FCI Poultry

Plant Name/EU number

Poultry Slaughter

Regulation (EC) No 853/2004, Annex II, Section III, Regulation (EC) No854/2004, Annex I, Section I, Regulation (EC)

No 2074/2005, Annex I, Regulation (EC) No 1/2005, Council Directive 2007/43/EC

Slaughter Date

FOOD CHAIN INFORMATION – TO BE COMPLETED AT FARM OF ORIGIN (*indicates that the box should be completed for first consignment only – see guideline

document)

Grower Name

Grower Address, Telephone Number

Crop ID/Flock Identifier Code

Place of Loading (if different)

Farm Private Veterinary Practitioner

Time of feed withdrawal

Date of loading

Catching Time – Start

Catching Time – Finish

Departure Time

Transport Registration No.

Number of Birds

Number of Birds per Crate

Enter Breed Type*

Flock/Registration No.

House No.

DOC Placement date*

Age (days)

Thinning – Circle

1st 2nd Final

Production Type* - Circle

Conventional / FR / Organic

Flock Evenness* - Circle

Good / Average / Poor

House fumigated prior to

placement of DOC* - Circle

Yes No

No of days from cleaning and

disinfection to placement of DOC*

Floor Temperature at

placement of DOC*

Litter Type*

Litter Quality – Circle

Dry+Friable / Partly Capped

Mostly Capped / Wet+Sticky

MORTALITY AND VETERINARY FINDINGS: Please arrange electronic transfer to slaughterhouse or attach paper copy of Veterinary Findings/Post Mortem

reports or indicate if this information was already submitted for this Crop ID with a previous consignment (Tick as appropriate)

Cumulative Daily Mortality Rate (CDMR)%

% Mortality at 7 days

Summary of Veterinary Findings

% Mortality from 7 days to date

Summary of Veterinary Findings

Where PRESCRIPTION MEDICATION was administered, please consult Annex 1 on reverse for details required on the prescription.

Please arrange electronic transfer of prescription(s) to slaughterhouse or attach paper copy of prescription(s) or indicate if this information was already

submitted for this crop ID with a previous consignment (tick as appropriate)

DECLARATION OF GROWER:

I present the above birds for slaughter for human consumption and declare that, to the best of my knowledge and judgement, the flock or holding of origin is not under

disease control restriction or investigation,

 the flock is healthy and has not tested positive for any condition which would render the meat unfit for human consumption,

 all feed additive and prescribed medication withdrawal periods have been observed,

 the means of transport is suitable and in a hygienic condition at the time of loading,

 the birds were not subjected to avoidable or undue stress during handling and loading,

 estimated transport time does not exceed 8 hours,

 the house was sampled for the presence of Salmonella within 3 weeks ** prior to the first movement of birds from the house as required by SI No 64 of 2009 on

_______________ (date). Results are Positive Negative (Tick as appropriate – if no result, treat as positive).

**NOTE: The exception is laying hens, which are tested for Salmonella every 15 weeks to comply with Regulation (EC) No 2160/2003.

Other accompanying documents, including reference number of health certificate, where applicable

Signed _________________________________ Person in charge Date ____________________

TO BE COMPLETED BY THE HAULIER/DRIVER

Name of Haulier/Driver:

Trailer covers used: Yes / No (Please circle as appropriate)

I declare that the transport vehicle was clean at the time of loading and that all precautions were taken to ensure the welfare of the birds during transport.

Haulier signature: _____________________________________ Date ____________________

BIRD INTAKE – TO BE COMPLETED AT SLAUGHTERHOUSE BY OPERATOR

DECLARATION OF FOOD BUSINESS OPERATOR: (Please circle Yes or No, as appropriate)

The above information is complete and correct Yes / No

To the best of my knowledge the birds are clean and healthy Yes / No

To the best of my knowledge the birds are in a satisfactory state as regards welfare Yes / No

The birds are hereby presented for slaughter for human consumption.

Signed ___________________________ Person in charge Date _______________________

Load number:

Time of arrival:

ANTE-MORTEM EXAMINATION TO BE COMPLETED BY THE VETERINARY INSPECTOR/TEMPORARY VETERINARY INSPECTOR

VETERINARY INSPECTION

OBSERVATIONS Indicate numbers affected where necessary

Documents: Food Chain Information

The FCI has been received Yes / No

The FCI is satisfactory Yes / No

Transport: Hygiene and Welfare

Dead on Arrival (State if excessive)

Birds: Health, Hygiene and Welfare

Handling: Hygiene and Welfare

DECLARATION OF Veterinary Inspector (VI)/ Temporary Veterinary Inspector (TVI):

Inspection of this consignment of birds and examination and analysis of the accompanying documents as prescribed by Regulation (EC) No 854/2004 of the European

Parliament and of the Council, Annex I, Section I, Chapter II, and Section IV, Chapter V, has shown no evidence of clinical signs of disease or other condition which might

adversely affect human or animal health, in particular zoonotic diseases and diseases on the OIE (Office International des Epizooties) list of notifiable diseases. There is no

evidence that welfare has been compromised on-farm, during transport or in the lairage. Standards of hygiene in the lairage and during bird handling are satisfactory.

The birds may be slaughtered for human consumption, subject to the following conditions (state as appropriate): Salmonella positive birds must be slaughtered at the

end of the day’s kill.

VI/TVI signature ___________________________________ Time _________________ Date _______________

The General Data Protection Regulation (Reg. 2016/679) requires that data subjec ts be aware of their rights in relation to their personal data. These details are

contained in a Privacy Notice which can be accessed at the following link: https://www.agriculture.gov.ie/foo dchaininformation/