Form 6510-7 Poultry Lot Information

OMB Number: 0583-0139
Expiration Date:
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor,and a person i s not requ1red to respond to, a collection of information unless it
valid displays a 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.
UNITED DEPARTMENT OF AGRICULUTRUE
FOOD SAFETY AND INSPECTION SERVICE

DATE PROCESSED

POULTRY LOT INFORMATION

(FROM RECORDS OF OFFICIAL ESTABLISHMENT)

DAY'S RUN

LOT NO (S).
OR

CLASS

NO. HEADS IN LOT*

CERTIFIED CHILLED (RTC weight)

CERTIFIED FROZEN (RTC weight)

DEAD ON ARRIVAL
No.Heads

Weight

CONDEMNED WT.
Carcasses

LIVE WEIGHT

DISPOSED CARCASSES**

Parts

*Total head in lot minus religious exempt head, if any (not receiving the mark of inspection)
** Carcasses disposed by plants operating under New Poultry Inspection System (NPIS)

PLANT NO.

FSIS FORM 6510-7 (07/27/2021)

NO. HEAD
RELIGIOUS EXEMPT
IN LOT

SIGNATURE OF AUTHORIZED PLANT OFFICIAL

REPLACES FSIS 6510 7 (08/12/2009), WHICH MAY BE USED UNTIL EXHAUSTED.

No. Heads