Farm Biosecurity Risk Assesment

• Farm Name

• Grower #

• Premise/National ID

• State ID

• Street Address, State, Zip Code

• Farm Type

  Broiler Breeder

  Pullet Female

  Pullet Male

  Spike

• Number of houses on location

• Number of houses NOT in use

• How many people work at this location?

• Conducted on

  Date

• Conducted by:

• Signature

  Sign

[1] Disease history in the location and surroundings.

• Last occurrence/s of the stated disease in a Mountaire and/or non-Mountaire site/premise (including this premise) in a 6-mile/10 kilometer radius?

• 1.1. Avian Influenza (AI) in commercial poultry (chickens, turkeys, ducks, etc.) - Low pathogenicity?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.2. Avian Influenza (AI) in avian species other than commercial poultry (chickens, turkeys, ducks, etc.)- High pathogenicity?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.3. Avian Influenza in an avian species other than commercial (i.e. backyard flocks, waterfowl, pet birds, etc.)?

  last 12 months

  last 3 years

  > 3 years or never

• 1.4. Exotic ND or vvND in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.5. Exotic ND or vvND in avian species other than commercial poultry?

  Last 12 months

  Last 3 years

  >3 years or never

• 1.6. MG (gallisepticum) in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.7 MS (synoviae) in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.8 Fowl cholera in Mountaire commercial poultry (broilers, pullets, breeders)?

  Last 12 months

  > 12 months or never

• 1.9. Infectious Coryza in commercial poultry (chickens, turkeys, ducks, etc.)?

  last 12 months

  last 3 years

  > 3 years or never

• 1.10. ILT in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  >3 years or never

• 1.11. Salmonella pullorum in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

[2] Physical proximity of other poultry-related operations to this location.

• Select the number of each of the types of sites/premises within a 1-mile radius of this location.

• 2.1. How many Mountaire broiler farms are within a 1 mile radius?

  >/= 3

• 2.2 How many non-Mountaire broiler farms within a 1 mile radius?

  >/= 3

  1-2

  None

• 2.3. How many Mountaire broiler breeder and/or pullet farms within a 1 mile radius?

  >/=3

  1-2

  none

• 2.4 How many non-Mountaire broiler breeder and/or pullet farms within a 1 mile radius?

  >/= 3

  1-2

  none

• 2.5. How many table egg pullet farms are within a 1 mile radius?

  >/=2

  1

  None

• 2.6 How many table egg layer farms within a 1 mile radius?

  >/=1

  None

• 2.7 How many turkey farms within a 1 mile radius?

  >/=1

  None

• 2.8. How many backyard poultry/hobby poultry/fighting chickens within a 1 mile radius?

  >/=3

  1-2

  none

• 2.9. How many poultry live auctions or flea markets within a 1 mile radius?

  >/=3

  1-2

  none

• 2.10. Number of livestock herds of any type (besides chicken, turkeys or hog) within a 1 mile radius?

  >/=1

  none

• 2.11. Number of hog farms within a 1 mile radius?

  >/=1

  none

• 2.12. Number of litter processing sites within a 1 mile radius?

  >/=1

  None

• 2.13. Is there a rendering route within a 1 mile radius?

  >/=3

  1-2

  none

• 2.14. Is there a preserve or natural site with waterfowl or wild birds within a 1 mile radius?

  >/=3

  1-2

  none

• 2.15. Is there a non-Mountaire poultry company office within a 1 mile radius?

  >/=3

  1-2

  none

• 2.16. Are there allied industries or poultry companies within a 1 mile radius?

  >/=3

  1-2

  none

• 2.17. Number of poultry processing plant/s within a 1 mile radius?

  >/=1

  none

• 2.18. Number of feed mill/s within a 1 mile radius?

  >/=1

  none

• 2.19. Number of hatchery/ies within a 1 mile radius?

  >/=1

  none

Premise

• A premise is a physical address containing the poultry growing operations. It boundaries are the perimeter buffer area (PBA), which is a functional zone surrounding the poultry houses and poultry raising area that separates them from areas unrelated to poultry production on that site and/or adjoining properties.

[1] Disease history in the location and surroundings.

• Select the correct response with regard to the most recent disease outbreaks on this farm?

• 1.1. Avian Influenza (AI) in commercial poultry (chickens, turkeys, ducks, etc.) - Low pathogenicity?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.2. Avian Influenza (AI) in commercial poultry (chickens, turkeys, ducks, etc.)- High pathogenicity?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.3. Avian Influenza in an avian species other than commercial (i.e. backyard flocks, waterfowl, pet birds, etc.)?

  last 12 months

  last 3 years

  >/=3 years or never

• 1.4. Exotic ND or vvND in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.5. Exotic ND or vvND in avian species other than commercial poultry?

