEC, II.4.2 originate from a Member State or region thereof: (1)or [listed in Annex II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I to Decision 2008/185/EC and the donor females of the ova used for their production comply with the conditions of Article 1 of Decision 2008/185/EC;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I or II to Decision 2008/185/EC and the donor females of the ova used for their production comply with the conditions of Article 1 of Decision 2008/185/EC;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or region thereof not listed in Annex I or II to Decision 2008/185/EC;] ] (1)or [II.4 are in vivo derived ova which originate from a Member State or region thereof: (1)or [listed in Annex II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I to Decision 2008/185/EC and which come from donor females complying with the conditions of Article 1 of Decision 2008/185/EC;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or region thereof listed in Annex I or II to Decision 2008/185/EC and which come from donor females complying with the conditions of Article 1 of Decision 2008/185/EC;] (1)or [not listed in Annex I or II to Decision 2008/185/EC and are destined for a Member State or region thereof not listed in Annex I or II to Decision 2008/185/EC;] ;] II.5 were sent to the place of loading in a sealed container under conditions complying with point 6 of Chapter III(II) of Annex D to Directive 92/65/EEC and bearing the number detailed in Box I.23. (1) Health certification requirements relating to classical swine fever : - Embryos/ova in accordance with Commission Decision 2008/855/EC of 3 November 2008 concerning animal health control measures relating to classical swine fever in certain Member States. Notes Part I: Box I.12: Box I.13: Box I.23: Box I.31: place of origin shall correspond to the embryo collection team or embryo production team of ova/embryos collection/production. place of destination shall correspond to the embryo collection team, embryo production team or to the holding of ova/embryos destination. identification of container and seal number shall be indicated. category: specify if: in vivo derived embryos, in vivo derived ova, in vitro produced embryos or micromanipulated embryos. donor identity shall correspond to the official identification of the animal. date of collection shall be indicated in the following format: dd/mm/yyyy. approval number of the team shall correspond to the embryo collection team or embryo production team of ova/embryos collection/production indicated in Box I.12. Part II: (1) Delete as appropriate (2) Only approved embryo collection or production teams listed in accordance with Article 11(4) of Council Directive 92/65/EEC on the Commission website: The colour of the stamp and signature must be different from that of the other particulars in the certificate. nw 2/ 5

3 2010/470 Porcine ova/embryos - Part A II. Helseinformasjon II.a. Sertifikatets referansenummer II.b. Lokalt referansenummer: Del II: Attestering Offentlig veterinær eller offentlig inspektør (med blokkbokstaver): Lokal veterinærenhet: Stempel Stilling og tittel: Den lokale veterinærenhetens nr.: Underskrift: nw 3/ 5

4 III.1. Kontrolldato Sertifikat til bruk ved handel innenfor Fellesskapet III.2. Sertifikatets referansenummer: III.3. Dokumentkontroll:: Nei Ja EU-standard Tilleggsgarantier Nasjonale krav III.4. Identitetskontroll: Nei Ja III.5. Fysisk kontroll:: Nei Antall kontrollerte dyr III.6. Laboratorieundersøkelser:: Nei Ja Del III: Kontroll III.7. Dyrevelferdskontroll Nei Ja III.8. Brudd på dyrevelferdsbestemmelser: III.8.1. Ugyldig transporttillatelse III.8.2. Transportmidlet oppfyller ikke kravene III.8.3. For høy lastetetthet Gjennomsnittsplass III.8.4. Transporttid ikke overholdt III.8.5. Utilstrekkelig vanning og fôring III.8.6. Uforsvarlig behandling av dyrene [nw] III.8.7.Supplementary measures for the journeys of long duration III.8.8.Certificate of proficiency of the driver [nw] III.8.9.Data registered in the log book III Annet III.10. Konsekvenser av transporten på dyr(ene) Antall døde dyr:: Anslag: Antall uegnede dyr: Anslag: Antall dyr som har født eller abortert: III.11. Korrigerende tiltak Prøvd for:: Stikkprøve Mistanke Resultater:: Foreligger ennå ikke III.9. Brudd på helsebestemmelser III.9.1. Manglende/ugyldig sertifikat III.9.2. Ikke samsvar med dokumentene III.9.3. Ikke-godkjent land III.9.4. Ikke-godkjent region/sone III.9.5. Forbudt art III.9.6. Manglende tilleggsgarantier III.9.7. Ikke-godkjent driftsenhet III.9.8. Syke dyr eller mistanke om sykdom III.9.9. laboratoriefunn III Manglende eller ureglementert identifikasjon III Nasjonale krav ikke oppfylt III Feilaktig adresse på bestemmelsesstedet III Annet III.12. Oppfølging av karantene III Utsatt avgang III Overføring III Karantene III Slakting/avliving III Destruering av skrotter/produkter III Tilbakesending III Bearbeiding av produkter III Bruk av produkter til andre formål Identifikasjon: III Slakting/avliving III Frigivelse III.13. Kontrollsted Virksomhet Driftsenhet Oppsamlingssentral Lokalene til en forhandler Godkjent organ Sædstasjon Havn Lufthavn Utførselssted Under transport Annet III.14. Offentlig veterinær eller offentlig inspektør Lokal veterinærenhet (med blokkbokstaver): Stilling og tittel Den lokale veterinærenhetens nr. Underskrift: nw 4/ 5

5 [nw] PLANNING [nw] 1.1. ORGANISER name and address (a) (b) [nw] 1.2. Name of the person in charge of the journey [nw] 1.3. Telephone / Fax [nw] 2. TOTAL EXPECTED DURATION (hours / days) [nw] 3.1. Place and country of DEPARTURE [nw] 4.1. Place and country of DESTINATION [nw] 3.2. Date [nw] 3.3. Time [nw] 4.2. Date [nw] 4.3. Time [nw] 5.1. Species [nw] 5.2. Number of animals [nw] 5.3. Veterinary certificate(s) number(s) [nw] 5.4. Estimated total weight of the consignment (in kg) [nw] 5.5. Total space foreseen for the consignment (in m²) [nw] 6. LIST OF FORESEEN RESTING, TRANSFER OR EXIT POINTS [nw] 6.1. Name of the places where animals are to be rested, or transferred (including exit points) [nw] Date [nw] 6.2. Arrival [nw] Time [nw] 6.3. Length (in hours) [nw] 6.4. Transporter name and authorisation N (if different from the organiser) [nw] 6.5 identification [nw] 7. I, the organiser, hereby declare that I am responsible for the organisation of the above-mentioned journey and I have made suitable arrangements to safeguard the welfare of the animals throughout the journey in accordance with the provisions of Council Regulation 1/2005 [nw] 8. Signature of the organiser [nw] (a) Organiser: see definition laid down in Article 2(q) of Council Regulation 1/2005 [nw] (b) If the organiser is a transporter the authorisation number shall be specified nw 5/ 5