Information
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Farm Name
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Grower Name
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Street Address, State, Zip Code
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Number of houses on contract
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Number of houses on premise
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Number of houses NOT in use
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Conducted on
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Conducted by:
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Signature
AREA
[1] Disease history in the location and surroundings.
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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?
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1.1. Avian Influenza (AI) in commercial poultry (chickens, turkeys, ducks, etc.) - Low pathogenicity or High pathogenicity?
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1.2. Avian Influenza in an avian species other than commercial (i.e. backyard flocks, waterfowl, pet birds, etc.)?
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1.3. Exotic ND or vvND in commercial poultry (chickens, turkeys, ducks, etc.)?
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1.4. Exotic ND or vvND in avian species other than commercial poultry?
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1.5. MG (gallisepticum) in commercial poultry (chickens, turkeys, ducks, etc.)?
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1.6. MS (synoviae) in commercial poultry (chickens, turkeys, ducks, etc.)?
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1.7. Infectious Coryza in commercial poultry (chickens, turkeys, ducks, etc.)?
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1.8. ILT in commercial poultry (chickens, turkeys, ducks, etc.)?
[2] Physical proximity of other poultry-related operations to this location.
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Select the number of each of the types of sites/premises within a 1-mile radius of this premise.
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2.1. How many Mountaire broiler farms are within a 1 mile radius?
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2.2. How many non-Mountaire broiler farms within a 1 mile radius?
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2.3. How many Mountaire broiler breeder and/or pullet farms within a 1 mile radius?
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2.4. How many non-Mountaire broiler breeder and/or pullet farms within a 1 mile radius?
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2.5. How many table egg pullet farms or table egg layer farms are within a 1 mile radius?
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2.6. How many turkey farms within a 1 mile radius?
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2.7. How many backyard poultry/hobby poultry/fighting chickens within a 1 mile radius?
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2.8. How many poultry live auctions or flea markets within a 1 mile radius?
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2.9. Number of hog farms within a 1 mile radius?
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2.10. Number of litter processing sites within a 1 mile radius?
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2.11. Is there a rendering route within a 1 mile radius?
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2.12. Number of landfills within a 1 mile radius?
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2.13. Is there a preserve or natural site with waterfowl or wild birds within a 1 mile radius?
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2.14. Is there a non-Mountaire poultry company office within a 1 mile radius?
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2.15. Are there allied industries or poultry companies within a 1 mile radius?
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2.16.1 Number of Mountaire processing plant/s within a 1 mile radius?
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2.16.2 Number of Non-Mountaire processing plant/s within a 1 mile radius?
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2.17. Number of feed mill/s within a 1 mile radius?
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2.18. Number of hatchery/ies within a 1 mile radius?
PREMISE
Premise
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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 on Premise.
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Select the correct response with regard to the most recent disease outbreaks on this farm?
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1.1. Avian Influenza (AI) in commercial poultry (chickens, turkeys, ducks, etc.) - Low pathogenicity or High pathogenicity?
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1.2. Exotic ND or vvND (chickens, turkeys, ducks, etc.)?
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1.3. MG (gallisepticum) (chickens, turkeys, ducks, etc.)?
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1.4. MS (synoviae) (chickens, turkeys, ducks, etc.)?
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1.5. Fowl cholera (broilers, pullets, breeders)?
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1.6. Infectious Coryza (chickens, turkeys, ducks, etc.)?
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1.7. ILT (chickens, turkeys, ducks, etc.)?
[2] Physical aspects related to the operation of the location being audited.
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With regard to the topics, select the one description which best describes the parts of this farm under the direct control of the caretaker.
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2.1. Warning sign at premise entrance?
- None
- Sign in English only
- Sign in English and/or Spanish or other language
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2.2. At premise entrance...
- multiple entrances, none locked
- 1 or more entrances, some unlocked
- 1 or more entrances, always locked
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2.3.1. Number of birds on premise?
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2.3.2. Number of birds on contract?
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2.3.3. Number of birds per house? (placed)
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2.4. Fencing
- no fencing on property
- some fencing around houses or property boundary
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2.5. Used litter storage
- litter on site, uncovered
- litter on site, covered (storage shed or tarped)
- no litter stored on site
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5.8. Cleaning and disinfection program between flocks...
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2.6.1. Source of bird drinking water?
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2.6.2. Source of cool cell water?
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5.10. Water sanitation...
- Drinking water not sanitized
- Drinking water regularly sanitized
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2.7. Farms/Manure
- 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
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2.8.1. Machinery on Premise
- 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 premise only once a month or less often
- Premise is self sufficient in all tools, equipment, and machinery
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2.9.1 Equipment washing...
- 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 is washed and disinfected prior to coming onto the premise
- Equipment is shared between different contracts and cleaned in between
- Equipment is shared between different contracts and not cleaned in between uses.
