Table IV

Perfect Score 100% Score allowed ...%

File No............

Department Of Health (Thirteen Items Are Here Omitted)

Dairy Inspection Division of Inspections

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