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Certificate of Veterinary Inspection · issued 2024-07-23

35-265153

RIDGLAN FARMS, INC. → IIT RESEARCH INSTITUTE · 8 dogs

Open source PDF ↗

Consignor (shipper)

RIDGLAN FARMS, INC.

10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517

Phone
608-437-8670

Consignee (buyer)

IIT RESEARCH INSTITUTE

STATE STREET DOCK 10 WEST 35TH STREET CHICAGO, IL 60616

State
IL
Shipped
2024-07-23
Inspected
2024-07-23
Issued
2024-07-23
Purpose
—
Species
Dog (Beagle)

Carrier

Not stated on the certificate.

Issuing Veterinarian

Richard J. Van Domelen, D.V.M.

P.O. BOX 318 MT. HOREB, WI 53572

Phone
608-437-8670
State license
404991
USDA accreditation
033491

Health declarations

Rabies
Vaccinated 07/17/2024, expires 07/17/2025, Nobivac 3-Rabies
Other declarations
Veterinarian certifies animals have been inspected and are not showing any signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and results of tests are as indicated on this certificate.

Vaccinations (2)

NameManufacturer / ProductLotAdministeredExpiresApplies to
RabiesNobivac / Nobivac 3-Rabies6882142024-07-172025-07-17all
Canine 1-DAPPvNobivac / Nobivac (Canine 1-DAPPv)2024-06-12all

Remarks / additional certifications

Owner/Agent: PAMELA J. BURKE. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572. Permit Number: IPOIASZLP. Not returning to WI. Number of Animals in Shipment: 8.

Veterinarian certifies animals have been inspected and are not showing any signs of infectious, contagious and/or communicable disease (except where noted). Vaccinations and results of tests are as indicated on this certificate.

Emails on form: ridglan@mhtc.net

Animals listed on this shipment (8)

IDBreedSexAge / DOBColorMicrochip / tattooOther
XJC-4BeagleF5 Mos5 Mos
YZC-4BeagleF5 Mos5 Mos
UXB-4BeagleM5 Mos5 Mos
WED-4BeagleM5 Mos5 Mos
XCD-4BeagleM5 Mos5 Mos
XTD-4BeagleM5 Mos5 Mos
ZAD-4BeagleM5 Mos5 Mos
ZVD-4BeagleM5 Mos5 Mos

The CVI form lists each dog individually. Per-animal vaccination and treatment history is on the source PDF.

Primary source

This certificate was published by Wisconsin DATCP and is hosted on cvicentral.com. Click through to see the original PDF with all vaccination dates, treatment records, and any handwritten notes.

Open CVI 35-265153 ↗
Extraction provenance
Source modeltier2b · claude-sonnet-4-6 · prompt tier2b.dittoaware
Extracted2026-05-27 00:37:50
Tokensin 4957 · out 2678 · cost $0.0550
Overall confidence0.82 · cross-tier agreement 1.00
Model notesPage 1 lists animals 1-7 (XJC-4 through ZAD-4); Page 2 (continuation) lists animal 7 again as ZVD-4 — this appears to be animal #8 (the form says 8 total). Animal #1 (XJC-4) is explicitly Female (F), age 5 Mos. Animal #2 (YZC-4) shows a vertical ditto line in the Sex column, inheriting F from row 1; age also inherited. Animal #3 (UXB-4) shows M explicitly. Animals 4-7 on page 1 (WED-4, XCD-4, XTD-4, ZAD-4) have ditto lines inheriting M and 5 Mos from UXB-4/XJC-4. Row 7 on page 1 (ZAD-4) has checkmark terminators on all ditto columns. Page 2 animal ZVD-4 explicitly shows M, 5 Mos, same vaccinations — treated as a fresh row (not ditto, but same values). Both pages share the same vaccination data for all animals. The permit number 'IPOIASZLP' is partially handwritten and may be 'IPOIASZLP' or similar — transcribed as best read. Owner mailing address differs from origin address (P.O. Box 318 Mt. Horeb vs. 10489 W. Blue Mounds Road), but both belong to Ridglan Farms. Serial number 688214 listed for Rabies vaccine on page 1 animal 1 and page 2 animal 7 — applied to all animals. Canine 1-DAPPv date 06/12/24 listed only for animal 1 on page 1 but via ditto convention applies to all.

shrine_id 962346 · doc_class ElectronicCvi