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2.10. Trash removal (i.e. dumpster)
- 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
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2.11. Vehicles from visitors...
- Vehicles are parked within 50 feet of chicken houses without being washed
- Vehicles are parked more than 50 feet of chicken houses without being washed
- Vehicles are washed before parking within 50 feet of the chicken houses
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2.12. Premise vehicles...
- Premise vehicles are used outside of the premise and on other poultry growing operations
- Premise vehicles are used outside of the premise but not on other poultry growing operations
- Premise vehicles are not used outside of the premise
[3] People that work on this premise performing poultry related tasks.
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3.1. Farm owners and/or main caretaker...
- The farm owner only owns one premise
- The farm owner owns more than one premise
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3.2. Farm residence
- 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
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3.3. Farm labor is..
- working at more than one premise
- Dedicated to one premise
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3.4. Farm owners and/or main caretakers are...
- culturally likely to be involved with biosecurity breaches
- not culturally likely to be involved with biosecurity breaches
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3.5. Farm laborers are...
- culturally likely to be involved with biosecurity breaches
- not culturally likely to be involved with biosecurity breaches
- Not applicable
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3.6. Multiple residences
- 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] General management of the premise
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4.1.1 All-in / All-out (defined as a common downtime amongst all houses on a premise)
- No
- Yes, with a common downtime <14 days
- Yes, with a common downtime of 14 -18 days
- Yes, with a common downtime of >18 days
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4.1.2 All-in / All-out (defined as a common downtime amongst all houses on the contract)
- No
- Yes, with a common downtime <14 days
- Yes, with a common downtime of 14 -18 days
- Yes, with a common downtime of >18 days
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4.2. Location of dead bird disposal
- Renderer comes to pick up dead birds from premise and contract
- Dead birds from other premises are disposed of on site
- Carry to another premise or contract for disposal
- Dead bird disposal is located on premise
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4.3. Type of dead bird disposal
- Burial
- Incineration
- Compost
- Grinding
- Landfill
- None
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4.4 Does the farm often have to use a secondary bird disposal
- No
- Yes, Burial
- Yes, incineration
- Yes, Composted
- Yes, Landfill
- Yes, Grinding
HOUSE
[5] Physical aspects of the house
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With regard to topics questioned, select the description which best describes the houses being audited.
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5.1. Visitor log is located...
- Not Present
- Present in only one house or at the entrance
- Present in every house
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5.2. Visitor log is...
- Not complete
- Partially complete
- Completed by Mountaire visitors only
- Complete
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5.3. Warning or biosecurity sign at house door...
- None
- Sign In English Only
- Sign In English and Spanish and/or other appropriate languages
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5.4. House doors when producer/employees in the house...
- All doors unlocked
- All doors are locked except entry door
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5.5. House doors when no producer/employee in house...
- No door
- All doors unlocked or left open
- All doors locked except entry door
- All doors locked
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5.6. Bushes and/or high weeds around the house...
- Grass poorly maintained
- Bushes present
- No bushes and grass well maintained
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5.7. Foot pan location...
- No foot pans at any major traffic doors
- 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)
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5.8. Foot pan condition...
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5.9. Control Room Cleanliness
[6] People that work in this location
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With regard to topics questioned, select the description which best describes the houses being audited.
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6.1. Grower and/or farm manager clothing policy...
- Clothing worn off premise and at other premises
- Clothing worn off premise but not at other premises
- Premise dedicated clothing
- House dedicated clothing
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6.2. Footwear for grower and/or farm manager...
- Footwear worn off premise and at another premise
- Footwear worn off premise but not on another premise
- Premise dedicated footwear
- House dedicated footwear
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6.3. Caretaker/employee clothing policy...
- Clothing worn off premise and at other premises
- Clothing worn off premise and not at other premises
- Premise dedicated clothing
- House dedicated clothing
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6.4. Footwear for caretaker/employee...
- Footwear worn off premise but at another premise
- Footwear worn off premise but not on another premise
- Premise dedicated footwear
- House dedicated footwear
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6.5. Visitor dress policy...
- No additional precautions taken before entering house
- Disposable booties
- Full PPE (coveralls, hairnet, and booties)
[7] Other animals besides the commercial birds
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With regard to topics questioned, select the description which best describes the houses being audited.
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7.1. Other livestock (non-poultry) having contact with chicken house(s)...
- 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
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7.2. Pets...
- 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
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7.3. Rodent control...
- No formal rodent control plan, clear evidence of rodents (feces, burrow holes, etc.)
- Four Bait stations are placed around the house but not routinely maintained/baited
- Four Bait Stations are placed around the house and are routinely maintained/baited
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7.4. Wild birds...
- 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
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7.5. Wild animals...
- Evidence of wild animal activity in house
- No evidence of wild animal activity in house
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7.5. Insects (flies and darkling beetles)...