Del I: Opplysninger om forsendelsen

Transkript

1 I.1. Avsender Sertifikat til bruk ved handel innenf Fellesskapet I.2. Sertifikatets referansenummer I.2.a. Lokalt referansenummer: I.3. Vedkommende sentrale myndighet Del I: Opplysninger om fsendelsen I.4. Vedkommende lokale myndighet Land I.5. Mottaker I.6. Nr. på tilhørende iginalsertifikat(er) Nr. på følgedokument(er) I.7. Fhandler 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 fhandler Driftsenhet Oppsamlingssentral Lokalene til en fhandler Godkjent gan Sædstasjon Godkjent akvakulturanlegg Godkjent gan Sædstasjon Godkjent akvakulturanlegg Embryogruppe Virksomhet Embryogruppe Virksomhet I.14. Lastested I.15. Avgangsdato og -klokkeslett I.16. Transptmiddel Fly Skip Jernbanevogn Veitranspt Identifikasjon:: Nummer: I.21 Temperatur i produktene Omgivelses- Kjølt Fryst I.23. Containernummer/plombenummer I.17. Transptør I.20. Antall/mengde I.22. Antall kolli I.25. Dyr sertifisert til / produkter sertifisert til: Avl Slakting Godkjente ganer Vilt til utsetting Kjæledyr I.26. Transitt gjennom tredjestat I.27. Transitt gjennom medlemsstater Utførselssted Kode Innførselssted GKS-nr. I.28. Ekspt I.29. Fventet transpttid Utførselssted Kode I.30. Reiseplan Ja Nei I.31. Identifikasjon av dyrene Art Kategi Identifikasjon Alder Antall kolli Mengde Type kolli nw 1/ 5

2 2011/214 Poultry, day-old chicks and hatching eggs in lots of under 20 (except f ratites and hatching eggs thereof) II. Helseinfmasjon II.a. Sertifikatets referansenummer II.b. Lokalt referansenummer: Del II: Attestering II.1 (2) (3) (4) Animal health attestation I, the undersigned official veterinarian, certify that: (a) either [the poultry, day-old chicks hatching eggs described above comply with the provisions of Article 14 of Council Directive 2009/158/EC.] [day-old chicks hatching eggs described above comply with the provisions of Article 14, Article 14 (2)(a) to (d) and the second subparagraph of Article 14 (2) of Council Directive 2009/158/EC.] (b) the poultry, day-old chicks hatching eggs described above comply with Article 15 of Council Directive 2009/158/EC. (c) the poultry, day-old chicks hatching eggs described above comply with the provisions of Commission Decision(s) / /EU concerning additional guarantees with regard to (indicate disease(s)) and in accdance with Article of Council Directive 2009/158/EC. (d) the poultry: (name and type (live inactivated) of Newcastle disease virus strain used in vaccine(s)) (e) (f) the day-old chicks: (name and type (live inactivated) of Newcastle disease virus strain used in vaccine(s)) on (date)]. the poultry from which the day-old chicks come: (name and type (live inactivated) of Newcastle disease virus strain used in vaccine(s)) II.2. (5)(8) (6) (6) (5) II.3. (7) Notes Part I: (g) the poultry from which the hatching eggs come: (name and type (live inactivated) of Newcastle disease virus strain used in vaccine(s)) Public health attestation I, the undersigned official veterinarian, certify that: (a) the poultry, the day-old chicks the hatching eggs come from a flock which has been tested f Salmonella serotypes with public health significance in accdance with Regulation (EC) No 2160/2003 of the European Parliament and of the Council. Date of last sampling of the flock from which the testing result is known: Result of all testing in the flock: either [positive;] [negative] (b) and, if breeding poultry, day-old chicks hatching eggs are intended f breeding, neither Salmonella Enteritidis n Salmonella Typhimurium were detected within the control programme referred to in point II.2(a). Additional health infmation II.3.1. This consignment complies with the animal health conditions laid down in Commission Decision 2006/415/EC. II.3.2. This consignment complies with the animal health conditions laid down in Commission Decision 2006/563/EC. II.3.3. This consignment complies with the animal health conditions laid down in Commission Decision / /EU in relation to vaccination against avian influenza. Box I.16: Box I.19: Box I.31: Part II: Registration number (railway wagons container and lries), flight number (aircraft) name (ship). Use the appropriate HS codes: 01.05, , Categy: select one of the following: pure line/grandparents/parents/laying pullets/fattening/others. Identification: indicate the identification details of flocks of igin. Age: provide the date of collection (in case of eggs) the approximate age (in case of poultry) (2) Keep as appropriate. Only applicable if II.3.1. II.3.2. is complied with. nw 2/ 5