  Last 12 months

  Last 3 years

  >3 years or never

• 1.6. MG (gallisepticum) in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.7 MS (synoviae) in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

• 1.8 Fowl cholera in Mountaire commercial poultry (broilers, pullets, breeders)?

  Last 12 months

  > 12 months or never

• 1.9. Infectious Coryza in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  last 3 years

  >3 years or never

• 1.10. ILT in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  >3 years or never

• 1.11. Salmonella pullorum in commercial poultry (chickens, turkeys, ducks, etc.)?

  Last 12 months

  Last 3 years

  Last 10 years

  >10 years or never

[2] Physical aspects related to the operation of the location being audited.

• With regard to the topics, select the one description which best describes the parts of this farm under the direct control of the caretaker.

• 2.1. Warning sign at premise entrance?

  Select None Sign in English only Sign in English and/or Spanish or other language

  • None
  • Sign in English only
  • Sign in English and/or Spanish or other language

• 2.2. At premise entrance...

  Select multiple entrances, none locked 1 or more entrances, some unlocked 1 or more entrances, always locked

  • multiple entrances, none locked
  • 1 or more entrances, some unlocked
  • 1 or more entrances, always locked

• 2.3. Number of birds on premise

  >100,000

  45,000 - 100,000

  12,000 - 45,000

  <12,000

• 2.4. Fencing

  Select no fencing on property some fencing around houses or property boundary

  • no fencing on property
  • some fencing around houses or property boundary

• 2.5. Used litter storage

  Select litter on site, uncovered litter on site, covered (storage shed or tarped) no litter stored on site

  • litter on site, uncovered
  • litter on site, covered (storage shed or tarped)
  • no litter stored on site

• 2.6. Water on the site comes from...

  Select Natural creek, pond, lake, or permanent standing water less than 100 yards from houses Natural creek, pond, lake, or permanent standing water less than >/=100 yards from houses Natural creek, pond, lake, or permanent standing water on site boundary but more than 1000 yards from houses No open water of any kind on site or site boundary

  • Natural creek, pond, lake, or permanent standing water less than 100 yards from houses
  • Natural creek, pond, lake, or permanent standing water less than >/=100 yards from houses
  • Natural creek, pond, lake, or permanent standing water on site boundary but more than 1000 yards from houses
  • No open water of any kind on site or site boundary

• 2.7. Farms/Manure

  Select Houses within 500 feet of the farm land on which litter or manure is spread, hauled, or fed Houses further than 500 feet of any farm land on which litter or manure is spread, hauled, or fed

  • Houses within 500 feet of the farm land on which litter or manure is spread, hauled, or fed
  • Houses further than 500 feet of any farm land on which litter or manure is spread, hauled, or fed

• 2.8. Machinery

  Select Outside tools, equipment or machinery are brought onto premise or shared with other premises once a week or more often Outside tools, equipment or machinery are brought onto premise or shared with other premises more often than once per month Outside tools, equipment or machinery are brought onto premise or shared with other premises only once a month or less often Premise is self sufficient in all tools, equipment, and machinery

  • Outside tools, equipment or machinery are brought onto premise or shared with other premises once a week or more often
  • Outside tools, equipment or machinery are brought onto premise or shared with other premises more often than once per month
  • Outside tools, equipment or machinery are brought onto premise or shared with other premises only once a month or less often
  • Premise is self sufficient in all tools, equipment, and machinery

• 2.9. Equipment washing...

  Select Equipment from outside the premise, which may come within 100 feet of the houses, is never washed before being brought onto the premise Incoming equipment, which may come within 100 feet of the houses, is washed/disinfected, only when coming from other premises Incoming equipment is washed and disinfected prior to entering the premise Equipment is maintained and stays on the premise

  • Equipment from outside the premise, which may come within 100 feet of the houses, is never washed before being brought onto the premise
  • Incoming equipment, which may come within 100 feet of the houses, is washed/disinfected, only when coming from other premises
  • Incoming equipment is washed and disinfected prior to entering the premise
  • Equipment is maintained and stays on the premise

• 2.10. Trash removal (i.e. dumpster)

  Select Professional services picks up trash from on site container that holds trash from multiple bird housing premises Professional services picks up trash from on-site container that only hold trash from that premise only Premise owner disposes trash from only this site

  • Professional services picks up trash from on site container that holds trash from multiple bird housing premises
  • Professional services picks up trash from on-site container that only hold trash from that premise only
  • Premise owner disposes trash from only this site

• 2.11. Vehicles from visitors...

  Select Vehicles are parked within 100 feet of chicken houses without being washed Vehicles are parked more than 100 feet of chicken houses without being washed Vehicles are washed before parking within 100 feet of the chicken houses

  • Vehicles are parked within 100 feet of chicken houses without being washed
  • Vehicles are parked more than 100 feet of chicken houses without being washed
  • Vehicles are washed before parking within 100 feet of the chicken houses

• 2.12. Premise vehicles...

