Ãîëîâíà ñòîð³íêà á³çíåñ-ïîðòàëó "Ëåîíîðì"

 

ÒΠ«Í²Ö «ËÅÎÍÎÐÌ» º Îô³ö³éíèì ïàðòíåðîì ÄÏ «ÓêðÍÄÍÖ» òà óïîâíîâàæåíèì íà ðåàë³çàö³þ Îô³ö³éíèõ òåêñò³â ÍÄ â åëåêòðîííîìó âèãëÿä³. Ñòðîê íàäàííÿ ïîñëóãè: ïðîòÿãîì 1-2 ðîáî÷èõ äí³â ï³ñëÿ íàäõîäæåííÿ ãðîøîâèõ êîøò³â..

ÊÎÍÒÀÊÒÈ ÍÎÂÈÍÈ ÐŪÑÒÐÀÖ²ß ÌÀÃÀÇÈÍ ÍÎÐÌÀÒÈÂͲ ÀÊÒÈ ÏÎØÓÊ (RUS)

̲ͲÑÒÅÐÑÒÂÎ ÀÃÐÀÐÍί ÏÎ˲ÒÈÊÈ ÒÀ ÏÐÎÄÎÂÎËÜÑÒÂÀ ÓÊÐÀ¯ÍÈ

ÍÀÊÀÇ

01.08.2014

ì. Êè¿â

N 288

Çàðåºñòðîâàíî â ̳í³ñòåðñòâ³ þñòèö³¿ Óêðà¿íè
03 æîâòíÿ 2014 ð. çà N 1202/25979

Ïðî çàòâåðäæåííÿ Ïðàâèë çàïîâíåííÿ, çáåð³ãàííÿ, ñïèñàííÿ âåòåðèíàðíèõ äîêóìåíò³â òà âèìîã äî ¿õ îáë³êó

³äïîâ³äíî äî ñòàòò³ 32 Çàêîíó Óêðà¿íè "Ïðî âåòåðèíàðíó ìåäèöèíó", ñòàòò³ 7 Çàêîíó Óêðà¿íè "Ïðî áåçïå÷í³ñòü òà ÿê³ñòü õàð÷îâèõ ïðîäóêò³â", ïóíêòó 11 Ïîðÿäêó âèäà÷³ âåòåðèíàðíèõ äîêóìåíò³â, çàòâåðäæåíîãî ïîñòàíîâîþ Êàá³íåòó ̳í³ñòð³â Óêðà¿íè â³ä 21 ëèñòîïàäà 2013 ðîêó N 857,

ÍÀÊÀÇÓÞ:

1. Çàòâåðäèòè Ïðàâèëà çàïîâíåííÿ, çáåð³ãàííÿ, ñïèñàííÿ âåòåðèíàðíèõ äîêóìåíò³â òà âèìîã äî ¿õ îáë³êó, ùî äîäàþòüñÿ.

2. Âèçíàòè òàêèì, ùî âòðàòèâ ÷èíí³ñòü, íàêàç Äåðæàâíîãî êîì³òåòó âåòåðèíàðíî¿ ìåäèöèíè Óêðà¿íè â³ä 13 êâ³òíÿ 2009 ðîêó N 85 "Ïðî çàòâåðäæåííÿ Ïîðÿäêó âèäà÷³ âåòåðèíàðíèõ äîêóìåíò³â", çàðåºñòðîâàíèé â ̳í³ñòåðñòâ³ þñòèö³¿ Óêðà¿íè 16 ÷åðâíÿ 2009 ðîêó çà N 519/16535 (³ç çì³íàìè).

3. Äåïàðòàìåíòó òâàðèííèöòâà (Ãåòÿ À. À.) çàáåçïå÷èòè ïîäàííÿ öüîãî íàêàçó íà äåðæàâíó ðåºñòðàö³þ äî ̳í³ñòåðñòâà þñòèö³¿ Óêðà¿íè â óñòàíîâëåíîìó çàêîíîäàâñòâîì ïîðÿäêó.

4. Öåé íàêàç íàáèðຠ÷èííîñò³ ç äíÿ éîãî îô³ö³éíîãî îïóáë³êóâàííÿ.

5. Êîíòðîëü çà âèêîíàííÿì öüîãî íàêàçó ïîêëàñòè íà çàñòóïíèêà ̳í³ñòðà Äèêóíà À. ª.

 

̳í³ñòð

². Î. Øâàéêà

ÏÎÃÎÄÆÅÍÎ:

 

Ãîëîâà Äåðæàâíî¿
ô³ñêàëüíî¿ ñëóæáè Óêðà¿íè

². Î. Á³ëîóñ

Çàñòóïíèê Ãîëîâè Äåðæàâíî¿
âåòåðèíàðíî¿ òà ô³òîñàí³òàðíî¿
ñëóæáè Óêðà¿íè

Â. Â. Áàøèíñüêèé

Ãîëîâà Äåðæàâíî¿ ñëóæáè Óêðà¿íè
ç ïèòàíü ðåãóëÿòîðíî¿ ïîë³òèêè
òà ðîçâèòêó ï³äïðèºìíèöòâà

Ì. Þ. Áðîäñüêèé

 

ÏÐÀÂÈËÀ
çàïîâíåííÿ, çáåð³ãàííÿ, ñïèñàííÿ âåòåðèíàðíèõ äîêóìåíò³â òà âèìîã äî ¿õ îáë³êó

I. Çàãàëüí³ ïîëîæåííÿ

1.1. Ö³ Ïðàâèëà âñòàíîâëþþòü ôîðìè áëàíê³â âåòåðèíàðíèõ äîêóìåíò³â, ïðàâèëà çàïîâíåííÿ âåòåðèíàðíèõ äîêóìåíò³â, ïðàâèëà çáåð³ãàííÿ òà ñïèñàííÿ âåòåðèíàðíèõ äîêóìåíò³â, âèìîãè äî îáë³êó âåòåðèíàðíèõ äîêóìåíò³â.

Âåòåðèíàðí³ äîêóìåíòè, ôîðìè ÿêèõ íàâåäåíî ó äîäàòêàõ 1 - 12 äî öèõ Ïðàâèë, îôîðìëþþòüñÿ íà âëàñíèõ áëàíêàõ êîìïåòåíòíîãî îðãàíó, ÿê³ âèãîòîâëÿþòüñÿ äðóêàðñüêèì ñïîñîáîì (ó òîìó ÷èñë³ ³ç çàñòîñóâàííÿì êîìï'þòåðíî¿ òåõí³êè).

1.2. ̳æíàðîäí³ âåòåðèíàðí³ ñåðòèô³êàòè, âåòåðèíàðí³ ñâ³äîöòâà, âåòåðèíàðí³ äîâ³äêè âèäàþòüñÿ äåðæàâíèìè ³íñïåêòîðàìè âåòåðèíàðíî¿ ìåäèöèíè àáî óïîâíîâàæåíèìè ë³êàðÿìè âåòåðèíàðíî¿ ìåäèöèíè ô³çè÷íèì òà þðèäè÷íèì îñîáàì.

1.3. Ó öèõ Ïðàâèëàõ òåðì³íè âæèâàþòüñÿ ó çíà÷åííÿõ, íàâåäåíèõ ó Çàêîíàõ Óêðà¿íè "Ïðî âåòåðèíàðíó ìåäèöèíó" òà "Ïðî áåçïå÷í³ñòü òà ÿê³ñòü õàð÷îâèõ ïðîäóêò³â".

II. Ïðàâèëà çàïîâíåííÿ âåòåðèíàðíèõ äîêóìåíò³â

2.1. Ïîñàäîâà îñîáà ïðè âèäà÷³ âåòåðèíàðíîãî äîêóìåíòà çàñâ³ä÷óº ò³ëüêè òå, ó ÷îìó îñîáèñòî ïåðåêîíàíà, àáî òå, ùî ï³äòâåðäæóºòüñÿ ³íøèìè âåòåðèíàðíèìè äîêóìåíòàìè âñòàíîâëåíî¿ ôîðìè, âèäàíèìè âåòåðèíàðíèìè ôàõ³âöÿìè, ùî ìàþòü ïðàâî íà îôîðìëåííÿ öèõ äîêóìåíò³â.

Âåòåðèíàðí³ äîêóìåíòè, íàïèñàí³ ÷îðíèëîì ð³çíîãî êîëüîðó àáî íåîäíàêîâèì ïî÷åðêîì (êð³ì ï³äïèñó), à òàêîæ òàê³, ùî ìàþòü âèïðàâëåííÿ, íå ìàþòü ï³äïèñó òà/àáî ïå÷àòêè, äàòè âèäà÷³, ââàæàþòüñÿ íåä³éñíèìè.

Äîçâîëÿºòüñÿ çàïîâíþâàòè âåòåðèíàðíèé äîêóìåíò, éîãî äðóãèé îðèã³íàë ³ êîð³íåöü äðóêàðñüêèìè ïðèñòðîÿìè àáî êóëüêîâîþ ðó÷êîþ ï³ä êîï³þâàëüíèé ïàï³ð, ï³äïèñóþ÷è ïîò³ì êîæåí çàïîâíåíèé áëàíê âåòåðèíàðíîãî äîêóìåíòà, éîãî äðóãèé îðèã³íàë ³ êîð³íåöü îêðåìî. Ïðè çàïîâíåíí³ âåòåðèíàðíèõ äîêóìåíò³â äîïóñêàºòüñÿ çàñòîñóâàííÿ àáðåâ³àòóðè (ñêîðî÷åííÿ), ÿêà ïðèéíÿòà â Óêðà¿í³.

Äðóãèé îðèã³íàë òà êîð³íåöü âåòåðèíàðíîãî äîêóìåíòà ïîâèíí³ ì³ñòèòè îðèã³íàëè ï³äïèñ³â, â³äáèòêè ïå÷àòîê.

Âåòåðèíàðí³ ñâ³äîöòâà ôîðì N 1 òà N 2 çàïîâíþþòüñÿ óêðà¿íñüêîþ ìîâîþ òà ñóïðîâîäæóþòü òîâàðè, ÿê³ âèâîçÿòüñÿ çà ìåæ³ ðàéîíó (ì³ñòà), ïðè ¿õ òðàíñïîðòóâàíí³ òåðèòîð³ºþ Óêðà¿íè.

Âåòåðèíàðí³ ñâ³äîöòâà ôîðì N 1, N 2, N 3 ÑÍÄ çàïîâíþþòüñÿ ðîñ³éñüêîþ ìîâîþ òà ñóïðîâîäæóþòü òîâàðè òåðèòîð³ºþ êðà¿í ÑÍÄ.

̳æíàðîäí³ âåòåðèíàðí³ ñåðòèô³êàòè çàïîâíþþòü óêðà¿íñüêîþ ³ àíãë³éñüêîþ ìîâàìè òà/àáî ìîâîþ êðà¿íè-åêñïîðòåðà (³ìïîðòåðà).

Çàïîâíåííÿ òà âèäà÷à ì³æíàðîäíèõ âåòåðèíàðíèõ ñåðòèô³êàò³â íà îêðåì³ âèäè âàíòàæ³â çä³éñíþþòüñÿ â³äïîâ³äíèìè äåðæàâíèìè ³íñïåêòîðàìè âåòåðèíàðíî¿ ìåäèöèíè òà óïîâíîâàæåíèìè ë³êàðÿìè âåòåðèíàðíî¿ ìåäèöèíè ç óðàõóâàííÿì ôîðì, ïîãîäæåíèõ âåòåðèíàðíèìè àäì³í³ñòðàö³ÿìè ³íøèõ êðà¿í, òà/àáî ôîðì, âñòàíîâëåíèõ êðà¿íîþ ïðèçíà÷åííÿ, ³ ïðîâîäÿòüñÿ â³äïîâ³äíî äî ñàí³òàðíèõ çàõîä³â êðà¿íè ïðèçíà÷åííÿ òà ì³æíàðîäíèõ íîðì.

Âåòåðèíàðí³ äîêóìåíòè ä³éñí³ äëÿ ïðåä'ÿâëåííÿ äî â³äïðàâëåííÿ ïðîòÿãîì 5 äí³â ³ äî ê³íöÿ òðàíñïîðòóâàííÿ é ñòðîê³â ðåàë³çàö³¿ òîâàð³â ïðè äîòðèìàíí³ óìîâ çáåð³ãàííÿ òà ïðàâèë ïåðåâåçåííÿ.

2.2. Ïðè â³äïðàâëåíí³ òîâàð³â ÷è ïðè ïåðåì³ùåíí³ òâàðèí àâòîìîá³ëüíèì òðàíñïîðòîì âåòåðèíàðíèé äîêóìåíò ïåðåäàºòüñÿ âîä³þ (åêñïåäèòîðó) ÿê äîäàòîê äî òîâàðíî-òðàíñïîðòíèõ äîêóìåíò³â ç ïîäàëüøîþ ïåðåäà÷åþ éîãî îäåðæóâà÷ó â ïóíêò³ ïðèçíà÷åííÿ.

Ïðè ïåðåâåçåíí³ òîâàð³â çàë³çíè÷íèì, âîäíèì ³ ïîâ³òðÿíèì òðàíñïîðòîì âåòåðèíàðí³ ñâ³äîöòâà (ôîðì N 1, N 2) îôîðìëÿþòüñÿ êîìïëåêòîì: âåòåðèíàðíå ñâ³äîöòâî, éîãî äðóãèé îðèã³íàë ³ êîð³íåöü âåòåðèíàðíîãî ñâ³äîöòâà.

2.3. Âåòåðèíàðí³ äîêóìåíòè âèäàþòüñÿ íà ï³äñòàâ³ áåçïîñåðåäíüîãî îãëÿäó îá'ºêòà äåðæàâíîãî âåòåðèíàðíî-ñàí³òàðíîãî êîíòðîëþ òà íàãëÿäó.

2.4. Ïðè ïåðåâåçåíí³ òîâàð³â çàë³çíè÷íèì, âîäíèì àáî àâ³àö³éíèì òðàíñïîðòîì äðóãèé îðèã³íàë âåòåðèíàðíîãî ñâ³äîöòâà âèäàþòü ñòàðøîìó ïðîâ³äíèêó (ïîãîíè÷ó), ùî ñóïðîâîäæóº òâàðèí (ôîðìà N 1), àáî êëàäóòü ðàçîì ç âàíòàæåì ó âàãîí, òðþì, áàãàæ (ôîðìà N 2).

2.5. Âåòåðèíàðí³ äîêóìåíòè ï³äïèñóþòüñÿ äåðæàâíèìè ³íñïåêòîðàìè âåòåðèíàðíî¿ ìåäèöèíè àáî óïîâíîâàæåíèìè ë³êàðÿìè âåòåðèíàðíî¿ ìåäèöèíè òà ñêð³ïëþþòüñÿ ïå÷àòêîþ äåðæàâíî¿ óñòàíîâè âåòåðèíàðíî¿ ìåäèöèíè.

ϳñëÿ âèäà÷³ â³äïîâ³äíîãî âåòåðèíàðíîãî äîêóìåíòà çàÿâíèêó àáî óïîâíîâàæåí³é íèì îñîá³ çä³éñíþºòüñÿ â³äïîâ³äíèé çàïèñ ó æóðíàëàõ ðåºñòðàö³¿ âèäà÷³ âåòåðèíàðíèõ äîêóìåíò³â, ôîðìè ÿêèõ çàòâåðäæóþòüñÿ ãîëîâíèì äåðæàâíèì ³íñïåêòîðîì âåòåðèíàðíî¿ ìåäèöèíè Óêðà¿íè.

Îñîáà, ÿêà îäåðæàëà âåòåðèíàðíå ñâ³äîöòâî, ñòàâèòü ñâ³é ï³äïèñ ïðî éîãî îòðèìàííÿ íà êîð³íö³.

2.6. Îïèñ áëàíê³â âåòåðèíàðíèõ äîêóìåíò³â çàòâåðäæóºòüñÿ íàêàçîì ̳íàãðîïîë³òèêè Óêðà¿íè.

2.7. Ñï³ðí³ ïèòàííÿ, ïîâ'ÿçàí³ ç âèäà÷åþ âåòåðèíàðíîãî äîêóìåíòà, âèð³øóþòüñÿ ó âñòàíîâëåíîìó çàêîíîäàâñòâîì ïîðÿäêó.

III. Âèìîãè äî îôîðìëåííÿ âåòåðèíàðíèõ äîêóìåíò³â íà ïåðåì³ùåííÿ òâàðèí

3.1. Ïðè â³äïðàâëåíí³ òâàðèí ó ê³ëüêîñò³ äî 5 ãîë³â âêëþ÷íî, ¿õ ïåðåë³ê ³ç çàçíà÷åííÿì ñòàò³, â³êó, ³äåíòèô³êàö³éíîãî íîìåðà, ñå𳿠³ íîìåðà ïàñïîðòà, íîìåðà âåòåðèíàðíî¿ êàðòêè âíîñèòüñÿ â ãðàôó "Îñîáëèâ³ â³äì³òêè" âåòåðèíàðíîãî äîêóìåíòà.

