YERBRIER KENNELS.PDF

i.e`es /0/3 Of
Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
LII New Renewal Permit # K14-000005
Name: Betty Yerbrier Kennel Name: Yerbrier Kennels
Mailing Address: 5447 South El Mirage Road Kennel Location: 5447 South El Mirage Road, Tolleson
City: Tolleson ZIP: 85353 County Superyisorial District: District # 5
Phone: 623-680-5597 Kennel Phone: 623-680-5597
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. INVe assume complete responsibility for the kennel at the premises for which I/we are making
api c ti n 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
(AR SI 11/1 ppi
2. j2q_1/We certify that I/We have 016) dogs and that the kennel meets the definition in statute.
3. III e certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 1 7 (, .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).
4. VIJ IANe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
pr s of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to

,
practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is
mairltpinc\4 on the premises for each dog.
NVe certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
his application.
6. rj ANe understand that a dog remaining within the kennel is not required to be licensed individually under
A.R.S. 1-1008. I/we also understand that a dog leaving the controlled kennel conditions shall be licensed
under A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
Linde.r this section.
e understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
twenty-five dollars in addition to the annual fee.
8. r/4/11/We understand that a person who knowingly fails to obtain a kennel permit within thirty days after
wriften ndtification from the county enforcement agent is guilty of a class 2 misdemeanor..
9. Ii he undersigned understand that that the kennel permit does not authorize the operation of any type
of usinIss and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information INVe have provided is true and accurate under penalty of law.
/ —
Applicant Signature AK' &el Date:
Applicant Signature Date:
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached M
Copy of Person's Valid Identification Attached /V/A
Type of Identification submitted AIM
BOS Approval Date Term of Permit /2.. 0101441
2 of 2

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.00v
Receipt Number: R15-225602 Receipt Date: 10/02/2015
Person ID: P0999105
Phone: 623 6805597
YERBRIER KENNELS 10/2/2015 5:58:08PM
5447 S EL MIRAGE RD
TOLLESON, AZ 85353
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K16-000005 $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash: $0.00
Check: $328.00
Credit Card: $0.00
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.maricopagov and click on Balance Due: $0.00
"Contact 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: Animaitt Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
iuffmanm EBUSOFF

Maricopa County
Animal Care & Control
2500 South 27 th Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT PREMISE INSPECTION
Name: Betty Yerbrier Kennel Name: Yerbrier Kennels
Mailing Address: 5447 S El Mirage Rd Kennel Location: 5447 S El Mirage Rd
City: Tolleson ZIP: 85353 County Supervisorial District: 5
Phone: 623-680-5597 Kennel Phone: 623-680-5597
1. Are all dogs over the age of three months properly vaccinated for rabies and in possession of a
valid rabies vaccination certificate?
YES
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
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
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the Inspector by
check upon each return visit.)
N
Deputy Enforcement Agent ‘71,4e , Date 16/411

Nancy I
hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description
animal Vaccination
has - Vaccine AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: 4-1006707 been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
vacCinated Year yrs, 7 White Fl Poodle, Canine Bella Certificate (623) AZ Lower Animal
1605 in 9 12/1612007 478-9294 478-9295 85353
months toy Buckeye
8.4vigoity accordance Given Hospital
10/12/2015 Rd,
with Ste.
the Due WEIGHT: 101
manufacturer's 10/11/2018 Date
lbs
Lot
Date recommendation 5300570B #, Phone: Tolleson, 54475. Yerbrier Client
Issued for (623) AZ El Kennel, No,
the Nobivac Last #2 ID #1 ID Rabies 680-5597 85353 Mirage 5908
10/12/2015 vaccine Manufacturer Visit Tag Rd. K-15-005
used # &
on 1011212015
above Yerington,
date. 12/5/2017 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVIV1 this Description
animal Vaccination
Vaccine
has AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Year 5 White MI Toy Canine Certificate (623) AZ Lower
1605 2 yrs, 611612008 Cash 478-9294
in - Poodle 478-9295 86353 Buckeye Animal-Hospital
months
accordance Given
Rd,
with Ste.
the Due . WEIGHT: 101
—919/2016
manufacturer's Date
lbs
Lot
Date recommendation 528456.30 if Phone: 5447 Yerbrier Client
Issued , —; Tolleson, El S. No.
the for (623) AZ Mirage Kennel, 5908
vaccine Nobizzac, Marruf Last #2 ID #1 ID Rabies 680-5597 85353
9/10/2013 acturer Visit Tag Rd. K-14-005
used # &
on
above 9/10/2013 Yerington,
date: 9/3/2013 Exp. Betty
Date

