Certificate of Veterinary Inspection · issued 2024-12-16
35-265197
RIDGLAN FARMS, INC. → IIT RESEARCH INSTITUTE · 40 dogs
Consignor (shipper)
RIDGLAN FARMS, INC.
10489 W. BLUE MOUNDS ROAD BLUE MOUNDS, WI 53517
Consignee (buyer)
STATE STREET DOCK 10 WEST 35TH STREET CHICAGO, IL 60616
Carrier
Not stated on the certificate.
Issuing Veterinarian
Richard J. Van Domelen, D.V.M.
P.O. BOX 318 MT. HOREB, WI 53572
Health declarations
Vaccinations (2)
| Name | Manufacturer / Product | Lot | Administered | Expires | Applies to |
|---|---|---|---|---|---|
| Rabies | Nobivac 3-Rabies | 2024-12-10 | 2025-12-10 | all | |
| Canine 1-DAPPv | Canine 1-DAPPv | 2024-11-19 | all |
Remarks / additional certifications
Owner/Agent: Pamela J. Bulke. Permit Number: IPOIJBKO. Not returning to WI. 40 animals in shipment. Shipping date 12/16/2024. Owner mailing address: P.O. Box 318 Mt. Horeb, WI 53572.
Veterinarian certifies animals have been inspected and are not showing signs of infectious, contagious and/or communicable disease (except where noted). No warranty is made or implied.
Emails on form: ridglan@mhtc.net
Animals listed on this shipment (40)
| ID | Breed | Sex | Age / DOB | Color | Microchip / tattoo | Other |
|---|---|---|---|---|---|---|
| AYK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| AZK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| DCK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| DGK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| EIK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| GAK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| GUK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| GVK-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| HVO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| HWO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| IQO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| JFO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| JIO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| JQO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| JSO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| JWO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| LXO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| OIO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| OTO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| PKO-4 | Beagle | F | 5-6 Mos | 5-6 Mos | ||
| DHL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| DQL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| DYL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| EEL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| EVL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| FSP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| FTP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| GQL-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| GZP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| HQP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| HSP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| IHP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| ILP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| IVP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| JBP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| JKP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| KRP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| LTP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| OCP-4 | Beagle | M | 5-6 Mos | 5-6 Mos | ||
| OYP-4 | Beagle | M | 5-6 Mos | 5-6 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.
Extraction provenance
shrine_id 1080521 · doc_class PaperCvi