KENNEL PERMIT FOR ERICA WELLMAN DBA FRIENDS FOR LIFE.PDF
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Maricopa County
Animal Care & Control
2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K18-000010
PREMISE INSPECTION
Number of Dogs: 14
Name: Erica Wellman Kennel Name: Friends for Life
Mailing Address: 143 W Vaughn Kennel Address: Same
City: Gilbert State: AZ Zip: 85233 City: Gilbert Zip: 85233
County Supervisorial District: 2
Phone: 480-215-6018 Kennel Phone: 480-497-8296
1. Are all dogs over the age of three months properly vaccinated for rabies and in
possession of a valid rabies vaccination certificate?
YES
2. Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a
person keeps, harbors or maintains five or more dogs under controlled conditions?
YES
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND N/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
NONE
Deputy Enforcement Agent & Badge #: Lt Timothy Rummel Date: 06/03/17
October 2015
Maricopa County
Animal Care And Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
C1 New Yi Renewal Permit # IA L¥-QO00lO
oar { Ga W2\\mour Kennel Name: tr OMS bow Che An ime?
Name:
ese
Mailing Address: ) LH 3. \J aus hn Kennel Location: 14] 2 yo .Uoughn
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city
Home Phone: _«} GO) ~22 L5- Gols Kennel Phone C) GO Y 74 S24 G&G
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred twenty eight dollars ($328.00) within ten (10) days of receipt.
Pursuant to Arizona statute and county ordinance, a person must obtain a kennel permit issued by the Board of
Supervisors if the person operates a kennel in which there are five or more dogs which are not individually
licensed. A.R.S. §11-1009(A). A kennel is defined as “an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions.” A.R.S.
§ 11-1001(8).
An appointment will be scheduled for inspection of the_kennel premises by an Animal Control Officer upon
receipt of this kennel permit application and fee. This kennel application properly executed and a copy of the
inspection report will then be forwarded to, and must be approved by, the Maricopa County Board of
Supervisors. The kennel permit form will be sent to you after approval and will be valid for one year from the
date of the Board's approval.
NOTE: Failure to show for a scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 for each additional visit. Failure of inspection may result in denial of the kennel
permit and require individual licensing of each dog under the provisions of A.R.S. §11-1008.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
1. \WWe assume complete responsibility for the kennel at the premises for which I/we are making
application for a permit and understand that “kennel” means an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions (ARS 11-
1001).
2. CA certify that I/We have } 4 dogs and that the kennel meets the definition in statute.
3. Tie certify that IWWe have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 13-2910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
(Violations of license and leash laws DO NOT apply).