  Select Premise vehicles are used outside of the PBA and on other poultry growing operations Premise vehicles are used outside of the PBA but not on other poultry growing operations Premise vehicles are not used outside premise

  • Premise vehicles are used outside of the PBA and on other poultry growing operations
  • Premise vehicles are used outside of the PBA but not on other poultry growing operations
  • Premise vehicles are not used outside premise

[3] People that work on this premise performing poultry related tasks.

• 3.1. Farm owners and/or main caretaker...

  Select The farm owner whom only owns one premise The farm owner that owns more than one premise

  • The farm owner whom only owns one premise
  • The farm owner that owns more than one premise

• 3.2 Farm labor is..

  Select working at more than one premise Dedicated to one premise

  • working at more than one premise
  • Dedicated to one premise

• 3.3 Farm owners and/or main caretakers are...

  Select culturally likely to be involved with biosecurity breaches not culturally likely to be involved with biosecurity breaches

  • culturally likely to be involved with biosecurity breaches
  • not culturally likely to be involved with biosecurity breaches

• 3.4 Farm laborers are...

  Select culturally likely to be involved with biosecurity breaches not culturally likely to be involved with biosecurity breaches

  • culturally likely to be involved with biosecurity breaches
  • not culturally likely to be involved with biosecurity breaches

• 3.5. Farm residence

  Select Farm owner and/or main caretaker lives off site Persons, outside of the farm owner and/or main caretaker, lives on site Farm owner and/or main caretaker lives on site

  • Farm owner and/or main caretaker lives off site
  • Persons, outside of the farm owner and/or main caretaker, lives on site
  • Farm owner and/or main caretaker lives on site

• 4.3. Multiple residences

  Select 1 or more residences on the premise within 500 feet of the poultry houses 1 or more residences on the premise greater than 500 feet from the houses No residence on premise

  • 1 or more residences on the premise within 500 feet of the poultry houses
  • 1 or more residences on the premise greater than 500 feet from the houses
  • No residence on premise

• 4.4. Caretaker / Employee dress policy

  Select may enter premise, or may approach within 100 feet of the houses, without any biosecurity precautions All company recommended biosecurity precautions are required before entering the premise or within 100 feet of the houses

  • may enter premise, or may approach within 100 feet of the houses, without any biosecurity precautions
  • All company recommended biosecurity precautions are required before entering the premise or within 100 feet of the houses

• 4.5. Visitor dress policy

  Select Visitors, coming into contact with the poultry on site, are within 100 foot of the houses without any biosecurity precautions Visitors, coming into poultry on site, are dressed in Mountaire recommended PPE when within 100 feet of the houses

  • Visitors, coming into contact with the poultry on site, are within 100 foot of the houses without any biosecurity precautions
  • Visitors, coming into poultry on site, are dressed in Mountaire recommended PPE when within 100 feet of the houses

[4] General management of the premise

• 4.1. All-in / All-out (defined as a common downtime amongst all houses on a premise)

  Select No Yes, with a common downtime <21 days Yes, with a common downtime >21 days

  • No
  • Yes, with a common downtime <21 days
  • Yes, with a common downtime >21 days

• 4.2. Method of dead bird disposal

  Select Renderer comes to pick up dead birds from premise Dead birds from other premises are disposed of on site Carry to another premise for disposal Dead bird disposal is located on premise

  • Renderer comes to pick up dead birds from premise
  • Dead birds from other premises are disposed of on site
  • Carry to another premise for disposal
  • Dead bird disposal is located on premise

• 4.3. Type of dead bird disposal

  Rendering

  Freezers

  Composted or buried on site

  Incinerated

[5] Physical aspects of the house

• With regard to topics questioned, select the description which best describes the houses being audited.

• 5.1. Visitor log is located...

  Select Not Present Present in one house or in a mailbox Present in every house

  • Not Present
  • Present in one house or in a mailbox
  • Present in every house

• 5.2. Visitor log is...

  Not complete

  Partially complete

  Complete

• 5.3. Warning or biosecurity sign at house door...

  Select None Sign In English Only Sign In English and Spanish and/or other appropriate languages

  • None
  • Sign In English Only
  • Sign In English and Spanish and/or other appropriate languages

• 5.4. House doors when producer/employees in the house...

  Select All doors unlocked All doors are locked except entry door

  • All doors unlocked
  • All doors are locked except entry door

• 5.5. House doors when no producer/employee in house...

  Select All doors unlocked All doors locked except entry door All doors locked

  • All doors unlocked
  • All doors locked except entry door
  • All doors locked

• 5.6. Bushes and/or high weeds around the house...

  Select Grass poorly maintained Bushes present No bushes and grass well maintained

  • Grass poorly maintained
  • Bushes present
  • No bushes and grass well maintained

• 5.7. Downtime...