Ïðè â³äïðàâëåíí³ á³ëüøå 5 ãîë³â òâàðèí äî âåòåðèíàðíîãî äîêóìåíòà äîäàºòüñÿ îïèñ òâàðèí ³ç çàçíà÷åííÿì ñòàò³, â³êó, ³äåíòèô³êàö³éíîãî íîìåðà, ñå𳿠³ íîìåðà ïàñïîðòà, íîìåðà âåòåðèíàðíî¿ êàðòêè, ÿêèé ñêð³ïëþºòüñÿ ïå÷àòêîþ óñòàíîâè, ùî âèäàëà âåòåðèíàðíèé äîêóìåíò.

3.2. Ïðè ïåðåâåçåíí³ òâàðèí îáîâ'ÿçêîâî çàçíà÷àºòüñÿ ê³ëüê³ñòü ãîë³â ñëîâàìè.

3.3. ʳëüê³ñòü ïðåä'ÿâëåíèõ äî â³äïðàâëåííÿ òâàðèí àáî ïðîäóêö³¿ òâàðèííîãî ïîõîäæåííÿ ïîâèííà â³äïîâ³äàòè ê³ëüêîñò³, çàçíà÷åí³é ó âåòåðèíàðíîìó äîêóìåíò³.

Âåòåðèíàðí³ äîâ³äêè, ÿê³ âèäàí³ íà ïåðåäçàá³éíèé îãëÿä ïòèö³, ä³éñí³ ïðîòÿãîì 1 äîáè.

IV. Ïðàâèëà çáåð³ãàííÿ òà ñïèñàííÿ âåòåðèíàðíèõ äîêóìåíò³â

4.1. Çàïîâíåí³ êîð³íö³ âåòåðèíàðíèõ äîêóìåíò³â çáåð³ãàþòüñÿ ïðîòÿãîì äâîõ ðîê³â â àðõ³â³ äåðæàâíî¿ óñòàíîâè âåòåðèíàðíî¿ ìåäèöèíè, ÿêà â³äïîâ³äຠçà ¿õ îáë³ê.

ϳñëÿ çàê³í÷åííÿ ñòðîêó çáåð³ãàííÿ êîð³íö³ âèäàíèõ âåòåðèíàðíèõ äîêóìåíò³â òà áëàíêè ç³ïñîâàíèõ âåòåðèíàðíèõ äîêóìåíò³â ï³äëÿãàþòü ñïèñàííþ òà çíèùåííþ.

 àêòàõ íà ñïèñàííÿ êîð³íö³â âèäàíèõ âåòåðèíàðíèõ äîêóìåíò³â, ñòðîê çáåð³ãàííÿ ÿêèõ çàê³í÷èâñÿ, óêàçóþòüñÿ ¿õ ê³ëüê³ñòü ³ íîìåðè.

4.2. Âåòåðèíàðí³ ñâ³äîöòâà, âèäàí³ ô³çè÷íèì òà þðèäè÷íèì îñîáàì, çáåð³ãàþòüñÿ ïðîòÿãîì ïåð³îäó ðåàë³çàö³¿ õàð÷îâèõ ïðîäóêò³â.

4.3. ϳñëÿ äîñòàâêè õàð÷îâîãî ïðîäóêòó âåòåðèíàðí³ äîêóìåíòè çáåð³ãàþòüñÿ ó âëàñíèêà (ðåàë³çàòîðà) àáî ó ñïðàâàõ îô³ö³éíîãî ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, à ïðè ðåàë³çàö³¿ íà àãðîïðîäîâîëü÷èõ ðèíêàõ - ó äåðæàâíèõ ëàáîðàòîð³ÿõ âåòåðèíàðíî-ñàí³òàðíî¿ åêñïåðòèçè.

V. Âèìîãè äî îáë³êó âåòåðèíàðíèõ äîêóìåíò³â

5.1. Âèäà÷ó âåòåðèíàðíèõ äîêóìåíò³â ðåºñòðóþòü ó æóðíàëàõ, ïðîíóìåðîâàíèõ, ïðîøíóðîâàíèõ, ñêð³ïëåíèõ ïå÷àòêîþ òà çàñâ³ä÷åíèõ ï³äïèñîì êåð³âíèêà îðãàíó ÷è óñòàíîâè, ùî â³äïîâ³äຠçà ¿õ âèäà÷ó ³ çáåð³ãàííÿ, ³ç çàçíà÷åííÿì äàòè âèäà÷³, êîìó ³ íà ÿêèé âàíòàæ âèäàíî, ê³ëüêîñò³ âàíòàæó, ñóìè óòðèìàíèõ êîøò³â òà ï³äïèñîì ë³êàðÿ, ùî âèäàâ âåòåðèíàðíèé äîêóìåíò.

5.2. Ñïåö³àë³ñòè âåòåðèíàðíî¿ ìåäèöèíè áëàíêè âåòåðèíàðíèõ äîêóìåíò³â îòðèìóþòü ó äåðæàâíèõ îðãàíàõ àáî óñòàíîâàõ âåòåðèíàðíî¿ ìåäèöèíè ï³ä ï³äïèñ.

VI. Íàãëÿä çà äîòðèìàííÿì Ïðàâèë âèäà÷³ âåòåðèíàðíèõ äîêóìåíò³â

Íàãëÿä çà äîòðèìàííÿì öèõ Ïðàâèë ïîêëàäàºòüñÿ íà äåðæàâíèõ ³íñïåêòîð³â âåòåðèíàðíî¿ ìåäèöèíè ãîëîâíèõ óïðàâë³íü âåòåðèíàðíî¿ ìåäèöèíè â Àâòîíîìí³é Ðåñïóáë³ö³ Êðèì, îáëàñòÿõ, ì³ñòàõ Êèºâ³ ³ Ñåâàñòîïîë³, ðàéîíàõ (ì³ñòàõ), ðåã³îíàëüíèõ ñëóæá äåðæàâíîãî âåòåðèíàðíî-ñàí³òàðíîãî êîíòðîëþ òà íàãëÿäó íà äåðæàâíîìó êîðäîí³ òà òðàíñïîðò³.

 

Äèðåêòîð Äåïàðòàìåíòó òâàðèííèöòâà

À. À. Ãåòÿ

 

ÂÅÒÅÐÈÍÀÐÍÀ ÄβÄÊÀ

N

 

â³ä "___" ____________ 20__ ðîêó

Âèäàíà ______________________________________________________________________________
                   (êîìó - íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ þðèäè÷íî¿ îñîáè àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³ ô³çè÷íî¿ îñîáè
_____________________________________________________________________________________
                                                                                          òà ¿¿ ì³ñöå ïðîæèâàííÿ)
ó òîìó, ùî íàëåæí³ éîìó _______________________________________________________________
                                                                                   (íàéìåíóâàííÿ ïðîäóêö³¿; âèä, â³ê, ñòàòü òâàðèí, ïòèö³ (ðèáè))
_____________________________________________________________________________________
ó ê³ëüêîñò³ _____________________, ______________________, ______________________________,
                                (êã, ì³ñöü, øòóê, ãîë³â)                          (óïàêîâêà)                                    (ìàðêóâàííÿ, N ³ ôîðìà òàâðà)
ï³ääàí³ _______________________________________________________________________________
                                   (êë³í³÷íîìó îãëÿäó, äîñë³äæåííÿì, òðèõ³íåëîñêîﳿ, âàêöèíàö³¿, îáðîáêàì, äåç³íôåêö³¿,
_____________________________________________________________________________________,
                                                                        êîíñåðâàö³¿, ïàñòåðèçàö³¿ (ñòåðèë³çàö³¿) òîùî)
â³äïðàâëÿþòüñÿ ç______________________________________________________________________,
                                                                                                                   (ì³ñöå â³äïðàâêè)
íàïðàâëÿþòüñÿ ________________________     _____________________________________________
                                                   (âèä òðàíñïîðòó)                                                                   (ìàðøðóò ïðÿìóâàííÿ)
â ____________________________________________________________________________________
äëÿ __________________________________________________________________________________
                                                (äîðîùóâàííÿ, â³äãîä³âë³, çàáîþ, ðåàë³çàö³¿, çáåð³ãàííÿ, ïåðåðîáêè òîùî)
_____________________________________________________________________________________

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                   (âêàçóþòüñÿ: ³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ ³ íîìåð ïàñïîðòà,
_____________________________________________________________________________________
                         íîìåð âåòåðèíàðíî¿ êàðòêè òà íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí,
                                                                         ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________

Âåòåðèíàðíà äîâ³äêà ÷èííà ò³ëüêè â îðèã³íàë³ íà òåðèòî𳿠ðàéîíó (ì³ñòà).

                  Ì. Ï.

_______________________________________
(ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè)

_______________________________________
(ïîñàäà)

_______________________________________
(ï³äïèñ)

 

 

 

  
ÔÎÐÌÀ N 1

________________________________________
                  (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                                (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
_____________________________________________________________________________________
ó òîìó, ùî ñåðåä òâàðèí ________________________________________________________________
                                                                                                                      (óêàçàòè âèä òâàðèí)
ó ê³ëüêîñò³ ________________________________________ ãîë³â, ùî ïðåä'ÿâëåí³ äëÿ âåòåðèíàðíîãî
                                                                 (ñëîâàìè)
îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ, õâîðèõ ³ ï³äîçðþâàíèõ íà çàõâîðþâàííÿ íà çàðàçí³ õâîðîáè íå âèÿâëåíî, âîíè âèõîäÿòü (âèâîçÿòüñÿ) ³ç ___________________________________________________
                                                                                                                        (íàçâà íàñåëåíîãî ïóíêòó,
_____________________________________________________________________________________,
                                                                            ãîñïîäàðñòâà àáî âëàñíèêà)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Òâàðèíè ïåðåä â³äïðàâëåííÿì __________________
_____________________________________________________________________________________
                               (óêàçàòè ñòðîêè ³ ì³ñöå ïðîô³ëàêòè÷íîãî êàðàíòèíó, ÿêèì ï³ääàâàëèñÿ äîñë³äæåííÿì,
_____________________________________________________________________________________
                                                                         ùåïëåííÿì àáî ³íøèì îáðîáêàì, äàòè)
_____________________________________________________________________________________
_____________________________________________________________________________________

Òâàðèíè íàïðàâëÿþòüñÿ ________________________________________________________________
                                                                                                  (ïóíêò, ñòàíö³ÿ ïðèçíà÷åííÿ òà îäåðæóâà÷)
äëÿ __________________________________________________________________________________
                                                                            (çàáîþ, â³äãîä³âë³, ïðîäàæó, ðîçâåäåííÿ òîùî)
³ ïðÿìóþòü: çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) çà ìàðøðóòîì ____________________________________________________________________________
                                                        (óêàçàòè îñíîâí³ ïóíêòè òðàíñïîðòóâàííÿ: ñòàíö³ÿ, ïîðò íàâàíòàæåííÿ)

Ñïåöèô³êàö³ÿ (ãóðòîâà â³äîì³ñòü, òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ________________ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                   (äàòà òà íîìåð ïîãîäæåííÿ íà âèâ³ç çà ìåæ³ àäì³í³ñòðàòèâíî¿ òåðèòîð³¿)
_____________________________________________________________________________________
                           (³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ òà íîìåð ïàñïîðòà, ñåð³ÿ òà íîìåð âåòåðèíàðíî¿ êàðòêè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                (íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí, ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                            (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ ïåðåâàíòàæåííÿ, âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

ʳëüê³ñòü îãëÿíóòèõ òâàðèí (ïòèö³, ðèáè òîùî) (ãîë³â, ì³ñöü, âàãè)

Âèÿâëåíî

Íå âèñòà÷ຠ(ãîë³â, ì³ñöü, âàãè)

Ñê³ëüêè òâàðèí çàòðèìàíî, ïðè÷èíè çàòðèìàííÿ ³ ÿêèõ âæèòî çàõîä³â (êàðàíòèí, ùåïëåííÿ, íàäàííÿ âåòåðèíàðíî¿ äîïîìîãè òîùî)

Äîçâîëåíî äî ïîäàëüøîãî òðàíñïîðòóâàííÿ (ê³ëüê³ñòü òâàðèí, ì³ñöü òîùî)

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, ïå÷àòêà

õâîðèõ òâàðèí

òðóï³â òâàðèí

 

 

 

 

 

 

 

 

 

  
ÔÎÐÌÀ N 1

________________________________________
                  (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                              (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                      ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
_____________________________________________________________________________________
ó òîìó, ùî ñåðåä òâàðèí ________________________________________________________________
                                                                                                                  (óêàçàòè âèä òâàðèí)
ó ê³ëüêîñò³ ________________________________________ ãîë³â, ùî ïðåä'ÿâëåí³ äëÿ âåòåðèíàðíîãî
                                                                   (ñëîâàìè)
îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ, õâîðèõ ³ ï³äîçðþâàíèõ íà çàõâîðþâàííÿ íà çàðàçí³ õâîðîáè íå âèÿâëåíî, âîíè âèõîäÿòü (âèâîçÿòüñÿ) ³ç ___________________________________________________
                                                                                                                                   (íàçâà íàñåëåíîãî ïóíêòó,
_____________________________________________________________________________________,
                                                                               ãîñïîäàðñòâà àáî âëàñíèêà)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Òâàðèíè ïåðåä â³äïðàâëåííÿì __________________
_____________________________________________________________________________________
                              (óêàçàòè ñòðîêè ³ ì³ñöå ïðîô³ëàêòè÷íîãî êàðàíòèíó, ÿêèì ï³ääàâàëèñÿ äîñë³äæåííÿì,
_____________________________________________________________________________________
                                                                             ùåïëåííÿì àáî ³íøèì îáðîáêàì, äàòè)
_____________________________________________________________________________________
_____________________________________________________________________________________

Òâàðèíè íàïðàâëÿþòüñÿ ________________________________________________________________
                                                                                                  (ïóíêò, ñòàíö³ÿ ïðèçíà÷åííÿ òà îäåðæóâà÷)
äëÿ __________________________________________________________________________________
                                                                         (çàáîþ, â³äãîä³âë³, ïðîäàæó, ðîçâåäåííÿ òîùî)
³ ïðÿìóþòü: çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) çà ìàðøðóòîì ___________________________________________________________________________
                                                             (óêàçàòè îñíîâí³ ïóíêòè òðàíñïîðòóâàííÿ: ñòàíö³ÿ, ïîðò íàâàíòàæåííÿ)

Ñïåöèô³êàö³ÿ (ãóðòîâà â³äîì³ñòü, òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ________________ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                      (äàòà òà íîìåð ïîãîäæåííÿ íà âèâ³ç çà ìåæ³ àäì³í³ñòðàòèâíî¿ òåðèòîð³¿)
_____________________________________________________________________________________
                       (³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ òà íîìåð ïàñïîðòà, ñåð³ÿ òà íîìåð âåòåðèíàðíî¿ êàðòêè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                     (íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí, ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                          (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ ïåðåâàíòàæåííÿ, âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

ʳëüê³ñòü îãëÿíóòèõ òâàðèí (ïòèö³, ðèáè òîùî) (ãîë³â, ì³ñöü, âàãè)

Âèÿâëåíî

Íå âèñòà÷ຠ(ãîë³â, ì³ñöü, âàãè)

Ñê³ëüêè òâàðèí çàòðèìàíî, ïðè÷èíè çàòðèìàííÿ ³ ÿêèõ âæèòî çàõîä³â (êàðàíòèí, ùåïëåííÿ, íàäàííÿ âåòåðèíàðíî¿ äîïîìîãè òîùî)

Äîçâîëåíî äî ïîäàëüøîãî òðàíñïîðòóâàííÿ (ê³ëüê³ñòü òâàðèí, ì³ñöü òîùî)

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, ïå÷àòêà

õâîðèõ òâàðèí

òðóï³â òâàðèí

 

 

 

 

 

 

 

 

 

  
ÔÎÐÌÀ N 1

________________________________________
                  (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ___________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÊÎвÍÅÖÜ
ÂÅÒÅÐÈÍÀÐÍÎÃΠѲÄÎÖÒÂÀ N

Âèäàíèé _____________________________________________________________________________
                                 (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                    ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
_____________________________________________________________________________________
ó òîìó, ùî ñåðåä òâàðèí ________________________________________________________________
                                                                                                                  (óêàçàòè âèä òâàðèí)
ó ê³ëüêîñò³ ________________________________________ ãîë³â, ùî ïðåä'ÿâëåí³ äëÿ âåòåðèíàðíîãî
                                                                    (ñëîâàìè)
îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ, õâîðèõ ³ ï³äîçðþâàíèõ íà çàõâîðþâàííÿ íà çàðàçí³ õâîðîáè íå âèÿâëåíî, âîíè âèõîäÿòü (âèâîçÿòüñÿ) ³ç ___________________________________________________
                                                                                                                                    (íàçâà íàñåëåíîãî ïóíêòó,
_____________________________________________________________________________________,
                                                                                   ãîñïîäàðñòâà àáî âëàñíèêà)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Òâàðèíè ïåðåä â³äïðàâëåííÿì __________________
_____________________________________________________________________________________
                               (óêàçàòè ñòðîêè ³ ì³ñöå ïðîô³ëàêòè÷íîãî êàðàíòèíó, ÿêèì ï³ääàâàëèñÿ äîñë³äæåííÿì,
_____________________________________________________________________________________
                                                                     ùåïëåííÿì àáî ³íøèì îáðîáêàì, äàòè)
_____________________________________________________________________________________
_____________________________________________________________________________________