“A Ca We certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
premises of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to
Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
hitp://pets. maricopa.gov
Receipt Number: R17-134936 Receipt Date: 05/23/2017
Person 1D: P1279029
Phone: 480 4978296
FRIENDS FOR LIFE RESCUE 7:
5/23/2017 4:07:55PM
143 W VAUGHN AVE
GILBERT, AZ 85233
\tem: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K18-000010 $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash:
Check:
Credit Card: $328.00
Total Payments Received: $328.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.maricopa.gov and click on Balance Due: $0.00
Contact
5 1 12 4 4 2 481 1781 62 31 96.526016 Us to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
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2 1 27 0 0 0 166 1743 34 987 -1
3 1 27 1 0 0 166 1743 34 987 -1
4 1 27 1 1 0 166 1743 34 987 -1
5 1 27 1 1 1 172 1743 24 23 42.597237 19
5 1 27 1 1 2 173 1775 22 37 42.725239 221
5 1 27 1 1 3 173 1822 27 43 44.994499 CSL
5 1 27 1 1 4 152 2005 45 273 4.265709 ALVOISILYZD
5 1 27 1 1 5 166 2286 30 281 36.485680 NGILYNIOOVA
5 1 27 1 1 6 166 2581 30 149 19.735584 SHIG¥e
2 1 28 0 0 0 167 1058 227 2169 -1
3 1 28 1 0 0 168 1058 226 2169 -1
4 1 28 1 1 0 375 1073 19 808 -1
5 1 28 1 1 1 379 1073 5 23 64.546959 =
5 1 28 1 1 2 379 1249 5 98 0.000000 wensaenaeesey
5 1 28 1 1 3 380 1381 5 26 2.352533 Ss
5 1 28 1 1 4 375 1879 19 2 59.116535 |
4 1 28 1 2 0 356 1058 30 824 -1
5 1 28 1 2 1 359 1058 25 146 15.498867 HSacWISLSICG
5 1 28 1 2 2 359 1249 25 120 82.804031 SNINVO
5 1 28 1 2 3 358 1496 28 3 93.044693 |
5 1 28 1 2 4 356 1699 5 56 0.000000 a
5 1 28 1 2 5 359 1878 13 4 12.620325 ;
4 1 28 1 3 0 330 1304 41 786 -1
5 1 28 1 3 1 355 1304 16 103 7.622051 stile
5 1 28 1 3 2 338 1700 23 165 0.000000 SNOHEF7AL
5 1 28 1 3 3 330 1879 24 3 96.440125 |
5 1 28 1 3 4 338 2061 21 29 10.619736 1
4 1 28 1 4 0 295 1142 34 357 -1
5 1 28 1 4 1 303 1142 26 107 11.268902 aSvSSid
5 1 28 1 4 2 300 1285 29 123 63.903881 SWAIO
5 1 28 1 4 3 295 1496 17 3 64.605530 i
4 1 28 1 5 0 242 1254 56 1312 -1
5 1 28 1 5 1 242 1254 39 114 10.831814 Saigvy
5 1 28 1 5 2 264 1496 12 3 43.902878 i
5 1 28 1 5 3 272 1700 11 15 0.000000 #
5 1 28 1 5 4 265 1730 23 64 0.000000 jBLES
5 1 28 1 5 5 265 1805 23 57 23.701748 “LSND
5 1 28 1 5 6 278 2170 20 49 34.213272 adéy
5 1 28 1 5 7 280 2225 14 24 75.333191 0
5 1 28 1 5 8 280 2258 18 41 92.915016 usd
5 1 28 1 5 9 275 2308 23 60 37.170715 yuied
5 1 28 1 5 10 275 2378 19 39 0.000000 [eq
5 1 28 1 5 11 280 2426 14 42 60.428200 esn
5 1 28 1 5 12 284 2476 4 8 74.397255 -
5 1 28 1 5 13 274 2492 19 74 2.837667 INIWd
4 1 28 1 6 0 241 1255 22 1105 -1
5 1 28 1 6 1 247 1255 15 87 2.215815 Ssiayvy
5 1 28 1 6 2 253 1380 10 1 94.205177 |
5 1 28 1 6 3 243 1824 4 10 26.955061 .
5 1 28 1 6 4 244 2174 7 27 26.336250 bay
5 1 28 1 6 5 241 2356 8 4 24.931135 ,
5 1 28 1 6 6 242 2538 8 11 0.000000 n
4 1 28 1 7 0 167 1483 84 1744 -1
5 1 28 1 7 1 216 1483 29 16 46.810463 |
5 1 28 1 7 2 220 1791 20 22 36.284103 is
5 1 28 1 7 3 219 1822 22 43 42.167900 Sey
5 1 28 1 7 4 224 2066 2 4 21.697182 .
5 1 28 1 7 5 167 2122 84 35 0.000000 .