3 2011/214 Poultry, day-old chicks and hatching eggs in lots of under 20 (except f ratites and hatching eggs thereof) II. Helseinfmasjon II.a. Sertifikatets referansenummer II.b. Lokalt referansenummer: Del II: Attestering (3) (4) (5) (6) (7) (8) To certify in case of dispatch to a Member State, which has an EU-approved non-vaccinating status f Newcastle disease currently: Finland and Sweden. Otherwise delete reference. Complete if appropriate. The guarantees under II.2. only apply to poultry and day-old chicks belonging to, to hatching eggs derived from the species Gallus gallus turkeys. If any of the results were positive f the serotypes below during the life of the flock, indicate as positive. Flocks of breeding poultry of Gallus gallus: Salmonella Hadar, Salmonella Virchow and Salmonella Infantis. Flocks of productive poultry: Salmonella Enteritidis and Salmonella Typhimurium. Only applicable f Member States which carry out vaccination against avian influenza accding to an EU approved vaccination plan. In case of primary production of poultry f private domestic use leading to the direct supply, by the producer, of small quantities of primary products to the final consumer to local retail establishments directly supplying the primary products to the final consumer accding to Article 1(3) of Regulation (EC) No 2160/2003 an appropriate test immediately befe dispatch shall be perfmed and the date of this test and its result should be entered. The colour of the stamp and signature must be different from that of the other particulars in the certificate. 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 innenf 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. Labatieundersøkelser:: Nei Ja Del III: Kontroll III.7. Dyrevelferdskontroll Nei Ja III.8. Brudd på dyrevelferdsbestemmelser: III.8.1. Ugyldig transpttillatelse III.8.2. Transptmidlet oppfyller ikke kravene III.8.3. F høy lastetetthet Gjennomsnittsplass III.8.4. Transpttid ikke overholdt III.8.5. Utilstrekkelig vanning og fôring III.8.6. Ufsvarlig behandling av dyrene [nw] III.8.7.Supplementary measures f 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 III.10. Konsekvenser av transpten på dyr(ene) Antall døde dyr:: Anslag: Antall uegnede dyr: Anslag: Antall dyr som har født eller abtert: III.11. Krigerende tiltak Prøvd f:: Stikkprøve Mistanke Resultater:: Feligger 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. Fbudt art III.9.6. Manglende tilleggsgarantier III.9.7. Ikke-godkjent driftsenhet III.9.8. Syke dyr eller mistanke om sykdom III.9.9. labatiefunn III Manglende eller ureglementert identifikasjon III Nasjonale krav ikke oppfylt III Feilaktig adresse på bestemmelsesstedet III 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 fmål Identifikasjon: III Slakting/avliving III Frigivelse III.13. Kontrollsted Virksomhet Driftsenhet Oppsamlingssentral Lokalene til en fhandler Godkjent gan Sædstasjon Havn Lufthavn Utførselssted Under transpt 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 feseen f 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, transferred (including exit points) [nw] Date [nw] 6.2. Arrival [nw] Time [nw] 6.3. Length (in hours) [nw] 6.4. Transpter name and authisation N (if different from the ganiser) [nw] 6.5 identification [nw] 7. I, the ganiser, hereby declare that I am responsible f the ganisation of the above-mentioned journey and I have made suitable arrangements to safeguard the welfare of the animals throughout the journey in accdance with the provisions of Council Regulation 1/2005 [nw] 8. Signature of the ganiser [nw] (a) Organiser: see definition laid down in Article 2(q) of Council Regulation 1/2005 [nw] (b) If the ganiser is a transpter the authisation number shall be specified nw 5/ 5