Òâàðèíè íàïðàâëÿþòüñÿ ________________________________________________________________
                                                                                                 (ïóíêò, ñòàíö³ÿ ïðèçíà÷åííÿ òà îäåðæóâà÷)
äëÿ __________________________________________________________________________________
                                                                      (çàáîþ, â³äãîä³âë³, ïðîäàæó, ðîçâåäåííÿ òîùî)
³ ïðÿìóþòü: çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) çà ìàðøðóòîì ___________________________________________________________________________
                                                                (óêàçàòè îñíîâí³ ïóíêòè òðàíñïîðòóâàííÿ: ñòàíö³ÿ, ïîðò íàâàíòàæåííÿ)

Ñïåöèô³êàö³ÿ (ãóðòîâà â³äîì³ñòü, òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ________________ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                      (äàòà òà íîìåð ïîãîäæåííÿ íà âèâ³ç çà ìåæ³ àäì³í³ñòðàòèâíî¿ òåðèòîð³¿)
_____________________________________________________________________________________
                            (³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ òà íîìåð ïàñïîðòà, ñåð³ÿ òà íîìåð âåòåðèíàðíî¿ êàðòêè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                     (íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí, ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                         (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

 

 

  
ÔÎÐÌÀ N 2

________________________________________
                    (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                             (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                         ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
ó òîìó, ùî ïðåä'ÿâëåí³ äëÿ îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ ________________________________
                                                                                                                                                          (âèä ïðîäóêòó àáî ñèðîâèíè)
_____________________________________________________________________________________
ó ê³ëüêîñò³ _________________________ ì³ñöü (øòóê) çàãàëüíîþ âàãîþ ______________________ êã,
                                                  (ñëîâàìè)
_____________________________________________________________________________________
                                                          (óêàçàòè, â ÿêîìó ñòàí³: ñâ³æ³, îõîëîäæåí³, ìîðîæåí³, ïð³ñíî-ñóõ³,
_____________________________________________________________________________________,
                                                  ìîêðî-ñîëîí³; âîâíà - ìèòà, áðóäíà òîùî, òèï óïàêîâêè (áåç óïàêîâêè))
ïîõîäæåííÿ __________________________________________________________________________,
                                                                    (ì'ÿñî - áîºíñüêå; ñèðîâèíà - áîºíñüêà, çá³ðíà â³ä ïàäåæó òîùî)
âèâîçÿòüñÿ ³ç _________________________________________________________________________,
                                                      (íàçâè íàñåëåíîãî ïóíêòó ³ ãîñïîäàðñòâà, íàéìåíóâàííÿ ï³äïðèºìñòâà òîùî)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Ñâèíèíà äîñë³äæåíà (íåäîñë³äæåíà) íà òðèõ³íåëüîç; êîí³ ïåðåä çàáîºì ï³ääàí³ (íåï³ääàí³) ìàëå¿í³çàö³¿; ñèðîâèíà äîñë³äæåíà (íåäîñë³äæåíà) íà ñèá³ðêó; ïðîäåç³íô³êîâàíà (íåïðîäåçèíô³êîâàíà) (ïîòð³áíå ï³äêðåñëèòè). Ïðîäóêòè (ñèðîâèíà) íàïðàâëÿþòüñÿ äî ___________________________________________________________________________________
                                                                                      (óêàçàòè ïóíêò, ñòàíö³þ ïðèçíà÷åííÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________
çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) ç íàâàíòàæåííÿì íà ñòàíö³¿ (ïðèñòàí³, â ïîðòó) ______________________________________________
                                                                                                                    (àáî óêàçàòè ìàðøðóò ïðîõîäæåííÿ àâòîòðàíñïîðòó)
_____________________________________________________________________________________

Ñïåöèô³êàö³ÿ (òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ____________ ____ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                                         (çàïîâíþºòüñÿ ïðè â³äïðàâëåíí³ ïðîäóêò³â (ñèðîâèíè),
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                        ùî ï³äëÿãàþòü âèêîðèñòàííþ (ïåðåðîáö³) ç îáìåæåííÿìè)
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                   (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

Îãëÿíóòî ïðîäóêò³â, ñèðîâèíè òâàðèííîãî ïîõîäæåííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, âèëó÷åíèõ ÷åðåç íåäîáðîÿê³ñí³ñòü òà ïñóâàííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, äîïóùåíèõ äî ïîäàëüøîãî òðàíñïîðòóâàííÿ

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, òà ïå÷àòêà

ì³ñöü
(øòóê)

âàãà

 

 

 

 

 

 

 

  
ÔÎÐÌÀ N 2

________________________________________
                  (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                             (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                    ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
ó òîìó, ùî ïðåä'ÿâëåí³ äëÿ îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ ________________________________
                                                                                                                                                         (âèä ïðîäóêòó àáî ñèðîâèíè)
_____________________________________________________________________________________
ó ê³ëüêîñò³ _________________________ ì³ñöü (øòóê) çàãàëüíîþ âàãîþ _______________________ êã,
                                                 (ñëîâàìè)
_____________________________________________________________________________________
                                                     (óêàçàòè, â ÿêîìó ñòàí³: ñâ³æ³, îõîëîäæåí³, ìîðîæåí³, ïð³ñíî-ñóõ³,
_____________________________________________________________________________________,
                                              ìîêðî-ñîëîí³; âîâíà - ìèòà, áðóäíà òîùî, òèï óïàêîâêè (áåç óïàêîâêè))
ïîõîäæåííÿ __________________________________________________________________________,
                                                                    (ì'ÿñî - áîºíñüêå; ñèðîâèíà - áîºíñüêà, çá³ðíà â³ä ïàäåæó òîùî)
âèâîçÿòüñÿ ³ç _________________________________________________________________________,
                                                     (íàçâà íàñåëåíîãî ïóíêòó ³ ãîñïîäàðñòâà, íàéìåíóâàííÿ ï³äïðèºìñòâà òîùî)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Ñâèíèíà äîñë³äæåíà (íåäîñë³äæåíà) íà òðèõ³íåëüîç; êîí³ ïåðåä çàáîºì ï³ääàí³ (íåï³ääàí³) ìàëå¿í³çàö³¿; ñèðîâèíà äîñë³äæåíà (íåäîñë³äæåíà) íà ñèá³ðêó; ïðîäåç³íô³êîâàíà (íåïðîäåçèíô³êîâàíà) (ïîòð³áíå ï³äêðåñëèòè). Ïðîäóêòè (ñèðîâèíà) íàïðàâëÿþòüñÿ äî ___________________________________________________________________________________
                                                                                             (óêàçàòè ïóíêò, ñòàíö³þ ïðèçíà÷åííÿ)
_____________________________________________________________________________________
çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) ç íàâàíòàæåííÿì íà ñòàíö³¿ (ïðèñòàí³, â ïîðòó) ______________________________________________
                                                                                                                       (àáî óêàçàòè ìàðøðóò ïðîõîäæåííÿ àâòîòðàíñïîðòó)

Ñïåöèô³êàö³ÿ (òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ____________ ____ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                                     (çàïîâíþºòüñÿ ïðè â³äïðàâëåíí³ ïðîäóêò³â (ñèðîâèíè),
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                  ùî ï³äëÿãàþòü âèêîðèñòàííþ (ïåðåðîáö³) ç îáìåæåííÿìè òîùî)
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                  (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

Îãëÿíóòî ïðîäóêò³â, ñèðîâèíè òâàðèííîãî ïîõîäæåííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, âèëó÷åíèõ ÷åðåç íåäîáðîÿê³ñí³ñòü òà ïñóâàííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, äîïóùåíèõ äî ïîäàëüøîãî òðàíñïîðòóâàííÿ

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, òà ïå÷àòêà

ì³ñöü
(øòóê)

âàãà

 

 

 

 

 

 

________________________________________
                  (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

  
ÔÎÐÌÀ N 2

ÊÎвÍÅÖÜ
ÂÅÒÅÐÈÍÀÐÍÎÃΠѲÄÎÖÒÂÀ N

Âèäàíèé _____________________________________________________________________________
                              (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                 ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
ó òîìó, ùî ïðåä'ÿâëåí³ äëÿ îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ ________________________________
                                                                                                                                                          (âèä ïðîäóêòó àáî ñèðîâèíè)
_____________________________________________________________________________________
ó ê³ëüêîñò³ ________________________ ì³ñöü (øòóê) çàãàëüíîþ âàãîþ ________________________ êã,
                                            (ñëîâàìè)
_____________________________________________________________________________________
                                                    (óêàçàòè, â ÿêîìó ñòàí³: ñâ³æ³, îõîëîäæåí³, ìîðîæåí³, ïð³ñíî-ñóõ³,
_____________________________________________________________________________________,
                                               ìîêðî-ñîëîí³; âîâíà - ìèòà, áðóäíà òîùî, òèï óïàêîâêè (áåç óïàêîâêè))
ïîõîäæåííÿ __________________________________________________________________________,
                                                                   (ì'ÿñî - áîºíñüêå; ñèðîâèíà - áîºíñüêà, çá³ðíà â³ä ïàäåæó òîùî)
âèâîçÿòüñÿ ³ç _________________________________________________________________________,
                                                   (íàçâà íàñåëåíîãî ïóíêòó ³ ãîñïîäàðñòâà, íàéìåíóâàííÿ ï³äïðèºìñòâà òîùî)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Ñâèíèíà äîñë³äæåíà (íåäîñë³äæåíà) íà òðèõ³íåëüîç; êîí³ ïåðåä çàáîºì ï³ääàí³ (íåï³ääàí³) ìàëå¿í³çàö³¿; ñèðîâèíà äîñë³äæåíà (íåäîñë³äæåíà) íà ñèá³ðêó; ïðîäåç³íô³êîâàíà (íåïðîäåçèíô³êîâàíà) (ïîòð³áíå ï³äêðåñëèòè). Ïðîäóêòè (ñèðîâèíà) íàïðàâëÿþòüñÿ äî ___________________________________________________________________________________
                                                                                       (óêàçàòè ïóíêò, ñòàíö³þ ïðèçíà÷åííÿ)
_____________________________________________________________________________________
çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) ç íàâàíòàæåííÿì íà ñòàíö³¿ (ïðèñòàí³, â ïîðòó) ______________________________________________
                                                                                                                     (àáî óêàçàòè ìàðøðóò ïðîõîäæåííÿ àâòîòðàíñïîðòó)

Ñïåöèô³êàö³ÿ (òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ____________ ____ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                                     (çàïîâíþºòüñÿ ïðè â³äïðàâëåíí³ ïðîäóêò³â (ñèðîâèíè),
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                      ùî ï³äëÿãàþòü âèêîðèñòàííþ (ïåðåðîáö³) ç îáìåæåííÿìè)
_____________________________________________________________________________________
_____________________________________________________________________________________
                                               (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

 

________________________________________
               (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ___________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

  
  
ÔÎÐÌÀ N 1

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                               (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                       ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
_____________________________________________________________________________________
ó òîìó, ùî ñåðåä òâàðèí ________________________________________________________________
                                                                                                               (óêàçàòè âèä òâàðèí)
ó ê³ëüêîñò³ ________________________________________ ãîë³â, ùî ïðåä'ÿâëåí³ äëÿ âåòåðèíàðíîãî
                                                               (ñëîâàìè)
îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ, õâîðèõ ³ ï³äîçðþâàíèõ íà çàõâîðþâàííÿ íà çàðàçí³ õâîðîáè íå âèÿâëåíî, âîíè âèõîäÿòü (âèâîçÿòüñÿ) ³ç ___________________________________________________
                                                                                                                                     (íàçâà íàñåëåíîãî ïóíêòó,
_____________________________________________________________________________________,
                                                                             ãîñïîäàðñòâà àáî âëàñíèêà)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Òâàðèíè ïåðåä â³äïðàâëåííÿì __________________
_____________________________________________________________________________________
                                 (óêàçàòè ñòðîêè ³ ì³ñöå ïðîô³ëàêòè÷íîãî êàðàíòèíó, ÿêèì ï³ääàâàëèñÿ äîñë³äæåííÿì,
_____________________________________________________________________________________
                                                                          ùåïëåííÿì àáî ³íøèì îáðîáêàì, äàòè)
_____________________________________________________________________________________
_____________________________________________________________________________________

Òâàðèíè íàïðàâëÿþòüñÿ ________________________________________________________________
                                                                                                   (ïóíêò, ñòàíö³ÿ ïðèçíà÷åííÿ òà îäåðæóâà÷)
äëÿ __________________________________________________________________________________
                                                                         (çàáîþ, â³äãîä³âë³, ïðîäàæó, ðîçâåäåííÿ òîùî)
³ ïðÿìóþòü: çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) çà ìàðøðóòîì _________________________________________________________________________
                                                              (óêàçàòè îñíîâí³ ïóíêòè òðàíñïîðòóâàííÿ: ñòàíö³ÿ, ïîðò íàâàíòàæåííÿ)

Ñïåöèô³êàö³ÿ (ãóðòîâà â³äîì³ñòü, òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ________________ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                       (äàòà òà íîìåð ïîãîäæåííÿ íà âèâ³ç çà ìåæ³ àäì³í³ñòðàòèâíî¿ òåðèòîð³¿)
_____________________________________________________________________________________
                        (³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ òà íîìåð ïàñïîðòà, ñåð³ÿ òà íîìåð âåòåðèíàðíî¿ êàðòêè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                      (íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí, ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                      (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ ïåðåâàíòàæåííÿ, âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

ʳëüê³ñòü îãëÿíóòèõ òâàðèí (ïòèö³, ðèáè, òîùî) (ãîë³â, ì³ñöü, âàãè)

Âèÿâëåíî

Íå âèñòà÷ຠ(ãîë³â, ì³ñöü, âàãè)

Ñê³ëüêè òâàðèí çàòðèìàíî, ïðè÷èíè çàòðèìàííÿ ³ ÿêèõ âæèòî çàõîä³â (êàðàíòèí, ùåïëåííÿ, íàäàííÿ âåòåðèíàðíî¿ äîïîìîãè òîùî)

Äîçâîëåíî äî ïîäàëüøîãî òðàíñïîðòóâàííÿ (ê³ëüê³ñòü òâàðèí, ì³ñöü òîùî)

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, ïå÷àòêà

õâîðèõ òâàðèí

òðóï³â òâàðèí

 

 

 

 

 

 

 

 

 

  
ÔÎÐÌÀ N 1

________________________________________
                 (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÊÎвÍÅÖÜ
ÂÅÒÅÐÈÍÀÐÍÎÃΠѲÄÎÖÒÂÀ N

Âèäàíèé _____________________________________________________________________________
                               (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                       ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
_____________________________________________________________________________________
ó òîìó, ùî ñåðåä òâàðèí ________________________________________________________________
                                                                                                                  (óêàçàòè âèä òâàðèí)
ó ê³ëüêîñò³ ________________________________________ ãîë³â, ùî ïðåä'ÿâëåí³ äëÿ âåòåðèíàðíîãî
                                                                      (ñëîâàìè)
îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ, õâîðèõ ³ ï³äîçðþâàíèõ íà çàõâîðþâàííÿ íà çàðàçí³ õâîðîáè íå âèÿâëåíî, âîíè âèõîäÿòü (âèâîçÿòüñÿ) ³ç ___________________________________________________
                                                                                                                                     (íàçâà íàñåëåíîãî ïóíêòó,
_____________________________________________________________________________________,
                                                                           ãîñïîäàðñòâà àáî âëàñíèêà)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Òâàðèíè ïåðåä â³äïðàâëåííÿì __________________
_____________________________________________________________________________________
                                (óêàçàòè ñòðîêè ³ ì³ñöå ïðîô³ëàêòè÷íîãî êàðàíòèíó, ÿêèì ï³ääàâàëèñÿ äîñë³äæåííÿì,
_____________________________________________________________________________________
                                                                        ùåïëåííÿì àáî ³íøèì îáðîáêàì, äàòè)
_____________________________________________________________________________________
_____________________________________________________________________________________

Òâàðèíè íàïðàâëÿþòüñÿ ________________________________________________________________
                                                                                                 (ïóíêò, ñòàíö³ÿ ïðèçíà÷åííÿ òà îäåðæóâà÷)
äëÿ __________________________________________________________________________________
                                                                         (çàáîþ, â³äãîä³âë³, ïðîäàæó, ðîçâåäåííÿ òîùî)
³ ïðÿìóþòü: çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) çà ìàðøðóòîì ___________________________________________________________________________
                                                                (óêàçàòè îñíîâí³ ïóíêòè òðàíñïîðòóâàííÿ: ñòàíö³ÿ, ïîðò íàâàíòàæåííÿ)

Ñïåöèô³êàö³ÿ (ãóðòîâà â³äîì³ñòü, òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ________________ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                       (äàòà òà íîìåð ïîãîäæåííÿ íà âèâ³ç çà ìåæ³ àäì³í³ñòðàòèâíî¿ òåðèòîð³¿)
_____________________________________________________________________________________
                       (³äåíòèô³êàö³éíèé íîìåð òâàðèíè, ñåð³ÿ òà íîìåð ïàñïîðòà, ñåð³ÿ òà íîìåð âåòåðèíàðíî¿ êàðòêè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                     (íåîáõ³äí³ â³äì³òêè, ÿê³ çàïîâíþþòüñÿ ïðè â³äïðàâëåíí³ òâàðèí, ùî ïåðåõâîð³ëè íà çàðàçí³ õâîðîáè)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                          (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