5 1 28 1 7 6 223 2170 28 104 0.000000 WeOsd
5 1 28 1 7 7 222 2284 29 152 6.778698 AHASYN
5 1 28 1 7 8 222 2449 29 171 20.440769 Gala¥d7
5 1 28 1 7 9 229 3225 5 2 56.000790 |
4 1 28 1 8 0 183 1320 45 1907 -1
5 1 28 1 8 1 183 1320 45 86 28.930016 SWweN
5 1 28 1 8 2 195 1496 20 3 78.192978 i
5 1 28 1 8 3 185 3225 21 2 67.846329 |
4 1 28 1 9 0 168 1497 15 2 -1
5 1 28 1 9 1 168 1497 15 2 59.016628 |
2 1 29 0 0 0 138 1048 27 360 -1
3 1 29 1 0 0 138 1048 27 360 -1
4 1 29 1 1 0 138 1048 27 360 -1
5 1 29 1 1 1 138 1048 27 132 18.395958 QYO02Y
5 1 29 1 1 2 138 1194 27 214 59.785023 NOLWNIDOYA
2 1 30 0 0 0 133 1497 8 1729 -1
3 1 30 1 0 0 133 1497 8 1729 -1
4 1 30 1 1 0 133 1497 8 1729 -1
5 1 30 1 1 1 133 1497 8 1729 95.000000
=
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-10-2017
Expiration Date
ey
Issued by RNESTO SANDIGO...
Drug administered:
Manufacturer ZOETIS
Vaccine
Lot ID
Serial ID 188845C
About this animal
Pet Name WILSON License None on record
Species DOG ID#: 178474 Vacc ID HSOY
Breed TERRIER Microchip None on record
Primary
Registration None on record
Gender MALE/STERILIZED
Age ADULT - {2 a | g
Bites NO
Size SMALL
Veterinarian Signature
v
Zo
Veterinary License # 220
HANNA AAU
900074001860397
Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date -
Expiration Date
ii,
Issued by O SANDIGO...
Drug administered:
Manufacturer IS
70h
Vaccine
Lot ID
Serial ID 188842A —
About this animal
PetName qin@aisiep @ @ License None on record
Species DOG ID#: 170238 Vacc ID HSOY
Primary Breed SHEPHERD Microchip 900074001809195
Gender FEMALE/STERILIZED Registration None on record
Age 3 MONS TO 12 MONS
Size MEDIUM ~ Bites NO
~-aG-lbe
Veterinarian Signature
Veterinary License #
c
Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
/
4050 SOUTH AVE 4 1/2E
~ .
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date (05-09-2017.
Expiration Date 05-09-2018
Issued by ERNESTO SANDIGO...
Dr ministered:
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188845c
About this animal
Pet Name PIXIEDUST License None on record
Species DOG ID#: 177436 Vacc ID HSOY
Primary Breed TERRIER Microchip None on record
Gender MALE/STERILIZED Registration None on record
Age ADULT
Size SMALL Bites NO
Veterinarian Signature
Se
Veterinary License #
|
UA
00074001861223
Federal Tax ID 86-6053617
Printed using Shelter Pro
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RABIES VACCINATION CERTIFICATE FOR MARICOPA COUNTY, ARIZONA
DATE VACCINATED VACCINATION EXPIRES RABIES SERIAL NUMBER
|
-
NAME: Friends for Life FFL - Dag PET: Delta
143 W. Vaughn St.
Gilbert, AZ 85233 TELEPHONE: (480) 497-8296
SPECIES SEX AGE WEIGHT
Canine FS 03/12/2008 48.5 lbs.
BREED - COLOR MANUFACTURER TYPE
pert tt — ttt — tt — tt th }—f—} —} —t—1 ff 1}
Defensor 3 Killed
Shar-Pei Mix Tri-Color
| hereby certify that | have vaccinated this animal in accordance with the company's recommendation
for the vaccine used on the above date.
Higley Road Pet Clinic
866 N. Higley Rd., Suite 106
‘ Gilbert, AZ
Signature of licensed veterinarian administering vaccine.
Dr.SamWolf
IW)? —- 42lo AOS”
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date
Expiration Date
Issued by ERNESTO SANDIGO...
D ini :
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188846b
About this animal
Pet Name ERICA License None on record
Species DOG ID#: 177531 Vacc ID HSOY
Primary Breed CHIHUAHUA a i Microchip None on record
Gender FEMALE/STERILIZED Registration None on record
Age ADULT
Size SMALL ‘ Bites NO
Veterinarian Signature
Veterinary License #
|
UA HT
074001859005
Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
? Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 01-25-2017
* Expiration Date 01-25-2018 :
Issued by STACK DVM...
Drug administered: .