  Consistently 7 days or less

  Consistently less than 19 days

  Consistently 19 days or more

  Consistently 3 weeks or more

• 5.8. Cleaning and disinfection program between flocks...

  Outstanding

  Average

  Below Average

  Not Acceptable

• 5.9. Source of water...

  Pond and/or surface water

  Municipal or well

• 5.10. Water sanitation...

  Select Drinking water not sanitized Drinking water regularly sanitized

  • Drinking water not sanitized
  • Drinking water regularly sanitized

• 5.11. Cleaned slats between flocks...

  Slats not cleaned

  Slats cleaned

• 5.12. Breeder house type...

  Curtains

  Closed (solid sidewalls)

• 5.13. Breeder house flooring...

  Dirt floors

  Concrete floors

• 5.14. Foot pan location...

  Select No foot pans at main entry door/s Foot pans not present at all major traffic doors (doors used on a daily-weekly basis) Foot pans present at all major traffic doors (doors used on a daily-weekly basis)

  • No foot pans at main entry door/s
  • Foot pans not present at all major traffic doors (doors used on a daily-weekly basis)
  • Foot pans present at all major traffic doors (doors used on a daily-weekly basis)

• 5.15. Foot pan condition...

  Poorly maintained

  Well maintained

• 5.16. Egg room...

  Not clean or in good condition

  Clean and in good condition

• 5.17. Collection room...

  Not clean or in good condition

  Clean and in good condition

[6] People that work in this location

• With regard to topics questioned, select the description which best describes the houses being audited.

• 6.1. Producer clothing policy...

  Select Clothing worn off premise and at other premises Clothing worn off site but not at other premise Site dedicated clothing House dedicated clothing

  • Clothing worn off premise and at other premises
  • Clothing worn off site but not at other premise
  • Site dedicated clothing
  • House dedicated clothing

• 6.2. Footwear for producer...

  Select Footwear worm off site and at another premise Footwear worn off site, not on another premise Premise dedicated footwear House dedicated footwear

  • Footwear worm off site and at another premise
  • Footwear worn off site, not on another premise
  • Premise dedicated footwear
  • House dedicated footwear

• 6.3. Caretaker/employee clothing policy...

  Select Clothing worn off premise and at other premises Clothing worn off site and not at other premises Site dedicated clothing House dedicated clothing

  • Clothing worn off premise and at other premises
  • Clothing worn off site and not at other premises
  • Site dedicated clothing
  • House dedicated clothing

• 6.4. Footwear for caretaker/employee...

  Select Footwear worn off site at another premise Footwear worn off site, not on another premise Premise dedicated footwear House dedicated footwear

  • Footwear worn off site at another premise
  • Footwear worn off site, not on another premise
  • Premise dedicated footwear
  • House dedicated footwear

• 6.5. Visitor dress policy...

  Select No additional precautions taken before entering house Disposable booties Full PPE (coveralls, hairnet, and booties)

  • No additional precautions taken before entering house
  • Disposable booties
  • Full PPE (coveralls, hairnet, and booties)

[7] Other animals besides the commercial birds

• With regard to topics questioned, select the description which best describes the houses being audited.

• 7.1. Other livestock (non-poultry) having contact with chicken house(s)...

  Select Any other type of livestock with contact to chicken houses Any other type of livestock within 500 feet of chicken house No other livestock on farm

  • Any other type of livestock with contact to chicken houses
  • Any other type of livestock within 500 feet of chicken house
  • No other livestock on farm

• 7.2. Pets...

  Select Any avian pet anywhere on site Any non-avian pets allowed in the chicken houses Any non-avian pets on farm No pets of any kind on property

  • Any avian pet anywhere on site
  • Any non-avian pets allowed in the chicken houses
  • Any non-avian pets on farm
  • No pets of any kind on property

• 7.3. Rodent control...

  Select No formal rodent control plan, clear evidence of rodents (feces, burrow holes, etc.) Bait stations placed but not routinely maintained No sign of vermin, comprehensive bait station set-up

  • No formal rodent control plan, clear evidence of rodents (feces, burrow holes, etc.)
  • Bait stations placed but not routinely maintained
  • No sign of vermin, comprehensive bait station set-up

• 7.4. Wild birds...

  Select Wild birds seen in houses Wild bird presence or clear evidence (e.g. nests) thereof seen on or right next to houses No wild birds ever in houses

  • Wild birds seen in houses
  • Wild bird presence or clear evidence (e.g. nests) thereof seen on or right next to houses
  • No wild birds ever in houses

• 7.5. Wild animals...

  Select Evidence of wild animal activity in house No evidence of wild animal activity in house

  • Evidence of wild animal activity in house
  • No evidence of wild animal activity in house

• 7.5. Insects (flies and darkling beetles)...

  Present in large amounts

  Present in small amounts

  Not present