Form 6510-7 Poultry Loy Information

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 0583-0139. The time required to complete this information collection
is estimated to average 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.
1. DATE PROCESSED

U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE

POULTRY LOT INFORMATION

(FROM RECORDS OF OFFICIAL ESTABLISHMENT)
LOT NO(S).

2. DAY'S RUN

OR

3. CLASS

4. NO. HEAD IN LOT

5. CERTIFIED CHILLED (RTC weight)

8. No. Heads

*
**

DEAD ON ARRIVAL
9. Weight

6. CERTIFIED FROZEN (RTC weight)

CONDEMNED WT: PM Insp. Station
10. Carcasses

11. Parts

7. LIVE WEIGHT

CONDEMNED WT. PM NOT AT INSP. STATION**
12. Plant Rejects - No. Heads

From Summary Sheet or eADRS Line
From Post mortem other than Inspection Station - Salvage, elsewhere on slaughter floor.

14. PLANT NO.

FSIS FORM 6510-7 (2/03/2010)

15. SIGNATURE OF AUTHORIZED PLANT OFFICIAL

REPLACES FSIS 6510-7 (8/12/2009), WHICH MAY BE USED UNTIL EXHAUSTED.

13. Plant Rejects-WT