Manufacturer BOEHRINGER....
Vaccine . RABVAC 3
Lot ID :
Serial ID 4150416A
About this animal
-Pet Name ISABELLE’ License . None on record
Species DOG ID#: 172025 Vacc ID HSOY
Primary Breed IBIZAN HOUND Microchip 900074001824908
ee Registration None on record
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Size SMALL - Bites NO
Veterinarian Signature oe eee i
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Veterinary License # oo
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Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-25-2017
Expiration Date 05-25-2018
Issued by PAUL CARNEY DVM
Drug administered:
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188845C
About this animal
Pet Name License None on record
rt
Species OG 179032 Vacc ID HSOY
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Primary Breed DACHSHUND Microchip 900074001862396
FEMALE/STERILIZED Registration None on record
Gender
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Age ADULT | S-l a
Size sma. Bites NO
Blac T
Veterinarian Signature la) a
Veterinary License #
Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-17-2017
Expiration Date 05-17-2018
Issued by ERNESTO SANDIGO...
Drug administered:
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188845C
About this animal
Pet Name ; License None on record
mOken.%-))
Species DOG Mer. te Vacc ID HSOY
AWIN(LNUNNNAIIANNA NUM
Cone MALEISTERILIZED Microchip, None on recor
900074001859182
Age ADULT
@- lt -!S Bites NO
Size SMALL
aK poh. hyo
Veterinarian Signature
7 Zi
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Veterinary License #
Federal Tax ID 86-6053617
Printed using Shelter Pro
Humane Society of Yuma, Inc.
4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-15-2017
Expiration Date 05-15-2018
Issued by ERNESTO SANDIGO...
Drug administered:
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188854C
About this animal
Pet Name License None on record
~ Tadeo ’
Species DO 178649 Vacc ID HSOY
Primary Breed POODLE Microchip 900074001681175
MALE/STERILIZED Registration None on record
Gender
Sos SMALL lo~ t- ( e) Bites NO
Cnet - oh. Le hide
Veterinarian Signature
oC
“330 a
3302
Veterinary License #
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Federal Tax ID 86-6053617
using Shelter Pro
Printed
tHumane Society of Yuma, Inc.
4050.SQUTH AVE 4 1/2E
YUMA, AZ 85365
Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-22-2017
Expiration Date 05-22-2018
Issued by ERNESTO SANDIGO...
Drug administered:
Manufacturer ZOETIS
Vaccine DEFENSOR 3
Lot ID
Serial ID 188845C
About this animal
PetName ““KBNNAt License None on record
Species DOG ID#: 178988 Vacc ID HSOY
Primary Breed TERRIER Microchip 900074001859303
Gender FEMALE/STERILIZED Registration None on record
Age ADULT
Size SMALL al IS Bites NO
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plan ty
Lat
Veterinarian Signature
/ 330k
Veterinary License #
HAA
00074001859303
Federal Tax ID 86-6053617
Printed using Shelter Pro
‘Humane Society of Yuma, Inc.
, 4050 SOUTH AVE 4 1/2E
YUMA, AZ 85365
; Phone: (928) 782-1621
SAVE ONE UNTIL THERE ARE NONE
Vaccination Certificate
Vaccination information:
Vaccination ID HSOY
Vaccination Type RABIES
Effective Date 05-01-2017
Expiration Date 05-01-2018
Issued by SANDIGO/ CARNEY
Drug administered:
Manufacturer ZOETIS
Vaccine NOBIVAC 3 RABIES
Lot ID
Serial ID 188842a
About this animal
Pet Name 7 License None on record
Species DOG ID#: 177709 Vacc ID HSOY
Primary Breed CHIHUAHUA Microchip None on record
Gender MALE/STERILIZED Registration None on record
Age ADULT =
.
Size SMALL G* =26~ ]5 Bites NO
Brindle
Ly ’ VW6Q69deq
F Of “: 106] me oe
Veterinarian Ca phn. hg hye SS i/S 7
Signature
‘es
Veterinary License # 330
Federal Tax ID 88-6053617
Printed using Shelter Pro