 

________________________________________
                    (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ___________________________

Îáëàñòü _______________________________

"___" ____________ 20__ ðîêó

  
ÔÎÐÌÀ N 2

ÂÅÒÅÐÈÍÀÐÍŠѲÄÎÖÒÂÎ N

Âèäàíå ______________________________________________________________________________
                              (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
ó òîìó, ùî ïðåä'ÿâëåí³ äëÿ îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ ________________________________
                                                                                                                                                           (âèä ïðîäóêòó àáî ñèðîâèíè)
_____________________________________________________________________________________
ó ê³ëüêîñò³ ________________________ ì³ñöü (øòóê) çàãàëüíîþ âàãîþ ________________________ êã,
                                                  (ñëîâàìè)
_____________________________________________________________________________________
                                                     (óêàçàòè, â ÿêîìó ñòàí³: ñâ³æ³, îõîëîäæåí³, ìîðîæåí³, ïð³ñíî-ñóõ³,
_____________________________________________________________________________________,
                                             ìîêðî-ñîëîí³; âîâíà - ìèòà, áðóäíà òîùî, òèï óïàêîâêè (áåç óïàêîâêè))
ïîõîäæåííÿ __________________________________________________________________________,
                                                                  (ì'ÿñî - áîºíñüêå; ñèðîâèíà - áîºíñüêà, çá³ðíà â³ä ïàäåæó òîùî)
âèâîçÿòüñÿ ³ç _________________________________________________________________________,
                                                           (íàçâè íàñåëåíîãî ïóíêòó ³ ãîñïîäàðñòâà, íàéìåíóâàííÿ ï³äïðèºìñòâà òîùî)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Ñâèíèíà äîñë³äæåíà (íåäîñë³äæåíà) íà òðèõ³íåëüîç; êîí³ ïåðåä çàáîºì ï³ääàí³ (íåï³ääàí³) ìàëå¿í³çàö³¿; ñèðîâèíà äîñë³äæåíà (íåäîñë³äæåíà) íà ñèá³ðêó; ïðîäåç³íô³êîâàíà (íåïðîäåçèíô³êîâàíà) (ïîòð³áíå ï³äêðåñëèòè). Ïðîäóêòè (ñèðîâèíà) íàïðàâëÿþòüñÿ äî ___________________________________________________________________________________
                                                                                         (óêàçàòè ïóíêò, ñòàíö³þ ïðèçíà÷åííÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________
çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) ç íàâàíòàæåííÿì íà ñòàíö³¿ (ïðèñòàí³, â ïîðòó) ______________________________________________
                                                                                                                    (àáî óêàçàòè ìàðøðóò ïðîõîäæåííÿ àâòîòðàíñïîðòó)

Ñïåöèô³êàö³ÿ (òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ____________ ____ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                                        (çàïîâíþºòüñÿ ïðè â³äïðàâëåíí³ ïðîäóêò³â (ñèðîâèíè),
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                              ùî ï³äëÿãàþòü âèêîðèñòàííþ (ïåðåðîáö³) ç îáìåæåííÿìè)
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                      (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

³äì³òêè ïðî âåòåðèíàðíèé îãëÿä ïðè íàâàíòàæåíí³, íà øëÿõó òðàíñïîðòóâàííÿ ³ íà ì³ñö³ âèâàíòàæåííÿ

Äàòà òà íàéìåíóâàííÿ ïóíêòó, äå ïðîâîäèâñÿ âåòåðèíàðíèé îãëÿä (Í - íàâàíòàæåííÿ, Ò - òðàíçèò, Â - âèâàíòàæåííÿ)

Îãëÿíóòî ïðîäóêò³â, ñèðîâèíè òâàðèííîãî ïîõîäæåííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, âèëó÷åíèõ ÷åðåç íåäîáðîÿê³ñí³ñòü òà ïñóâàííÿ

ʳëüê³ñòü ïðîäóêò³â, ñèðîâèíè, äîïóùåíèõ äî ïîäàëüøîãî òðàíñïîðòóâàííÿ

ϳäïèñ òà ïð³çâèùå ë³êàðÿ âåòåðèíàðíî¿ ìåäèöèíè, ÿêèé ïðîâîäèâ îãëÿä, òà ïå÷àòêà

ì³ñöü
(øòóê)

âàãà

 

 

 

 

 

 

 

  
ÔÎÐÌÀ N 2

________________________________________
                (íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó)

Ðàéîí (ì³ñòî) ____________________________

Îáëàñòü ________________________________

"___" ____________ 20__ ðîêó

 

ÊÎвÍÅÖÜ
ÂÅÒÅÐÈÍÀÐÍÎÃΠѲÄÎÖÒÂÀ N

Âèäàíèé _____________________________________________________________________________
                               (êîìó - íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè òà ¿¿ ì³ñöåçíàõîäæåííÿ àáî ïð³çâèùå, ³ì'ÿ òà ïî áàòüêîâ³
                                                                                       ô³çè÷íî¿ îñîáè òà ì³ñöå ¿¿ ïðîæèâàííÿ)
ó òîìó, ùî ïðåä'ÿâëåí³ äëÿ îãëÿäó ³ ï³äëÿãàþòü â³äïðàâëåííþ ________________________________
                                                                                                                                                         (âèä ïðîäóêòó àáî ñèðîâèíè)
_____________________________________________________________________________________
ó ê³ëüêîñò³ __________________________ ì³ñöü (øòóê) çàãàëüíîþ âàãîþ ______________________ êã,
                                               (ñëîâàìè)
_____________________________________________________________________________________
                                                      (óêàçàòè, â ÿêîìó ñòàí³: ñâ³æ³, îõîëîäæåí³, ìîðîæåí³, ïð³ñíî-ñóõ³,
_____________________________________________________________________________________,
                                                ìîêðî-ñîëîí³; âîâíà - ìèòà, áðóäíà òîùî, òèï óïàêîâêè (áåç óïàêîâêè))
ïîõîäæåííÿ __________________________________________________________________________,
                                                                      (ì'ÿñî áîºíñüêå; ñèðîâèíà - áîºíñüêà, çá³ðíà â³ä ïàäåæó òîùî)
âèâîçÿòüñÿ ³ç _________________________________________________________________________,
                                                        (íàçâè íàñåëåíîãî ïóíêòó ³ ãîñïîäàðñòâà, íàéìåíóâàííÿ ï³äïðèºìñòâà òîùî)
áëàãîïîëó÷íîãî ùîäî çàðàçíèõ õâîðîá òâàðèí. Ñâèíèíà äîñë³äæåíà (íåäîñë³äæåíà) íà òðèõ³íåëüîç; êîí³ ïåðåä çàáîºì ï³ääàí³ (íåï³ääàí³) ìàëå¿í³çàö³¿; ñèðîâèíà äîñë³äæåíà (íåäîñë³äæåíà) íà ñèá³ðêó; ïðîäåç³íô³êîâàíà (íåïðîäåçèíô³êîâàíà) (ïîòð³áíå ï³äêðåñëèòè). Ïðîäóêòè (ñèðîâèíà) íàïðàâëÿþòüñÿ äî ___________________________________________________________________________________
                                                                                               (óêàçàòè ïóíêò, ñòàíö³þ ïðèçíà÷åííÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________
çàë³çíèöåþ, âîäíèì, àâòîìîá³ëüíèì, ïîâ³òðÿíèì òðàíñïîðòîì (ïîòð³áíå ï³äêðåñëèòè) ç íàâàíòàæåííÿì íà ñòàíö³¿ (ïðèñòàí³, â ïîðòó) ______________________________________________
                                                                                                                     (àáî óêàçàòè ìàðøðóò ïðîõîäæåííÿ àâòîòðàíñïîðòó)

Ñïåöèô³êàö³ÿ (òîâàðíî-òðàíñïîðòíà íàêëàäíà) N ___ â³ä "___" ____________ ____ ðîêó.

Îñîáëèâ³ â³äì³òêè: _____________________________________________________________________
                                                                                   (çàïîâíþºòüñÿ ïðè â³äïðàâëåíí³ ïðîäóêò³â (ñèðîâèíè),
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                        ùî ï³äëÿãàþòü âèêîðèñòàííþ (ïåðåðîáö³) ç îáìåæåííÿìè)
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                    (ï³äïèñ, ïð³çâèùå, ³í³ö³àëè òà ïîñàäà îñîáè, ùî âèäàëà ñâ³äîöòâî)

 

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 1

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà æèâîòíûõ (âêëþ÷àÿ ïòèö, ðûá, íàñåêîìûõ), à òàêæå áèîëîãè÷åñêèå îáúåêòû, èñïîëüçóåìûå äëÿ ðàçìíîæåíèÿ

 

 

  

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                   (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                    ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ïðè âåòåðèíàðíîì îñìîòðå ïîäëåæàùèõ ê îòïðàâêå ________________________________
                                                                                                                                           (óêàçàòü âèä æèâîòíûõ, áèîëîãè÷åñêèõ îáúåêòîâ)
_________________________ â êîëè÷åñòâå ________________________________ ãîëîâ (ìåñò, øòóê)
áîëüíûõ è ïîäîçðèòåëüíûõ ïî çàáîëåâàíèþ çàðàçíûìè áîëåçíÿìè íå îáíàðóæåíî è îíè âûõîäÿò (âûâîçÿòñÿ) èç
_____________________________________________________________________________________
                                                                       (óêàçàòü íàèìåíîâàíèå îðãàíèçàöèè-îòïðàâèòåëÿ,
_____________________________________________________________________________________
                                                ïîëíûé àäðåñ, â ò. ÷. íàçâàíèå íàñåëåííîãî ïóíêòà, óëèöû è íîìåð äîìà,
_____________________________________________________________________________________,
                                                                      ðàéîíà, îáëàñòè, Àâòîíîìíîé Ðåñïóáëèêè Êðûì)
áëàãîïîëó÷íîãî ïî îñîáî îïàñíûì è êàðàíòèííûì áîëåçíÿì æèâîòíûõ.

Ïðè îòïðàâêå íà ýêñïîðò óêàçûâàþò áëàãîïîëó÷èå õîçÿéñòâà è ìåñòíîñòè ñîãëàñíî òðåáîâàíèÿì ñòðàíû-èìïîðòåðà è ñðîê èõ áëàãîïîëó÷èÿ (ìåñ., ëåò) _______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Æèâîòíûå íàõîäèëèñü â Óêðàèíå: ñ ðîæäåíèÿ, íå ìåíåå 6 ìåñÿöåâ (íóæíîå ïîä÷åðêíóòü)
èëè ________________________________________ ìåñÿöåâ.

Æèâîòíûå ïåðåä îòïðàâêîé êàðàíòèíèðîâàëèñü ____________________________________________
                                                                                                                               (ìåñòî êàðàíòèíèðîâàíèÿ è êîëè÷åñòâî äíåé)
_____________________________________________________________________________________

 ïåðèîä êàðàíòèíèðîâàíèÿ æèâîòíûå íå èìåëè êîíòàêòà ñ äðóãèìè æèâîòíûìè; åæåäíåâíî êëèíè÷åñêè îñìàòðèâàëèñü è ó íèõ èçìåðÿëàñü òåìïåðàòóðà òåëà; â äåíü âûäà÷è ñâèäåòåëüñòâà îáñëåäîâàíû, áîëüíûõ è ïîäîçðèòåëüíûõ â çàáîëåâàíèè íå âûÿâëåíî.

 ïåðèîä êàðàíòèíèðîâàíèÿ ìàòåðèàë îò æèâîòíûõ èññëåäîâàëñÿ â ãîñóäàðñòâåííîé âåòåðèíàðíîé ëàáîðàòîðèè __________________________________________________________________________
                                                                                               (óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè)
è áûëè ïîëó÷åíû ñëåäóþùèå ðåçóëüòàòû:

Íàèìåíîâàíèå áîëåçíè

Äàòà èññëåäîâàíèÿ

Ìåòîä èññëåäîâàíèÿ

Ðåçóëüòàòû èññëåäîâàíèÿ

 

 

 

 

Ïðîâåäåíà èììóíèçàöèÿ ïðîòèâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Æèâîòíûå îáðàáîòàíû ïðîòèâ ïàðàçèòîâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Óïàêîâî÷íûé ìàòåðèàë è ñîïðîâîæäàþùèå ãðóçû ïðîèñõîäÿò íåïîñðåäñòâåííî èç õîçÿéñòâà-ïîñòàâùèêà è íå êîíòàìèíèðîâàíû âîçáóäèòåëÿìè èíôåêöèîííûõ áîëåçíåé.

Æèâîòíûå íàïðàâëÿþòñÿ _______________________________________________________________
                                                                                                              (ïóíêò íàçíà÷åíèÿ è ïîëó÷àòåëü)
_____________________________________________________________________________________
ïðè ñïåöèôèêàöèè (âåäîìîñòü, íàêëàäíàÿ) N __________ îò "___" ________________ ãîäà
äëÿ __________________________________________________________________________________
                                                                                     (îòêîðìà, ðàçâåäåíèÿ, ïðîäàæè, óáîÿ è ò. ä.)
è ñëåäóþò ____________________________________________________________________________
                                                      (æåëåçíîäîðîæíûì, âîäíûì, àâòîìîáèëüíûì, âîçäóøíûì òðàíñïîðòîì;
_____________________________________________________________________________________
                                                                      N àâòîìîáèëÿ, âàãîíà, íàçâàíèå ñóäíà, N ðåéñà è ò. ä.)
ïî ìàðøðóòó: _________________________________________________________________________
                                                                                                 (óêàçàòü îñíîâíûå ïóíêòû ñëåäîâàíèÿ)

Òðàíñïîðòíûå ñðåäñòâà î÷èùåíû è ïðîäåçèíôèöèðîâàíû.

Îñîáûå îòìåòêè:
_____________________________________________________________________________________
                                     (çàïîëíÿåòñÿ ïðè îòïðàâêå æèâîòíûõ, ïåðåáîëåâøèõ îñîáî îïàñíûìè çàáîëåâàíèÿìè,
_____________________________________________________________________________________
                                               ïåðåâîçêå íà îñîáûõ óñëîâèÿõ è ïî ñïåöèàëüíîìó ðàçðåøåíèþ (óêàçàíèþ),
_____________________________________________________________________________________
                                                                                           êåì îíî äàíî, íîìåð è äàòà)
_____________________________________________________________________________________
                                     (îòìåòêè îðãàíîâ ãîñâåòíàäçîðà îá îñìîòðå ïðè ïîãðóçêå, âûãðóçêå, â ïóòè ñëåäîâàíèÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

Âåòåðèíàðíûé âðà÷
________________________________________
(ïîäïèñü è ïîëíîå íàèìåíîâàíèå äîëæíîñòè,
________________________________________
ôàìèëèÿ, èíèöèàëû)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 1

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà æèâîòíûõ (âêëþ÷àÿ ïòèö, ðûá, íàñåêîìûõ), à òàêæå áèîëîãè÷åñêèå îáúåêòû, èñïîëüçóåìûå äëÿ ðàçìíîæåíèÿ

 

 

  

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                       (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                           ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ïðè âåòåðèíàðíîì îñìîòðå ïîäëåæàùèõ ê îòïðàâêå ________________________________
                                                                                                                                           (óêàçàòü âèä æèâîòíûõ, áèîëîãè÷åñêèõ îáúåêòîâ)
______________________________ â êîëè÷åñòâå ______________________________________ ãîëîâ (ìåñò, øòóê) áîëüíûõ è ïîäîçðèòåëüíûõ ïî çàáîëåâàíèþ çàðàçíûìè áîëåçíÿìè íå îáíàðóæåíî è îíè âûõîäÿò (âûâîçÿòñÿ) èç
_____________________________________________________________________________________
                                                                       (óêàçàòü íàèìåíîâàíèå îðãàíèçàöèè-îòïðàâèòåëÿ,
_____________________________________________________________________________________
                                                 ïîëíûé àäðåñ, â ò. ÷. íàçâàíèå íàñåëåííîãî ïóíêòà, óëèöû è íîìåð äîìà,
_____________________________________________________________________________________,
                                                                       ðàéîíà, îáëàñòè, Àâòîíîìíîé Ðåñïóáëèêè Êðûì)
áëàãîïîëó÷íîãî ïî îñîáî îïàñíûì è êàðàíòèííûì áîëåçíÿì æèâîòíûõ.

Ïðè îòïðàâêå íà ýêñïîðò óêàçûâàþò áëàãîïîëó÷èå õîçÿéñòâà è ìåñòíîñòè ñîãëàñíî òðåáîâàíèÿì ñòðàíû - èìïîðòåðà è ñðîê èõ áëàãîïîëó÷èÿ (ìåñ., ëåò) ______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Æèâîòíûå íàõîäèëèñü â Óêðàèíå: ñ ðîæäåíèÿ, íå ìåíåå 6 ìåñÿöåâ (íóæíîå ïîä÷åðêíóòü)
èëè ________________________________________ ìåñÿöåâ.

