Date

MM

DD

YYYY

Time *

Hour

Minute

Second

AM PM

Have you hosed down your vehicle tyres? *

Yes

No

If exiting vehicle, have you stepped in our foot bath?

Yes

No

Have you been exposed to other Poultry/Pigs in the past 48 hours?

Yes

No

Have you travelled overseas in the last 5 days?

Yes

No

Have you had any food borne illness in the last 48 hours?

Yes

No

Have you visited any other grading facilities in the last 48 hours?

Yes

No

I have been shown and agree to comply to the biosecurity control order

Yes

No