1 Inspection No. ......... Time ......... A. P. M. Date ...... 190
2 All persons in the households of those engaged in producing or handling milk are ......... free from all infectious disease .........
3 Date and nature of last case on farm .........
4 A sample of the water supply on this farm taken for analysis ......... 190... and found to be .........
| STABLE | Perfect | Allow |
| 5
COW STABLE is ...... located on
elevated ground with no stagnant water, hog pen, or privy within 100 feet | 1 | ... |
| 6 FLOORS
are ...... constructed of concrete or some nonabsorbent material | 1 | ... |
| 7 Floors are
...... properly graded and water-tight | 2 | ... |
| 8
DROPS are ......
constructed of concrete, stone, or some nonabsorbent material | 2 | ... |
| 9 Drops are
...... water-tight | 2 | ... |
| 10
FEEDING TROUGHS, platforms, or cribs are ...
well lighted and clean | 1 | ... |
| 11
CEILING is constructed of
...... and is ......
tight and dust proof | 2 | ... |
| 12 Ceiling is
...... free from hanging straw, dirt, or cobwebs | 1 | ... |
| 13
NUMBER OF WINDOWS
...... total square feet ... which is
...... sufficient | 2 | ... |
| 14 Window panes are
...... washed and kept clean | 1 | ... |
| 15
VENTILATION consists of
...... which is sufficient 3, fair 1, insufficient 0 | 3 | ... |
| 16
AIR SPACE is
...... cubic feet per cow which is
...... sufficient (600 and over—3) (500 to
600—2) (400 to 500—1) (under 400—0) | 3 | ... |
| 17
INTERIOR of stable painted or whitewashed on
...... which is satisfactory 2, fair 1, never 0 | 2 | ... |
| 18 WALLS
AND LEDGES are ...... free from dirt, dust, manure, or cobwebs | 2 | ... |
| 19 FLOORS
AND PREMISES are ...... free from dirt,
rubbish, or decayed animal or vegetable matter | 1 | ... |
| 20 COW BEDS are
...... clean | 1 | ... |
| 21 LIVE
STOCK, other than cows, are ...... excluded
from rooms in which milch cows are kept | 2 | ... |
| 22 There is
...... direct opening from barn into
silo or grain pit | 1 | ... |
| 23
BEDDING used is
...... clean, dry, and absorbent | 1 | ... |
| 24 SEPARATE BUILDING is ...... provided for cows
when sick | 1 | ... |
| 25 Separate quarters are ...... provided for cows
when calving | 1 | ... |
| 26 MANURE is ...... removed daily to at least 200
feet from the barn ( ... ft.) | 2 | ... |
| 27 Manure pile is ...... so located that the cows
cannot get at it | 1 | ... |
| 28 LIQUID MATTER is ...... absorbed and removed
daily and ...... allowed to overflow and saturate ground under or around cow barn | 2 | ... |
| 29 RUNNING WATER supply for washing stables is
...... located within building | 1 | ... |
| 30 DAIRY RULES of the Department of Health are
...... posted | 1 | ... |
| COW YARD | | |
| 31 COW YARD is ...... properly graded and drained | 1 | ... |
| 32 Cow yard is ...... clean, dry, and free from
manure | 2 | ... |
| COWS | | |
| 33 COWS have ...... been examined by veterinarian ...
Date ...... 190 Report was | 3 | ... |
| 34 Cows have ...... been tested by tuberculin, and
all tuberculous cows removed | 5 | ... |
| 35 Cows are ...... all in good flesh and condition
at time of inspection | 2 | ... |
| 36 Cows are ...... all free from clinging manure and
dirt. (No. dirty ... ) | 4 | ... |
| 37 LONG HAIRS are ...... kept short on belly, flanks,
udder, and tail | 1 | ... |
| 38 UDDER AND TEATS of cows are ...... thoroughly
cleaned before milking | 2 | ... |
| 39 ALL FEED is ...... of good quality and all grain
and coarse fodders are ...... free from dirt and mold | 1 | ... |
| 40 DISTILLERY waste or any substance in a state
of fermentation or putrefaction is ...... fed | 1 | ... |
| 41 WATER SUPPLY for cows is ...... unpolluted and
plentiful | 2 | ... |
| MILKERS AND MILKING | | |
| 42 ATTENDANTS are ...... in good physical condition | 1 | ... |
| 43 Special Milking Suits are ...... used | 1 | ... |
| 44 Clothing of milkers is ...... clean | 1 | ... |
| 45 Hands of milkers are ...... washed clean before
milking | 1 | ... |
| 46 MILKING is ...... done with dry hands | 2 | ... |
| 47 FORE MILK or first few streams from each teat
is ...... discarded | 2 | ... |
| 48 Milk is strained at ...... and ...... in clean
atmosphere | 1 | ... |
| 49 Milk strainer is ...... clean | 1 | ... |
| 50 MILK is ...... cooled to below 50° F. within two
hours after milking and kept below 50° F. until delivered to the creamery ...... ° | 2 | ... |
| 51 Milk from cows within 15 days before or 5 days
after parturition is ...... discarded | 1 | ... |
| UTENSILS | | |
| 52 MILK PAILS have ...... all seams soldered flush | 1 | ... |
| 53 Milk pails are ...... of the small-mouthed design,
top opening not exceeding 8 inches in diameter. Diameter ...... | 2 | ... |
| 54 Milk pails are ...... rinsed with cold water
immediately after using and washed clean with hot water and washing solution | 2 | ... |
| 55 Drying racks are ...... provided to expose milk
pails to the sun | 1 | ... |
| MILK HOUSE | | |
| 56 MILK HOUSE is ...... located on elevated ground
with no hog pen, manure pile, or privy within 100 feet | 1 | ... |
| 57 Milk house has ...... direct communication with
...... building | 1 | ... |
| 58 Milk house has ...... sufficient light and
ventilation | 1 | ... |
| 59 Floor is ...... properly graded and water-tight | 1 | ... |
| 60 Milk house is ...... free from dirt, rubbish, and all material not used in the handling and storage of milk | 1 | ... |
| 61 Milk house has ...... running or still supply of
pure clean water | 1 | ... |
| 62 Ice is ...... used for cooling milk and is cut from ... | 1 | ... |
| WATER | | |
| 63 WATER SUPPLY for utensils is from a ...... located
...... feet deep and apparently is ...... pure, wholesome, and uncontaminated | 5 | ... |
| 64 Is ...... protected against flood or surface
drainage | 2 | ... |
| 65 There is ...... privy or cesspool within 250 feet
( ... feet) of source of water supply | 2 | ... |
| 66 There is ...... stable, barnyard, or pile of
manure or other source of contamination within 200 feet ( ... feet) of source of water supply | 1 | ... |
| | 100 | |