Æèâîòíûå ïåðåä îòïðàâêîé êàðàíòèíèðîâàëèñü ____________________________________________
                                                                                                                               (ìåñòî êàðàíòèíèðîâàíèÿ è êîëè÷åñòâî äíåé)
_____________________________________________________________________________________

 ïåðèîä êàðàíòèíèðîâàíèÿ æèâîòíûå íå èìåëè êîíòàêòà ñ äðóãèìè æèâîòíûìè; åæåäíåâíî êëèíè÷åñêè îñìàòðèâàëèñü è ó íèõ èçìåðÿëàñü òåìïåðàòóðà òåëà; â äåíü âûäà÷è ñâèäåòåëüñòâà îáñëåäîâàíû, áîëüíûõ è ïîäîçðèòåëüíûõ â çàáîëåâàíèè íå âûÿâëåíî.

 ïåðèîä êàðàíòèíèðîâàíèÿ ìàòåðèàë îò æèâîòíûõ èññëåäîâàëñÿ â ãîñóäàðñòâåííîé âåòåðèíàðíîé ëàáîðàòîðèè
_____________________________________________________________________________________
                                                                                     (óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè)
è áûëè ïîëó÷åíû ñëåäóþùèå ðåçóëüòàòû:

Íàèìåíîâàíèå áîëåçíè

Äàòà èññëåäîâàíèÿ

Ìåòîä èññëåäîâàíèÿ

Ðåçóëüòàòû èññëåäîâàíèÿ

 

 

 

 

Ïðîâåäåíà èììóíèçàöèÿ ïðîòèâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Æèâîòíûå îáðàáîòàíû ïðîòèâ ïàðàçèòîâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Óïàêîâî÷íûé ìàòåðèàë è ñîïðîâîæäàþùèå ãðóçû ïðîèñõîäÿò íåïîñðåäñòâåííî èç õîçÿéñòâà-ïîñòàâùèêà è íå êîíòàìèíèðîâàíû âîçáóäèòåëÿìè èíôåêöèîííûõ áîëåçíåé.

Æèâîòíûå íàïðàâëÿþòñÿ _______________________________________________________________
                                                                                                                (ïóíêò íàçíà÷åíèÿ è ïîëó÷àòåëü)
_____________________________________________________________________________________
ïðè ñïåöèôèêàöèè (âåäîìîñòü, íàêëàäíàÿ) N __________ îò "___" ________________ ãîäà
äëÿ __________________________________________________________________________________
                                                                                 (îòêîðìà, ðàçâåäåíèÿ, ïðîäàæè, óáîÿ è ò. ä.)
è ñëåäóþò ____________________________________________________________________________
                                                           (æåëåçíîäîðîæíûì, âîäíûì, àâòîìîáèëüíûì, âîçäóøíûì òðàíñïîðòîì;
_____________________________________________________________________________________
                                                                                 N àâòîìîáèëÿ, âàãîíà, íàçâàíèå ñóäíà, N ðåéñà è ò. ä.)
ïî ìàðøðóòó: _________________________________________________________________________
                                                                                              (óêàçàòü îñíîâíûå ïóíêòû ñëåäîâàíèÿ)

Òðàíñïîðòíûå ñðåäñòâà î÷èùåíû è ïðîäåçèíôèöèðîâàíû.

Îñîáûå îòìåòêè:
_____________________________________________________________________________________
                                  (çàïîëíÿåòñÿ ïðè îòïðàâêå æèâîòíûõ, ïåðåáîëåâøèõ îñîáî îïàñíûìè çàáîëåâàíèÿìè,
_____________________________________________________________________________________
                                             ïåðåâîçêå íà îñîáûõ óñëîâèÿõ è ïî ñïåöèàëüíîìó ðàçðåøåíèþ (óêàçàíèþ),
_____________________________________________________________________________________
                                                                                           êåì îíî äàíî, íîìåð è äàòà)
_____________________________________________________________________________________
                                 (îòìåòêè îðãàíîâ ãîñâåòíàäçîðà îá îñìîòðå ïðè ïîãðóçêå, âûãðóçêå, â ïóòè ñëåäîâàíèÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

Âåòåðèíàðíûé âðà÷
________________________________________
(ïîäïèñü è ïîëíîå íàèìåíîâàíèå äîëæíîñòè,
________________________________________
ôàìèëèÿ, èíèöèàëû)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 1

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà æèâîòíûõ (âêëþ÷àÿ ïòèö, ðûá, íàñåêîìûõ), à òàêæå áèîëîãè÷åñêèå îáúåêòû, èñïîëüçóåìûå äëÿ ðàçìíîæåíèÿ

 

 

  

ÊÎÐÅØÎÊ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÂÈÄÅÒÅËÜÑÒÂÀ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                 (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                               ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ïðè âåòåðèíàðíîì îñìîòðå ïîäëåæàùèõ ê îòïðàâêå ________________________________
                                                                                                                                           (óêàçàòü âèä æèâîòíûõ, áèîëîãè÷åñêèõ îáúåêòîâ)
_________________________ â êîëè÷åñòâå ________________________________ ãîëîâ (ìåñò, øòóê)
áîëüíûõ è ïîäîçðèòåëüíûõ ïî çàáîëåâàíèþ çàðàçíûìè áîëåçíÿìè íå îáíàðóæåíî è îíè âûõîäÿò (âûâîçÿòñÿ) èç
_____________________________________________________________________________________
                                                                    (óêàçàòü íàèìåíîâàíèå îðãàíèçàöèè-îòïðàâèòåëÿ,
_____________________________________________________________________________________
                                                ïîëíûé àäðåñ, â ò. ÷. íàçâàíèå íàñåëåííîãî ïóíêòà, óëèöû è íîìåð äîìà,
_____________________________________________________________________________________,
                                                                       ðàéîíà, îáëàñòè, Àâòîíîìíîé Ðåñïóáëèêè Êðûì)
áëàãîïîëó÷íîãî ïî îñîáî îïàñíûì è êàðàíòèííûì áîëåçíÿì æèâîòíûõ.

Ïðè îòïðàâêå íà ýêñïîðò óêàçûâàþò áëàãîïîëó÷èå õîçÿéñòâà è ìåñòíîñòè ñîãëàñíî òðåáîâàíèÿì ñòðàíû-èìïîðòåðà è ñðîê èõ áëàãîïîëó÷èÿ (ìåñ., ëåò) _______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Æèâîòíûå íàõîäèëèñü â Óêðàèíå: ñ ðîæäåíèÿ, íå ìåíåå 6 ìåñÿöåâ (íóæíîå ïîä÷åðêíóòü)
èëè ________________________________________ ìåñÿöåâ.

Æèâîòíûå ïåðåä îòïðàâêîé êàðàíòèíèðîâàëèñü ____________________________________________
                                                                                                                                (ìåñòî êàðàíòèíèðîâàíèÿ è êîëè÷åñòâî äíåé)
_____________________________________________________________________________________

 ïåðèîä êàðàíòèíèðîâàíèÿ æèâîòíûå íå èìåëè êîíòàêòà ñ äðóãèìè æèâîòíûìè; åæåäíåâíî êëèíè÷åñêè îñìàòðèâàëèñü è ó íèõ èçìåðÿëàñü òåìïåðàòóðà òåëà; â äåíü âûäà÷è ñâèäåòåëüñòâà îáñëåäîâàíû, áîëüíûõ è ïîäîçðèòåëüíûõ â çàáîëåâàíèè íå âûÿâëåíî.

 ïåðèîä êàðàíòèíèðîâàíèÿ ìàòåðèàë îò æèâîòíûõ èññëåäîâàëñÿ â ãîñóäàðñòâåííîé âåòåðèíàðíîé ëàáîðàòîðèè
_____________________________________________________________________________________
                                                                                      (óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè)
è áûëè ïîëó÷åíû ñëåäóþùèå ðåçóëüòàòû:

Íàèìåíîâàíèå áîëåçíè

Äàòà èññëåäîâàíèÿ

Ìåòîä èññëåäîâàíèÿ

Ðåçóëüòàòû èññëåäîâàíèÿ

 

 

 

 

Ïðîâåäåíà èììóíèçàöèÿ ïðîòèâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Æèâîòíûå îáðàáîòàíû ïðîòèâ ïàðàçèòîâ:

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

___________________________________________________________ "___" ________________ ãîäà

Óïàêîâî÷íûé ìàòåðèàë è ñîïðîâîæäàþùèå ãðóçû ïðîèñõîäÿò íåïîñðåäñòâåííî èç õîçÿéñòâà-ïîñòàâùèêà è íå êîíòàìèíèðîâàíû âîçáóäèòåëÿìè èíôåêöèîííûõ áîëåçíåé.

Æèâîòíûå íàïðàâëÿþòñÿ _______________________________________________________________
                                                                                                            (ïóíêò íàçíà÷åíèÿ è ïîëó÷àòåëü)
_____________________________________________________________________________________
ïðè ñïåöèôèêàöèè (âåäîìîñòü, íàêëàäíàÿ) N __________ îò "___" ________________ ãîäà
äëÿ __________________________________________________________________________________
                                                                          (îòêîðìà, ðàçâåäåíèÿ, ïðîäàæè, óáîÿ è ò. ä.)
è ñëåäóþò ____________________________________________________________________________
                                                         (æåëåçíîäîðîæíûì, âîäíûì, àâòîìîáèëüíûì, âîçäóøíûì òðàíñïîðòîì;
_____________________________________________________________________________________
                                                                  N àâòîìîáèëÿ, âàãîíà, íàçâàíèå ñóäíà, N ðåéñà è ò. ä.)
ïî ìàðøðóòó: _________________________________________________________________________
                                                                                             (óêàçàòü îñíîâíûå ïóíêòû ñëåäîâàíèÿ)

Òðàíñïîðòíûå ñðåäñòâà î÷èùåíû è ïðîäåçèíôèöèðîâàíû.

Îñîáûå îòìåòêè:
_____________________________________________________________________________________
                               (çàïîëíÿåòñÿ ïðè îòïðàâêå æèâîòíûõ, ïåðåáîëåâøèõ îñîáî îïàñíûìè çàáîëåâàíèÿìè,
_____________________________________________________________________________________
                                               ïåðåâîçêå íà îñîáûõ óñëîâèÿõ è ïî ñïåöèàëüíîìó ðàçðåøåíèþ (óêàçàíèþ),
_____________________________________________________________________________________
                                                                                  êåì îíî äàíî, íîìåð è äàòà)
_____________________________________________________________________________________
                             (îòìåòêè îðãàíîâ ãîñâåòíàäçîðà îá îñìîòðå ïðè ïîãðóçêå, âûãðóçêå, â ïóòè ñëåäîâàíèÿ)
_____________________________________________________________________________________
_____________________________________________________________________________________

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

Âåòåðèíàðíûé âðà÷
________________________________________
(ïîäïèñü è ïîëíîå íàèìåíîâàíèå äîëæíîñòè,
________________________________________
ôàìèëèÿ, èíèöèàëû)

 

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 2

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà ïðîäóêòû è ïðîäîâîëüñòâåííîå ñûðüå æèâîòíîãî ïðîèñõîæäåíèÿ

 

 

  

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                   (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                       ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ____________________________________________________________________________
                                                                                                     (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå __________________________, _____________________, ________________________,
                                                  (ìåñò, øòóê, êã)                                         (óïàêîâêà)                                         (ìàðêèðîâêà)
âûðàáîòàííàÿ _________________________________________________________________________
                                                                             (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
                                                                                           (äàòà âûðàáîòêè)
ïîäâåðãíóòà âåòåðèíàðíî-ñàíèòàðíîé ýêñïåðòèçå â ïîëíîì îáúåìå /
èçãîòîâëåíà èç ñûðüÿ, ïðîøåäøåãî âåòåðèíàðíî-ñàíèòàðíóþ ýêñïåðòèçó (íóæíîå ïîä÷åðêíóòü),
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                             (ðåàëèçàöèè áåç îãðàíè÷åíèé, ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû
_____________________________________________________________________________________
                                                                  èëè ïåðåðàáîòêè ñîãëàñíî ïðàâèëàì âåòñàíýêñïåðòèçû)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                                  (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ, óñëîâèÿ ïåðåâîçêè)
â _____________________________ ïî ____________________________________________________
           (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)                   (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)
Ïðîäóêöèÿ ïîäâåðãíóòà äîïîëíèòåëüíûì ëàáîðàòîðíûì èññëåäîâàíèÿì _______________________
                                                                                                                                                                                         (íàèìåíîâàíèå
_____________________________________________________________________________________
                                                          ëàáîðàòîðèè, N ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèÿ)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                        (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
                                              âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,

_____________________________________________________________________________________
                                                                                  ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Âåòåðèíàðíîå ñâèäåòåëüñòâî ïîëó÷èë:
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî)
________________________________________
(äîëæíîñòü)
________________________________________
(äàòà è ïîäïèñü)

  
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 2

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà æèâîòíûõ (âêëþ÷àÿ ïòèö, ðûá, íàñåêîìûõ), à òàêæå áèîëîãè÷åñêèå îáúåêòû, èñïîëüçóåìûå äëÿ ðàçìíîæåíèÿ

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                   (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                  ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ____________________________________________________________________________
                                                                                               (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå _______________________, ____________________, ____________________________,
                                               (ìåñò, øòóê, êã)                                   (óïàêîâêà)                                             (ìàðêèðîâêà)
âûðàáîòàííàÿ _________________________________________________________________________
                                                                             (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
                                                                                                (äàòà âûðàáîòêè)
ïîäâåðãíóòà âåòåðèíàðíî-ñàíèòàðíîé ýêñïåðòèçå â ïîëíîì îáúåìå /
èçãîòîâëåíà èç ñûðüÿ, ïðîøåäøåãî âåòåðèíàðíî-ñàíèòàðíóþ ýêñïåðòèçó (íóæíîå ïîä÷åðêíóòü),
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                           (ðåàëèçàöèè áåç îãðàíè÷åíèé, ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû
_____________________________________________________________________________________
                                                                  èëè ïåðåðàáîòêè ñîãëàñíî ïðàâèëàì âåòñàíýêñïåðòèçû)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                             (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ, óñëîâèÿ ïåðåâîçêè)
â ______________________________ ïî ___________________________________________________
           (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)                    (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)

Ïðîäóêöèÿ ïîäâåðãíóòà äîïîëíèòåëüíûì ëàáîðàòîðíûì èññëåäîâàíèÿì _______________________
                                                                                                                                                                                         (íàèìåíîâàíèå
_____________________________________________________________________________________
                                                                     ëàáîðàòîðèè, N ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèÿ)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                           (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
                                             âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,
_____________________________________________________________________________________
                                                                                       ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Âåòåðèíàðíîå ñâèäåòåëüñòâî ïîëó÷èë:
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî)
________________________________________
(äîëæíîñòü)
________________________________________
(äàòà è ïîäïèñü)

  
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 2

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà ïðîäóêòû è ïðîäîâîëüñòâåííîå ñûðüå æèâîòíîãî ïðîèñõîæäåíèÿ

ÊÎÐÅØÎÊ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÂÈÄÅÒÅËÜÑÒÂÀ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                               (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                               ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ____________________________________________________________________________
                                                                                               (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå ________________________, _____________________, __________________________,
                                                  (ìåñò, øòóê, êã)                                      (óïàêîâêà)                                         (ìàðêèðîâêà)
âûðàáîòàííàÿ _________________________________________________________________________
                                                                            (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
                                                                                                     (äàòà âûðàáîòêè)
ïîäâåðãíóòà âåòåðèíàðíî-ñàíèòàðíîé ýêñïåðòèçå â ïîëíîì îáúåìå /
èçãîòîâëåíà èç ñûðüÿ, ïðîøåäøåãî âåòåðèíàðíî-ñàíèòàðíóþ ýêñïåðòèçó (íóæíîå ïîä÷åðêíóòü),
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                            (ðåàëèçàöèè áåç îãðàíè÷åíèé, ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû
_____________________________________________________________________________________
                                                                  èëè ïåðåðàáîòêè ñîãëàñíî ïðàâèëàì âåòñàíýêñïåðòèçû)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                              (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ, óñëîâèÿ ïåðåâîçêè)
â _______________________________ ïî __________________________________________________
              (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)                    (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)

Ïðîäóêöèÿ ïîäâåðãíóòà äîïîëíèòåëüíûì ëàáîðàòîðíûì èññëåäîâàíèÿì _______________________
                                                                                                                                                                                         (íàèìåíîâàíèå
_____________________________________________________________________________________
                                                                  ëàáîðàòîðèè, N ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèÿ)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                           (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
                                                 âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,
_____________________________________________________________________________________
                                                                                          ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Âåòåðèíàðíîå ñâèäåòåëüñòâî ïîëó÷èë:
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî)
________________________________________
(äîëæíîñòü)
________________________________________
(äàòà è ïîäïèñü)

  
________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

 

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 3

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà òåõíè÷åñêîå ñûðüå è êîðìà

 

 

  

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                 (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ____________________________________________________________________________
                                                                                                       (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå _______________________, ________________________, ________________________,
                                                   (ìåñò, øòóê, êã)                                        (óïàêîâêà)                                        (ìàðêèðîâêà)
ïðîèñõîæäåíèå _______________________________________________________________________,
                                                             (áîåíñêîå, ïàëîå, ñáîðíîå, ïîëó÷åííîå îò çäîðîâûõ èëè áîëüíûõ æèâîòíûõ)
âûðàáîòàíà (çàãîòîâëåíà) ïîä êîíòðîëåì ãîñâåòñëóæáû ______________________________________
                                                                                                                               (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                                 (ðåàëèçàöèè, ïåðåðàáîòêè, èñïîëüçîâàíèÿ áåç îãðàíè÷åíèé,
                                                                                         åñëè ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû è ðåæèì)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                                                       (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ)
â ____________________________________________________________________________________
                                                                                       (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)
ïî ___________________________________________________________________________________
                                                            (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)

Ñûðüå (êîðìà) ïîäâåðãíóòî _____________________________________________________________
                                                                       (äåçèíôåêöèè, ìîéêå, êîíñåðâàöèè - óêàçàòü ìåòîä è íàèìåíîâàíèå ïðåïàðàòîâ,
_____________________________________________________________________________________
              èññëåäîâàíèÿì - óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè, N, äàòó âûäà÷è ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèé)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                         (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                                   âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,
_____________________________________________________________________________________
                                                                                       ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 3

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà òåõíè÷åñêîå ñûðüå è êîðìà

 

 

  

ÂÅÒÅÐÈÍÀÐÍÎÅ ÑÂÈÄÅÒÅËÜÑÒÂÎ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                       (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                   ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
â òîì, ÷òî ____________________________________________________________________________
                                                                                                   (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå _______________________, ________________________, ________________________,
                                                (ìåñò, øòóê, êã)                                      (óïàêîâêà)                                              (ìàðêèðîâêà)
ïðîèñõîæäåíèå _______________________________________________________________________,
                                                              (áîåíñêîå, ïàëîå, ñáîðíîå, ïîëó÷åííîå îò çäîðîâûõ èëè áîëüíûõ æèâîòíûõ)
âûðàáîòàíà (çàãîòîâëåíà) ïîä êîíòðîëåì ãîñâåòñëóæáû ______________________________________
                                                                                                                                (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                                   (ðåàëèçàöèè, ïåðåðàáîòêè, èñïîëüçîâàíèÿ áåç îãðàíè÷åíèé,
                                                                                              åñëè ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû è ðåæèì)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                                                 (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ)
â ____________________________________________________________________________________
                                                                                      (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)
ïî ___________________________________________________________________________________
                                                      (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)

Ñûðüå (êîðìà) ïîäâåðãíóòî _____________________________________________________________
                                                                       (äåçèíôåêöèè, ìîéêå, êîíñåðâàöèè - óêàçàòü ìåòîä è íàèìåíîâàíèå ïðåïàðàòîâ,
_____________________________________________________________________________________
             èññëåäîâàíèÿì - óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè, N, äàòó âûäà÷è ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèé)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                            (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                          âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,
_____________________________________________________________________________________
                                                                                       ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

Äëÿ îòïðàâêè ïîäêîíòðîëüíûõ ãðóçîâ â ñòðàíû ÑÍÃ

Ôîðìà N 3

 

Âûäàåòñÿ âåòåðèíàðíûìè âðà÷àìè ãîñâåòó÷ðåæäåíèé íà òåõíè÷åñêîå ñûðüå è êîðìà

 

 

  

ÊÎÐÅØÎÊ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÂÈÄÅÒÅËÜÑÒÂÀ N

îò "___" ____________ 20__ ãîäà

ß, íèæåïîäïèñàâøèéñÿ âåòåðèíàðíûé âðà÷, âûäàë íàñòîÿùåå âåòåðèíàðíîå ñâèäåòåëüñòâî
_____________________________________________________________________________________
                                   (êîìó - íàèìåíîâàíèå þðèäè÷åñêîãî ëèöà è åãî ìåñòîíàõîæäåíèå èëè Ô. È. Î.
                                                                 ôèçè÷åñêîãî ëèöà è ìåñòî åãî ïðîæèâàíèÿ)
_____________________________________________________________________________________
â òîì, ÷òî ____________________________________________________________________________
                                                                                            (íàèìåíîâàíèå ïðîäóêöèè)
_____________________________________________________________________________________
â êîëè÷åñòâå ________________________, ________________________, _______________________,
                                                 (ìåñò, øòóê, êã)                                           (óïàêîâêà)                                           (ìàðêèðîâêà)
ïðîèñõîæäåíèå _______________________________________________________________________,
                                                                 (áîåíñêîå, ïàëîå, ñáîðíîå, ïîëó÷åííîå îò çäîðîâûõ èëè áîëüíûõ æèâîòíûõ)
âûðàáîòàíà (çàãîòîâëåíà) ïîä êîíòðîëåì ãîñâåòñëóæáû ______________________________________
                                                                                                                                (íàèìåíîâàíèå ïðåäïðèÿòèÿ, Ô. È. Î. âëàäåëüöà, àäðåñ)
_____________________________________________________________________________________,
ïðèçíàíà ãîäíîé äëÿ ___________________________________________________________________
                                                                                      (ðåàëèçàöèè, ïåðåðàáîòêè, èñïîëüçîâàíèÿ áåç îãðàíè÷åíèé,
                                                                                              åñëè ñ îãðàíè÷åíèÿìè - óêàçàòü ïðè÷èíû è ðåæèì)
è íàïðàâëÿåòñÿ ________________________________________________________________________
                                                                                                    (âèä òðàíñïîðòà, ìàðøðóò ñëåäîâàíèÿ)
â ____________________________________________________________________________________
                                                                                   (íàèìåíîâàíèå è àäðåñ ïîëó÷àòåëÿ)
ïî ___________________________________________________________________________________
                                                            (íàèìåíîâàíèå, N è äàòà âûäà÷è òîâàðîòðàíñïîðòíîãî äîêóìåíòà)

Ñûðüå (êîðìà) ïîäâåðãíóòî _____________________________________________________________
                                                                    (äåçèíôåêöèè, ìîéêå, êîíñåðâàöèè - óêàçàòü ìåòîä è íàèìåíîâàíèå ïðåïàðàòîâ,
_____________________________________________________________________________________
            èññëåäîâàíèÿì - óêàçàòü íàèìåíîâàíèå ëàáîðàòîðèè, N, äàòó âûäà÷è ýêñïåðòèçû è ðåçóëüòàòû èññëåäîâàíèé)

Îñîáûå îòìåòêè: ______________________________________________________________________
                                                             (óêàçûâàþòñÿ ýïèçîîòè÷åñêîå áëàãîïîëó÷èå ìåñòíîñòè, äàòà è íîìåð ðàçðåøåíèÿ
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
                                             âûøåñòîÿùåãî ãîñâåòèíñïåêòîðà íà âûâîç ïðîäóêöèè çà ïðåäåëû òåððèòîðèè,
_____________________________________________________________________________________
                                                                                      ïåðå÷èñëÿþòñÿ NN êëåéì è äð.)

Òðàíñïîðòíîå ñðåäñòâî î÷èùåíî è ïðîäåçèíôèöèðîâàíî.

Ñâèäåòåëüñòâî ïðåäúÿâëÿåòñÿ äëÿ êîíòðîëÿ ïðè ïîãðóçêå, â ïóòè ñëåäîâàíèÿ è ïåðåäàåòñÿ ãðóçîïîëó÷àòåëþ.

Êîïèè ñâèäåòåëüñòâà íå äåéñòâèòåëüíû. Ïðè óñòàíîâëåíèè íàðóøåíèé çàïîëíåíèÿ áëàíêà ñâèäåòåëüñòâî ïåðåäàåòñÿ ãëàâíîìó ãîñóäàðñòâåííîìó èíñïåêòîðó âåòåðèíàðíîé ìåäèöèíû ïî ìåñòó âûäà÷è ñ óêàçàíèåì âûÿâëåííûõ íàðóøåíèé.

Ì. Ï.

________________________________________
(ôàìèëèÿ, èìÿ, îò÷åñòâî âåòâðà÷à)
________________________________________
(äîëæíîñòü)
________________________________________
(ïîäïèñü)

 

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

̲ÆÍÀÐÎÄÍÈÉ ÂÅÒÅÐÈÍÀÐÍÈÉ ÑÅÐÒÈÔ²ÊÀÒ N
INTERNATIONAL VETERINARY CERTIFICATE
íà ì'ÿñî, ì'ÿñí³ òà ìîëî÷í³ ïðîäóêòè, ðèáó ³ ðèáîïðîäóêòè, ÿê³ åêñïîðòóþòü ç Óêðà¿íè
for meat, meat and milk products, fish and fish products exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò _______________________________________________________
Frontier Inspection Post

Íàéìåíóâàííÿ ïðîäóêö³¿ ________________________________________________________________
Name of the product

ʳëüê³ñòü ì³ñöü ________________________________________________________________________
Number of the products

Óïàêîâêà _____________________________________________________________________________
Type of package

Ìàðêóâàííÿ __________________________________________________________________________
Identification marks

Âàãà íåòòî ____________________________________________________________________________
Net weight

1. ÏÎÕÎÄÆÅÍÍß ÏÐÎÄÓÊÖ²¯ / ORIGIN OF THE PRODUCT

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ
_____________________________________________________________________________________
Name and address of producer, indicate the name of administrative territory
_____________________________________________________________________________________

Ïîõîäæåííÿ ïðîäóêö³¿ __________________________________________________________________
Origin of the product

2. ÍÀÏÐÀÂËÅÍÍß ÏÐÎÄÓÊÖ²¯ / DESTINATION OF THE PRODUCT

Êðà¿íà ïðèçíà÷åííÿ ____________________________________________________________________
Country of destination

Êðà¿íè òðàíçèòó _______________________________________________________________________
Countries of transit

Ïóíêò ïåðåòèíó êîðäîíó ________________________________________________________________
Point of crossing the board

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à ___________________________________________
Name and address of consignee

Òðàíñïîðò
(âêàçàòè N âàãîí³â, àâòîìàøèí, ðåéñè ë³òàêà, ñóäíà) ________________________________________
_____________________________________________________________________________________
Means of transport
(specify the number of the wagon, truck, flight number, name of the ship)

Ìàðøðóò ðóõó òðàíñïîðòó _______________________________________________________________
Route of transportation

N íàêëàäíèõ __________________________________________________________________________
No of consignments

3. ß, ÙÎ ÍÈÆ׊ϲÄÏÈÑÀÂÑß, ˲ÊÀÐ ÄÅÐÆÀÂÍί ÂÅÒÅÐÈÍÀÐÍί ÌÅÄÈÖÈÍÈ, ÇÀѲÄ×ÓÞ, ÙÎ ÏÎÄÀͲ ÄÎ ÎÃËßÄÓ Ì'ßÑÎ, Ì'ßÑͲ ÒÀ ÌÎËÎ×Ͳ ÏÐÎÄÓÊÒÈ, ÐÈÁÀ ² ÐÈÁÎÏÐÎÄÓÊÒÈ:

I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination meat, meat and milk products, fish and fish products:

îäåðæàí³ â³ä çäîðîâèõ òâàðèí, âèçíàí³ ïðèäàòíèìè äëÿ âæèâàííÿ â ¿æó                                                   
derived from healthy animals, recognized as fit for consumption

âèðîáëåí³ íà ï³äïðèºìñòâàõ, ùî ïåðåáóâàþòü ï³ä ïîñò³éíèì êîíòðîëåì äåðæàâíî¿ âåòåðèíàðíî¿ ñëóæáè, ìàþòü åêñïëóàòàö³éíèé äîçâ³ë íà åêñïîðò ³ â³äïîâ³äàþòü âåòåðèíàðíèì âèìîãàì
Óêðà¿íè                                                            
manufactured at the enterprises, which are under permanent supervision of the State Veterinary Services, have export permission and satisfy veterinary requirements of the Ukraine

âèõîäÿòü ç îáëàñò³, áëàãîïîëó÷íî¿ ùîäî ³íôåêö³éíèõ çàõâîðþâàíü òâàðèí (çà ñïèñêîì ÌÅÁ) òà ÿùóðó ïðîòÿãîì á³ëüø ÿê                          ì³ñÿö³â                                                                                                        
derived from the premises and locality, which are safe with respect with to infectious diseases (included in the O.I.E. list) and foot and months desease since more than ______________________ months

äî çàáîþ òâàðèíè áóëè ï³ääàí³ âåòåðèíàðíîìó îãëÿäó, à òóø³ òà îðãàíè â³ä íèõ - ï³ñëÿçàá³éí³é âåòåðèíàðíî-ñàí³òàðí³é åêñïåðòèç³, ñâèíèíó áóëî äîñë³äæåíî íà òðèõ³íåëüîç ç íåãàòèâíèì ðåçóëüòàòîì                                                                                                                            _                          
before slaughter the animals were subjected to the veterinary inspection; carcasses and their organs were - subjected to meat inspection; meat of swines was examined for measles, trichinellose with negative results

ì'ÿñí³ òà ìîëî÷í³ ïðîäóêòè, ðèáîïðîäóêòè ïåðåä â³äïðàâëåííÿì äîñë³äæåí³ íà ðàä³îàêòèâíå çàáðóäíåííÿ â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ, ð³âåíü ðàä³îàêòèâíîãî çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå ïåðåâèùóº                               Áê/êã                                
the meat and milk products, fish products before shipment were tested for radioactive contamination in the State Veterinary Laboratory, licensed for such tests. The level of contamination did not exceed ________________________ Bk/kg

4. ÄÎÄÀÒÊÎÂÀ ²ÍÔÎÐÌÀÖ²ß / ADDITIONAL INFORMATION

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ ìåòîäàìè òà çàñîáàìè, ùî ïðèéíÿò³ â Óêðà¿í³ ______
Means of Transport were cleaned and disinfected by methods and means, approved in the Ukraine

Óêëàäåíî / Made on "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                             (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

Ïå÷àòêà/Stamp                                           Ï³äïèñ/Signature __________________

  

ÓÊÐÀ¯ÍÀ
UKRAINE

___________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

ÊÎвÍÅÖÜ Ì²ÆÍÀÐÎÄÍÎÃÎ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÅÐÒÈÔ²ÊÀÒÀ
                                                                                               N
COUNTERFOIL OF INTERNATIONAL
VETERINARY CERTIFICATE
íà ì'ÿñî, ì'ÿñí³ òà ìîëî÷í³ ïðîäóêòè, ðèáó ³ ðèáîïðîäóêòè, ÿê³ åêñïîðòóþòü ç Óêðà¿íè
for meat, meat and milk products, fish and fish products exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò _______________________________________________________
Frontier Inspection Post

Íàéìåíóâàííÿ ïðîäóêö³¿ ________________________________________________________________
Name of the product

ʳëüê³ñòü ì³ñöü _________________________________________________________________________
Number of the products

Óïàêîâêà _____________________________________________________________________________
Type of package

Ìàðêóâàííÿ ___________________________________________________________________________
Identification marks

Âàãà íåòòî ____________________________________________________________________________
Net weight

1. ÏÎÕÎÄÆÅÍÍß ÏÐÎÄÓÊÖ²¯ / ORIGIN OF THE PRODUCT

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ ______________________________________________________________________________________
Name and address of producer, indicate the name of administrative territory
______________________________________________________________________________________

Ïîõîäæåííÿ ïðîäóêö³¿ ___________________________________________________________________
Origin of the product

2. ÍÀÏÐÀÂËÅÍÍß ÏÐÎÄÓÊÖ²¯ / DESTINATION OF THE PRODUCT

Êðà¿íà ïðèçíà÷åííÿ ____________________________________________________________________
Country of destination

Êðà¿íè òðàíçèòó _______________________________________________________________________
Countries of transit

Ïóíêò ïåðåòèíó êîðäîíó ________________________________________________________________
Point of crossing the board

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à ____________________________________________
Name and address of consignee

Òðàíñïîðò
(âêàçàòè N âàãîí³â, àâòîìàøèí, ðåéñè ë³òàêà, ñóäíà)                                                                                  
_____________________________________________________________________________________
Means of transport
(specify the number of the wagon, truck, flight number, name of the ship)

Ìàðøðóò ðóõó òðàíñïîðòó ______________________________________________________________
Route of transportation

N íàêëàäíèõ __________________________________________________________________________
No of consignments

3. ß, ÙÎ ÍÈÆ׊ϲÄÏÈÑÀÂÑß, ˲ÊÀÐ ÄÅÐÆÀÂÍί ÂÅÒÅÐÈÍÀÐÍί ÌÅÄÈÖÈÍÈ, ÇÀѲÄ×ÓÞ, ÙÎ ÏÎÄÀͲ ÄÎ ÎÃËßÄÓ Ì'ßÑÎ, Ì'ßÑͲ ÒÀ ÌÎËÎ×Ͳ ÏÐÎÄÓÊÒÈ, ÐÈÁÀ ² ÐÈÁÎÏÐÎÄÓÊÒÈ:

I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination meat, meat and milk products, fish and fish products:

îäåðæàí³ â³ä çäîðîâèõ òâàðèí, âèçíàí³ ïðèäàòíèìè äëÿ âæèâàííÿ â ¿æó                                                   
derived from healthy animals, recognized as fit for consumption

âèðîáëåí³ íà ï³äïðèºìñòâàõ, ùî ïåðåáóâàþòü ï³ä ïîñò³éíèì êîíòðîëåì äåðæàâíî¿ âåòåðèíàðíî¿ ñëóæáè, ìàþòü åêñïëóàòàö³éíèé äîçâ³ë íà åêñïîðò ³ â³äïîâ³äàþòü âåòåðèíàðíèì âèìîãàì
Óêðà¿íè                                                                 
manufactured at the enterprises, which are under permanent supervision of the State Veterinary Services, have export permission and satisfy veterinary requirements of the Ukraine

âèõîäÿòü ç îáëàñò³, áëàãîïîëó÷íî¿ ùîäî ³íôåêö³éíèõ çàõâîðþâàíü òâàðèí (çà ñïèñêîì ÌÅÁ) òà ÿùóðó ïðîòÿãîì á³ëüø ÿê                               ì³ñÿö³â                                                                                                   
derived from the premises and locality, which are safe with respect with to infectious diseases (included in the O.I.E. list) and foot and months desease since more than ______________________ months

- äî çàáîþ òâàðèíè áóëè ï³ääàí³ âåòåðèíàðíîìó îãëÿäó, à òóø³ òà îðãàíè â³ä íèõ - ï³ñëÿçàá³éí³é âåòåðèíàðíî-ñàí³òàðí³é åêñïåðòèç³, ñâèíèíó áóëî äîñë³äæåíî íà òðèõ³íåëüîç ç íåãàòèâíèì ðåçóëüòàòîì                                                                                                                                                        
before slaughter the animals were subjected to the veterinary inspection; carcasses and their organs were - subjected to meat inspection; meat of swines was examined for measles, trichinellose with negative results

ì'ÿñí³ òà ìîëî÷í³ ïðîäóêòè, ðèáîïðîäóêòè ïåðåä â³äïðàâëåííÿì äîñë³äæåí³ íà ðàä³îàêòèâíå çàáðóäíåííÿ â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ, ð³âåíü ðàä³îàêòèâíîãî çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå ïåðåâèùóº                             Áê/êã                                  
the meat and milk products, fish products before shipment were tested for radioactive contamination in the State Veterinary Laboratory, licensed for such tests. The level of contamination did not exceed ________________________ Bk/kg

4. ÄÎÄÀÒÊÎÂÀ ²ÍÔÎÐÌÀÖ²ß / ADDITIONAL INFORMATION

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ ìåòîäàìè òà çàñîáàìè, ùî ïðèéíÿò³ â Óêðà¿í³             
Means of Transport were cleaned and disinfected by methods and means, approved in the Ukraine

Óêëàäåíî / Made on "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                                   (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

Ïå÷àòêà/Stamp                                     Ï³äïèñ/Signature __________________

 

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

̲ÆÍÀÐÎÄÍÈÉ ÂÅÒÅÐÈÍÀÐÍÈÉ ÑÅÐÒÈÔ²ÊÀÒ N
INTERNATIONAL VETERINARY CERTIFICATE
íà ñèðîâèíó òâàðèííîãî ïîõîäæåííÿ, ÿêó åêñïîðòóþòü ç Óêðà¿íè
for raw of animal origin exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò _______________________________________________________
Frontier Inspection Post

Íàéìåíóâàííÿ ïðîäóêö³¿ / Name of the product _______________________________________________

ʳëüê³ñòü ì³ñöü / Number of packages _______________________________________________________

Óïàêîâêà / Type of package _______________________________________________________________

Ìàðêóâàííÿ / Identification marks ___________________________________________________________

Âàãà íåòòî / Net weight ___________________________________________________________________

1. Ïîõîäæåííÿ ïðîäóêö³¿ / Origin of the product

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ
Name and address of producer, indicate the name of administrative territory
_____________________________________________________________________________________

Ïîõîäæåííÿ ïðîäóêö³¿
Origin of the product _____________________________________________________________________
                                                                  (çá³ðíà, áîºíñüêà, ³íø³ äæåðåëà / from collected, slaughter, other sourses)

2. Íàïðàâëåííÿ ïðîäóêö³¿ / Destination of the product

Êðà¿íà ïðèçíà÷åííÿ / Country of destination __________________________________________________

Êðà¿íè òðàíçèòó / Countries of transit ________________________________________________________

Ïóíêò ïåðåòèíó êîðäîíó / Point of crossing the board ___________________________________________

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à
Name and address of consignee _____________________________________________________________

Òðàíñïîðò / Means of transport _____________________________________________________________
                                                                                              (âêàçàòè N âàãîíà, àâòîìàøèíè, ðåéñ ë³òàêà, ñóäíà /
                                                                                specify the number of the wagon, truck, flight number, name of the ship)

3. ß, ùî íèæ÷å ï³äïèñàâñÿ, ë³êàð äåðæàâíî¿ âåòåðèíàðíî¿ ìåäèöèíè, çàñâ³ä÷óþ, ùî ïîäàíà äî îãëÿäó âêàçàíà ñèðîâèíà:
I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination raw product:

îäåðæàíà â³ä çàáîþ çäîðîâèõ òâàðèí íà ï³äïðèºìñòâàõ, ùî ìàþòü åêñïëóàòàö³éíèé äîçâ³ë íà åêñïîðò ñèðîâèíè;
derived from healthy animals at the premises, having permission for export of raw product;

ïîõîäèòü ç ãîñïîäàðñòâ ³ ì³ñöåâîñò³, áëàãîïîëó÷íèõ ùîäî ³íôåêö³éíèõ õâîðîá çà ñïèñêîì ÌÅÁ ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â, à òàêîæ ñèá³ðêè (äëÿ õóòðÿíî¿ òà øê³ðÿíî¿ ñèðîâèíè) òà ñàëüìîíåëüîçó (äëÿ ïóõó ³ ï³ð'ÿ);
derived from the premises and locality, free from infectious diseases, included in the O.I.E. list during the 12 months, as well as anthrax (for fur, hides and skins) and salmonellosis (for down and feather);

çá³ðíó øê³ðÿíó ñèðîâèíó ïîâí³ñòþ äîñë³äæåíî ùîäî ñèá³ðêè ç íåãàòèâíèì ðåçóëüòàòîì â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ.
collected hides and skins, raw products were completely tested with negative results for anthrax in the State Veterinary Laboratory, licenced for carrying out such tests.

Ñèðîâèíó ïåðåä â³äïðàâêîþ äîñë³äæåíî ________________________ íà ðàä³îàêòèâíå çàáðóäíåííÿ â
                                                                                                             (äàòà äîñë³äæåííÿ)
äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ð³âåíü ðàä³îàêòèâíîãî çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå âèùå ______________________ Áê/êã.
The products before shipment were tested _______________________ for radioactive contamination in the
                                                                                                    (date of examination)
State Veterinary Laboratory, the level of contamination did not exceed ______________________ Bk/kg.

Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ ìåòîäàìè òà çàñîáàìè, ùî ïðèéíÿò³ â Óêðà¿í³.
Means of transport were cleaned and disinfected by the methods and means, approved in the Ukraine.

Óêëàäåíî / Made on "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                               (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

Ïå÷àòêà/Stamp                                        Ï³äïèñ/Signature ____________________________________

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

ÊÎвÍÅÖÜ Ì²ÆÍÀÐÎÄÍÎÃÎ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÅÐÒÈÔ²ÊÀÒÀ N
COUNTERFOIL OF INTERNATIONAL
VETERINARY CERTIFICATE
íà ñèðîâèíó òâàðèííîãî ïîõîäæåííÿ, ÿêó åêñïîðòóþòü ç Óêðà¿íè
for raw of animal origin exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò _______________________________________________________
Frontier Inspection Post

Íàéìåíóâàííÿ ïðîäóêö³¿ / Name of the product _______________________________________________

ʳëüê³ñòü ì³ñöü / Number of packages _______________________________________________________

Óïàêîâêà / Type of package _______________________________________________________________

Ìàðêóâàííÿ / Identification marks ___________________________________________________________

Âàãà íåòòî / Net weight ___________________________________________________________________

1. Ïîõîäæåííÿ ïðîäóêö³¿ / Origin of the product

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ
Name and address of producer, indicate the name of administrative territory
_____________________________________________________________________________________

Ïîõîäæåííÿ ïðîäóêö³¿
Origin of the product ____________________________________________________________________
                                                                      (çá³ðíà, áîºíñüêà, ³íø³ äæåðåëà / from collected, slaughter, other sourses)

2. Íàïðàâëåííÿ ïðîäóêö³¿ / Destination of the product

Êðà¿íà ïðèçíà÷åííÿ / Country of destination _________________________________________________

Êðà¿íè òðàíçèòó / Countries of transit _______________________________________________________

Ïóíêò ïåðåòèíó êîðäîíó / Point of crossing the board __________________________________________

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à
Name and address of consignee _____________________________________________________________

Òðàíñïîðò / Means of transport ____________________________________________________________
                                                                                                   (âêàçàòè N âàãîíà, àâòîìàøèíè, ðåéñ ë³òàêà, ñóäíà /
                                                                                specify the number of the wagon, truck, flight number, name of the ship)

3. ß, ùî íèæ÷å ï³äïèñàâñÿ, ë³êàð äåðæàâíî¿ âåòåðèíàðíî¿ ìåäèöèíè, çàñâ³ä÷óþ, ùî ïîäàíà äî îãëÿäó âêàçàíà ñèðîâèíà:
I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination raw product:

îäåðæàíà â³ä çàáîþ çäîðîâèõ òâàðèí íà ï³äïðèºìñòâàõ, ùî ìàþòü åêñïëóàòàö³éíèé äîçâ³ë íà åêñïîðò ñèðîâèíè;
derived from healthy animals at the premises, having permission for export of raw product;

ïîõîäèòü ç ãîñïîäàðñòâ ³ ì³ñöåâîñò³, áëàãîïîëó÷íèõ ùîäî ³íôåêö³éíèõ õâîðîá çà ñïèñêîì ÌÅÁ ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â, à òàêîæ ñèá³ðêè (äëÿ õóòðÿíî¿ òà øê³ðÿíî¿ ñèðîâèíè) òà ñàëüìîíåëüîçó (äëÿ ïóõó ³ ï³ð'ÿ);
derived from the premises and locality, free from infectious diseases, included in the O.I.E. list during the 12 months, as well as anthrax (for fur, hides and skins) and salmonellosis (for down and feather);

çá³ðíó øê³ðÿíó ñèðîâèíó ïîâí³ñòþ äîñë³äæåíî ùîäî ñèá³ðêè ç íåãàòèâíèì ðåçóëüòàòîì â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ.
collected hides and skins, raw products were completely tested with negative results for anthrax in the State Veterinary Laboratory, licenced for carrying out such tests.

Ñèðîâèíó ïåðåä â³äïðàâêîþ äîñë³äæåíî ________________________ íà ðàä³îàêòèâíå çàáðóäíåííÿ â
                                                                                                           (äàòà äîñë³äæåííÿ)
äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ð³âåíü ðàä³îàêòèâíîãî çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå âèùå ______________________ Áê/êã.
The products before shipment were tested ________________________ for radioactive contamination in the
                                                                                                    (date of examination)
State Veterinary Laboratory, the level of contamination did not exceed ______________________ Bk/kg.

Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ ìåòîäàìè òà çàñîáàìè, ùî ïðèéíÿò³ â Óêðà¿í³.
Means of transport were cleaned and disinfected by the methods and means, approved in the Ukraine.

Óêëàäåíî / Made on "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                                 (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

Ïå÷àòêà/Stamp                                      Ï³äïèñ/Signature ____________________________________

 

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

̲ÆÍÀÐÎÄÍÈÉ ÂÅÒÅÐÈÍÀÐÍÈÉ ÑÅÐÒÈÔ²ÊÀÒ
INTERNATIONAL VETERINARY CERTIFICATE N
íà êîðìè ðîñëèííîãî ïîõîäæåííÿ, ÿê³ åêñïîðòóþòü ç Óêðà¿íè
for feeds of vegetal origin exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò
Frontier Inspection Post __________________________________________________________________

Íàéìåíóâàííÿ ïðîäóêö³¿
Name of the product ____________________________________________________________________

Âàãà íåòòî
Net weight ____________________________________________________________________________

1. Ïîõîäæåííÿ ïðîäóêö³¿ / Origin of the product

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ _____________________________________________________________________________________
Name and address of producer, indicate the name of administrative territory ____________________________

2. Íàïðàâëåííÿ ïðîäóêö³¿ / Destination of the product

Êðà¿íà ïðèçíà÷åííÿ
Country of destination ____________________________________________________________________

Êðà¿íè òðàíçèòó
Countries of transit _______________________________________________________________________

Ïóíêò ïåðåòèíó êîðäîíó
Point of crossing the board _________________________________________________________________

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à
Name and address of consignee _____________________________________________________________

Òðàíñïîðò
Means of transport _______________________________________________________________________
                                                                     (âêàçàòè N âàãîíà, àâòîìàøèíè / specify the number of the wagon, truck)

3. ß, ùî íèæ÷å ï³äïèñàâñÿ, ë³êàð äåðæàâíî¿ âåòåðèíàðíî¿ ìåäèöèíè, çàñâ³ä÷óþ, ùî ïîäàí³ äî îãëÿäó âêàçàí³ êîðìè ðîñëèííîãî ïîõîäæåííÿ ïîõîäÿòü ³ç ì³ñöåâîñò³, â³ëüíî¿ â³ä ³íôåêö³éíèõ õâîðîá òâàðèí çà ñïèñêîì ÌÅÁ ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â, à òàêîæ â³ä ³íøèõ ãîñòðîçàðàçíèõ ³íôåêö³éíèõ õâîðîá, ÿê³ íåáåçïå÷í³ äëÿ âåëèêî¿ ðîãàòî¿ õóäîáè, ñâèíåé òà ïòèö³; ïðîòÿãîì îñòàíí³õ 3 ì³ñÿö³â íå ìàþòü â ñîá³ åíòåðîïàòîãåííî¿ ì³êðîôëîðè ³ ñàëüìîíåë òà òîêñèãåííèõ ãðèá³â, ùî ï³äòâåðäæóºòüñÿ åêñïåðòèçîþ äåðæàâíî¿ âåòåðèíàðíî¿ ëàáîðàòîð³¿, ÿêà àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ. Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ çàñîáàìè òà ìåòîäàìè, ùî ïðèéíÿò³ â Óêðà¿í³.

(I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination above mentional feeds of vegetal origin: originate from the locality, free both from infectious disease included in the O.I.E. list during the last 12 months, and also from other infectious diseases, which are dangerous for cows, pigs and poultry, during the last 3 months: do not contain enteropathogenic strains of microflora and salmonella and toxigenic fungi what is confirmed by the examination in the State Veterinary Laboratory, approved for conducting such examinations. Means of transport have been cleaned and disinfected by the methods and means approved in Ukraine.)

Çåðíî ïåðåä â³äïðàâêîþ ______________ ðîêó ïåðåâ³ðåíî íà ðàä³îàêòèâíå çàáðóäíåííÿ â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ.
Åêñïåðòèçà N ______ íà ðàä³îàêòèâíå çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå âèùå ______________ Áê/êã.
The grains before shipment on ______________ were tested for radioactive contamination in the State Veterinary Laboratory licensed for conducting such tests.
Analysis N ________ the level of contamination did not exceed ______________ Bk/kg.

Óêëàäåíî / Made on _______________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                                     (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

ϳäïèñ/Signature
Ì. Ï./Stamp

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

ÊÎвÍÅÖÜ Ì²ÆÍÀÐÎÄÍÎÃÎ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÅÐÒÈÔ²ÊÀÒÀ
COUNTERFOIL OF INTERNATIONAL
VETERINARY CERTIFICATE N
íà êîðìè ðîñëèííîãî ïîõîäæåííÿ, ÿê³ åêñïîðòóþòü ç Óêðà¿íè
for feeds of vegetal origin exported from Ukraine

Ïðèêîðäîííèé ³íñïåêö³éíèé ïóíêò
Frontier Inspection Post __________________________________________________________________

Íàéìåíóâàííÿ ïðîäóêö³¿
Name of the product ____________________________________________________________________

Âàãà íåòòî
Net weight ____________________________________________________________________________

1. Ïîõîäæåííÿ ïðîäóêö³¿ / Origin of the product

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ âèðîáíèêà, âêàçàòè àäì³í³ñòðàòèâíî-òåðèòîð³àëüíó îäèíèöþ _____________________________________________________________________________________
Name and address of producer, indicate the name of administrative territory ____________________________

2. Íàïðàâëåííÿ ïðîäóêö³¿ / Destination of the product

Êðà¿íà ïðèçíà÷åííÿ
Country of destination ____________________________________________________________________

Êðà¿íè òðàíçèòó
Countries of transit _______________________________________________________________________

Ïóíêò ïåðåòèíó êîðäîíó
Point of crossing the board _________________________________________________________________

Íàéìåíóâàííÿ òà ì³ñöåçíàõîäæåííÿ îäåðæóâà÷à
Name and address of consignee _____________________________________________________________

Òðàíñïîðò
Means of transport _______________________________________________________________________
                                                                          (âêàçàòè N âàãîíà, àâòîìàøèíè / specify the number of the wagon, truck)

3. ß, ùî íèæ÷å ï³äïèñàâñÿ, ë³êàð äåðæàâíî¿ âåòåðèíàðíî¿ ìåäèöèíè, çàñâ³ä÷óþ, ùî ïîäàí³ äî îãëÿäó âêàçàí³ êîðìè ðîñëèííîãî ïîõîäæåííÿ ïîõîäÿòü ³ç ì³ñöåâîñò³, â³ëüíî¿ â³ä ³íôåêö³éíèõ õâîðîá òâàðèí çà ñïèñêîì ÌÅÁ ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â, à òàêîæ â³ä ³íøèõ ãîñòðîçàðàçíèõ ³íôåêö³éíèõ õâîðîá, ÿê³ íåáåçïå÷í³ äëÿ âåëèêî¿ ðîãàòî¿ õóäîáè, ñâèíåé òà ïòèö³; ïðîòÿãîì îñòàíí³õ 3 ì³ñÿö³â íå ìàþòü â ñîá³ åíòåðîïàòîãåííî¿ ì³êðîôëîðè ³ ñàëüìîíåë òà òîêñèãåííèõ ãðèá³â, ùî ï³äòâåðäæóºòüñÿ åêñïåðòèçîþ äåðæàâíî¿ âåòåðèíàðíî¿ ëàáîðàòîð³¿, ÿêà àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ. Òðàíñïîðòí³ çàñîáè î÷èùåí³ òà ïðîäåç³íô³êîâàí³ çàñîáàìè òà ìåòîäàìè, ùî ïðèéíÿò³ â Óêðà¿í³.

(I, the undersigned veterinarian of the Government of the Ukraine certify, that subjected to examination above mentional feeds of vegetal origin: originate from the locality, free both from infectious disease included in the O.I.E. list during the last 12 months, and also from other infectious diseases, which are dangerous for cows, pigs and poultry, during the last 3 months: do not contain enteropathogenic strains of microflora and salmonella and toxigenic fungi what is confirmed by the examination in the State Veterinary Laboratory, approved for conducting such examinations. Means of transport have been cleaned and disinfected by the methods and means approved in Ukraine.)

Çåðíî ïåðåä â³äïðàâêîþ ______________ ðîêó ïåðåâ³ðåíî íà ðàä³îàêòèâíå çàáðóäíåííÿ â äåðæàâí³é âåòåðèíàðí³é ëàáîðàòîð³¿, ùî àêðåäèòîâàíà íà òàê³ äîñë³äæåííÿ.
Åêñïåðòèçà N ______ íà ðàä³îàêòèâíå çàáðóäíåííÿ ïðè äîñë³äæåíí³ íå âèùå ______________ Áê/êã.
The grains before shipment on ______________ were tested for radioactive contamination in the State Veterinary Laboratory licensed for conducting such tests.
Analysis N ________ the level of contamination did not exceed ______________ Bk/kg.

Óêëàäåíî / Made on _______________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
_____________________________________________________________________________________
                                                                               (ïîñàäà, ïð³çâèùå, ³í³ö³àëè / title, name)

ϳäïèñ/Signature
Ì. Ï./Stamp

 

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

̲ÆÍÀÐÎÄÍÈÉ ÂÅÒÅÐÈÍÀÐÍÈÉ ÑÅÐÒÈÔ²ÊÀÒ
INTERNATIONAL VETERINARY CERTIFICATE N
Ïðî ñòàí çäîðîâ'ÿ òâàðèí
On origin and health of animals

ß, ùî íèæ÷å ï³äïèñàâñÿ, äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
I, signing below, state doctor of veterinary medicine
_____________________________________________________________________________________,
                                                                              (ïð³çâèùå, ³í³ö³àëè, ïîñàäà / name, title)
çàñâ³ä÷óþ, ùî ï³ñëÿ ïðîâåäåíîãî ìíîþ êë³í³÷íîãî îãëÿäó _____________________________________
hereby certify that after the testing conducted by myself                                            (äàòà/date)
òâàðèíè ______________________________________________________________________________
animals                                                                     (âèä òâàðèí / animals species)
â ê³ëüêîñò³ ______________________________________________________________________ ãîë³â,
in number                                                                                                                                                 heads
ùî íàëåæàòü
belonging to
_____________________________________________________________________________________
      (íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè, íàñåëåíîãî ïóíêòó, ðàéîíó, îáëàñò³ / names of legal entity, village, district, region)
_____________________________________________________________________________________
³ â³äïðàâëÿþòüñÿ ______________________________________________________________________
directed to                                         (êðà¿íà, ïóíêò ïåðåòèíó êîðäîíó ³ ê³íöåâèé ïóíêò ïðèçíà÷åííÿ /
                                                                         country, point of crossing the board and the last station of destination)
_____________________________________________________________________________________,
                                         (N àâòîìàøèí, âàãîí³â àáî íàçâà ñóäíà, ðåéñó ë³òàêà (ïîòð³áíå ï³äêðåñëèòè) /
                                              N of carriage or ship's name, plane flight, cargo cars) (please underline)
ïðîòÿãîì 21 äíÿ ïåðåáóâàëè ï³ä âåòåðèíàðíèì íàãëÿäîì ³ âèçíàí³ êë³í³÷íî çäîðîâèìè.
under veterinary surveillance during 21 days and found as healthy clinically.

Òâàðèíè, ÿê³ âèõîäÿòü ç Óêðà¿íè, â³ëüí³ â³ä ÿùóðó, âåçèêóëÿðíîãî ñòîìàòèòó, âåçèêóëÿðíî¿ õâîðîáè ñâèíåé, ÷óìè âåëèêî¿ ³ äð³áíî¿ ðîãàòî¿ õóäîáè, êîíòàã³îçíî¿ ïëåâðîïíåâìîí³¿ âåëèêî¿ ðîãàòî¿ õóäîáè, âóçëèêîâîãî äåðìàòèòó, ïðîïàñíèö³ äîëèíè Ðèôò, áëóòàíãà, â³ñïè îâåöü ³ ê³ç, àôðèêàíñüêî¿ ÷óìè êîíåé, àôðèêàíñüêî¿ ÷óìè ñâèíåé, ÷óìè ïòèö³.

Animals from Ukraine are free from foot-and-mouth disease, vesicular stomatitis, vesicular disease of swine, cattle goat and sheep pest, contagious pleuropneumonia of cattle, dermatitis nodulosa, Rift valley fever, blue tongue, sheep and goat pox, African pest of horses, African swine fever, poultry cholera.

Ö³ òâàðèíè âèõîäÿòü ³ç àäì³í³ñòðàòèâíîãî   __________________________________________ ðàéîíó,
These animals are originated from administrative                                                                                      region,
áëàãîïîëó÷íîãî ùîäî êëàñè÷íî¿ ÷óìè ñâèíåé, ÷óìè ïòèö³, òà ³ç ãîñïîäàðñòâà, áëàãîïîëó÷íîãî ùîäî áðóöåëüîçó, òóáåðêóëüîçó, ëåïòîñï³ðîçó, êàìï³ëîáàêòåð³îçó, òðèõîìîíîçó, ï³ðîïëàçì³äîç³â, ñèá³ðêè, òðèõîô³ò³¿, â³ðóñíî¿ ä³àðå¿, õâîðîáè Àóºñê³, ïàðàòóáåðêóëüîçó, ³íôåêö³éíîãî ðèíîòðàõå¿òó ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â.
free from hog cholera and from farm without brucellosis, tuberculosis, leptospirosis, campylobacillosis, trichomonosis, pyroplasmidosis, anthrax, trichophytosis, viral diarrhoea, Aujeszky disease, paratuberculosis, infectious rinotracheitis during the last 12 months.

Òâàðèí äîñë³äæåíî ç íåãàòèâíèì ðåçóëüòàòîì íà:
Animals were tested with negative results for:

òóáåðêóëüîç _____________________ - âíóòð³øíüîøê³ðíèé òåñò, òóáåðêóë³í ÏÏÄ;
tuberculosis                 (äàòà/date)                 intracutaneous test, PPD tuberculin;

áðóöåëüîç _____________________ - ÐÀ, ÐÑÊ, ÐÁÏ;
brucellosis                 (äàòà/date)                FN, CFT, RBA;

åíçîîòè÷íèé ëåéêîç _____________________ - ðåàêö³ÿ ³ìóíîäèôó糿
enzootic leucemia                        (äàòà/date)                immunodiffusion test

Òâàðèí âàêöèíîâàíî ïðîòè:
Animals are vaccinated against:

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

Òâàðèí çà 14 äí³â äî â³äïðàâêè äâ³÷³ îáðîáèëè ïðîòè ëåïòîñï³ðîçó äèã³äðîñòðåïòîì³öèíîì ó äîç³ ïî 25 ìã/êã ìàñè ò³ëà ç ³íòåðâàëîì ó 14 äí³â.
Animals were treated twice 14 days before departure against leptospirosis with dihydrostreptomycinum in dose 25 mg/kg of bodyweight with 14 days interval.

Ì'ÿñî, ùî éîãî îäåðæàòü â³ä çàáîþ öèõ òâàðèí, çà ðàä³îàêòèâíèì çàáðóäíåííÿì íå ïåðåâèùóâàòèìå ì³æíàðîäíèõ ãðàíè÷íîäîïóñòèìèõ ð³âí³â (600 Áê).
The meat obtained from these animals after slaughter will not exceed the international permissible level of radioactive contamination (600 Bk).

Òâàðèíàì íå ââîäèëè ñèíòåòè÷í³ ãîðìîíàëüí³ àáî òèðåîñòàòè÷í³ ïðåïàðàòè òà àíòèá³îòèêè.
The animals were not treated with synthetic hormonal or thyreostatic drugs and antibiotics.

Çàñîáè òðàíñïîðòóâàííÿ ïðîäåç³íô³êîâàíî.
Transportation means are disinfected.

Óêëàäåíî "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
______________________________                                      ______________________________
                        (ï³äïèñ/signature)                                                                                         (ïð³çâèùå, ³í³ö³àëè / name)

Ì. Ï.
(Stamp)

  

ÓÊÐÀ¯ÍÀ
UKRAINE

____________________________________________________
(íàéìåíóâàííÿ êîìïåòåíòíîãî îðãàíó / name of the Competent Authority)

ÊÎвÍÅÖÜ Ì²ÆÍÀÐÎÄÍÎÃÎ
ÂÅÒÅÐÈÍÀÐÍÎÃÎ ÑÅÐÒÈÔ²ÊÀÒÀ
COUNTERFOIL OF INTERNATIONAL
VETERINARY CERTIFICATE N
Ïðî ñòàí çäîðîâ'ÿ òâàðèí
On origin and health of animals

ß, ùî íèæ÷å ï³äïèñàâñÿ, ë³êàð äåðæàâíî¿ âåòåðèíàðíî¿ ìåäèöèíè
I, signing below, state doctor of veterinary medicine
_____________________________________________________________________________________,
                                                                                    (ïð³çâèùå, ³í³ö³àëè, ïîñàäà / name, title)
çàñâ³ä÷óþ, ùî ï³ñëÿ ïðîâåäåíîãî ìíîþ êë³í³÷íîãî îãëÿäó _____________________________________
hereby certify that after the testing conducted by myself                                                  (äàòà/date)
òâàðèíè ______________________________________________________________________________
animals                                                                     (âèä òâàðèí / animals species)
â ê³ëüêîñò³ ______________________________________________________________________ ãîë³â,
in number                                                                                                                                                 heads,
ùî íàëåæàòü
belonging to
_____________________________________________________________________________________
       (íàéìåíóâàííÿ þðèäè÷íî¿ îñîáè, íàñåëåíîãî ïóíêòó, ðàéîíó, îáëàñò³ / names of legal entity, village, district, region)
_____________________________________________________________________________________
³ â³äïðàâëÿþòüñÿ ______________________________________________________________________
directed to                                             (êðà¿íà, ïóíêò ïåðåòèíó êîðäîíó ³ ê³íöåâèé ïóíêò ïðèçíà÷åííÿ /
                                                                               country, point of crossing the board and the last station of destination)
_____________________________________________________________________________________,
                                        (N àâòîìàøèí, âàãîí³â àáî íàçâà ñóäíà, ðåéñó ë³òàêà) (ïîòð³áíå ï³äêðåñëèòè) /
                                              N of carriage or ship's name, plane flight, cargo cars) (please underline)
ïðîòÿãîì 21 äíÿ ïåðåáóâàëè ï³ä âåòåðèíàðíèì íàãëÿäîì ³ âèçíàí³ êë³í³÷íî çäîðîâèìè.
under veterinary surveillance during 21 days and found as healthy clinically.

Òâàðèíè âèõîäÿòü ç Óêðà¿íè, â³ëüí³ â³ä ÿùóðó, âåçèêóëÿðíîãî ñòîìàòèòó, âåçèêóëÿðíî¿ õâîðîáè ñâèíåé, ÷óìè âåëèêî¿ ³ äð³áíî¿ ðîãàòî¿ õóäîáè, êîíòàã³îçíî¿ ïëåâðîïíåâìîí³¿ âåëèêî¿ ðîãàòî¿ õóäîáè, âóçëèêîâîãî äåðìàòèòó, ïðîïàñíèö³ äîëèíè Ðèôò, áëóòàíãà, â³ñïè îâåöü ³ ê³ç, àôðèêàíñüêî¿ ÷óìè êîíåé, àôðèêàíñüêî¿ ÷óìè ñâèíåé, ÷óìè ïòèö³.
Animals from Ukraine are free from foot-and-mouth disease, vesicular stomatitis, vesicular disease of swine, cattle goat and sheep pest, contagious pleuropneumonia of cattle, dermatitis nodulosa, Rift valley fever, blue tongue, sheep and goat pox, African pest of horses, African swine fever, poultry cholera.

Ö³ òâàðèíè âèõîäÿòü ³ç àäì³í³ñòðàòèâíîãî   __________________________________________ ðàéîíó,
These animals are originated from administrative                                                                                      region,
áëàãîïîëó÷íîãî ùîäî êëàñè÷íî¿ ÷óìè ñâèíåé, ÷óìè ïòèö³, òà ³ç ãîñïîäàðñòâà, áëàãîïîëó÷íîãî ùîäî áðóöåëüîçó, òóáåðêóëüîçó, ëåïòîñï³ðîçó, êàìï³ëîáàêòåð³îçó, òðèõîìîíîçó, ï³ðîïëàçì³äîç³â, ñèá³ðêè, òðèõîô³ò³¿, â³ðóñíî¿ ä³àðå¿, õâîðîáè Àóºñê³, ïàðàòóáåðêóëüîçó, ³íôåêö³éíîãî ðèíîòðàõå¿òó ïðîòÿãîì îñòàíí³õ 12 ì³ñÿö³â.
free from hog cholera and from farm without brucellosis, tuberculosis, leptospirosis, campylobacillosis, trichomonosis, pyroplasmidosis, anthrax, trichophytosis, viral diarrhoea, Aujeszky disease, paratuberculosis, infectious rinotracheitis during the last 12 months.

Òâàðèí äîñë³äæåíî ç íåãàòèâíèì ðåçóëüòàòîì íà:
Animals were tested with negative results for:

òóáåðêóëüîç _____________________ - âíóòð³øíüîøê³ðíèé òåñò, òóáåðêóë³í ÏÏÄ;
tuberculosis                  (äàòà/date)              - intracutaneous test, PPD tuberculin;

áðóöåëüîç _____________________ - ÐÀ, ÐÑÊ, ÐÁÏ;
brucellosis                (äàòà/date)                 FN, CFT, RBA;

åíçîîòè÷íèé ëåéêîç _____________________ - ðåàêö³ÿ ³ìóíîäèôó糿
enzootic leucemia                           (äàòà/date)             immunodiffusion test

Òâàðèí âàêöèíîâàíî ïðîòè:
Animals are vaccinated against:

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

_________________________

_________________________
(äàòà/date)

_________________________

Òâàðèí çà 14 äí³â äî â³äïðàâêè äâ³÷³ îáðîáèëè ïðîòè ëåïòîñï³ðîçó äèã³äðîñòðåïòîì³öèíîì ó äîç³ ïî 25 ìã/êã ìàñè ò³ëà ç ³íòåðâàëîì ó 14 äí³â.
Animals were treated twice 14 days before departure against leptospirosis with dihydrostreptomycinum in dose 25 mg/kg of bodyweight with 14 days interval.

Ì'ÿñî, ùî îäåðæàòü â³ä çàáîþ öèõ òâàðèí, çà ðàä³îàêòèâíèì çàáðóäíåííÿì íå ïåðåâèùóâàòèìå ì³æíàðîäíèõ ãðàíè÷íîäîïóñòèìèõ ð³âí³â (600 Áê).
The meat obtained from these animals after slaughter will not exceed the international permissible level of radioactive contamination (600 Bk).

Òâàðèíàì íå ââîäèëè ñèíòåòè÷í³ ãîðìîíàëüí³ àáî òèðåîñòàòè÷í³ ïðåïàðàòè òà àíòèá³îòèêè.
The animals were not treated with synthetic hormonal or thyreostatic drugs and antibiotics.

Çàñîáè òðàíñïîðòóâàííÿ ïðîäåç³íô³êîâàíî.
Transportation means are disinfected.

Óêëàäåíî "___" ____________ 20__ ðîêó

Äåðæàâíèé ë³êàð âåòåðèíàðíî¿ ìåäèöèíè
State doctor of veterinary medicine
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                          (ï³äïèñ/signature)                                                                                        (ïð³çâèùå, ³í³ö³àëè / name)

Ì. Ï.
(Stamp)

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