1
Nancy hereby 2016 Item Rabies
McEachem, certify
that Rabies
DVM this Description Vaccination
animal vaccine .
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
been 3 (623) W.
vaccinated : Year 11 Black FS Poodle, Canine Certificate (623) AZ Lower Animal
yrs, 111112003 Charity 478-9294 478-9295 85363
in 11 toy Buckeye
accordance Given months Hospital
10.-22015 Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's ,.1914/20113 Date
lbs
Lot
Date recommendation 5300510B. # Phone: 5447 Yerbrier Client
Tolleson, S.
Issued for (623) El No.
the -,Nob±va6 Last ID ID AZ Mirage Kennel, 5908
vaccine .Manufacturer Visit #2 #1 Rabies 880-5597 85353 Rd.
10/12/2015 used Tag K-15-005
on # &
above 10/5/2015 Yerington,
date. Exp.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that
DVM t , Rabies Description
nszytal Vaccination
has - Vaccine AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: buy 3 BIRTHDAY: GENDER: SPECIES: (623) W.
pa ' va ,a Year. yr. 1 White Ml Canine Certificate (623) AZ Lower Animal
1605 ted ', , 0 8117/2013 Poodle, Bubbles 478-9294 85353
-41.24e.,,,oke, in t • months toy 478-9295 Buckeye
accordance 915/2014 Given .Hospital
Rd,
with . Ste.
the WEIGHT: 101
Due
manufacturer's 94/2017 Date
4.40
lbs
Lot
Date recommendation 5300570B # Phone: 5447 Yerbrier Client
Tolleson, S.
Issued for (623) El No.
the ID ID AZ Mirage Kennel, 5908
vaccine Nobivac Manufacturer Last #2 #1 Rabies 680-5597 86353 Rd.
9/512014 Visit Tag K-14-005
used # &
on
above 9/5/2014 Yerington,
date. 9/1/2018 Exp. Betty
- Date

Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description
animal Vaccination
Vaccine
been has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: 3 (623) W.
vaccinated Year 7 White Ft Canine Certificate (623) AZ Lower
1605 2 yrs, 5117/2007 Poodle, Brook 478-9294 85353
in Mini 478-9295 Buckeye
,accordance Given months flospita
9/5/2014 Rd,
with Ste.
the 9/. Due WEIGHT: 101
•
manufacturer's 4/2017 Date
5.40
lbs
Lot
Date recommendation S30057073 #. Phone: 5447
Tolleson, S. Yerbrier lient,NO:
Issued for . (623) AZ El
the Nobivac Last ID ID Mirage Kennel, • 5908
vaccine Manufacturer Visit #2 #1 Rabies 680-5597 85353 Rd.
9/5/2014 Tag K-14,005
used # &
on
above 91512014 Yerington,
date. 9/1/2018 Exp.
, Date Betty

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description 110
animal Vaccine Vaccination
nrgegcre.-doil has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
vaccinated Year 12 8/112001 White Fl Toy Canine Certificate (623) AZ Lower Animal
1605 in 1 yrs, Poodle Britney 478-9294 478-9295 85353
accordance Given month . Buckeye Hospital
y.,...9/10/2013
Rd,
with Ste.
the De WEIGHT: 101
,9/92016
manufacturer's Date
. lbs
Lot
Date recommendation S2845630 . # 'Phone: 5447 --.Client
Issued Tolleson, S. Yerbrier No.
the for (623) AZ El Kennel, 5908
_Nobivac Last #2 ID #1 ID Rabies 680-5597 85353 Mirage
9/10/2013 vaccine Manufacturer Visit Rd. K-14-005
used # Tag &
on
above 9/10/2013 Yerington,
- date. 9/3/2013 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description
animal Vaccination
has - Vaccine AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Year. yrs, 8 White Fl Poodle, Canine Certificate 478-9294 (623) AZ Lower Animal.
1605 in 3 6/16/2007 Bridget 478-9295 85353
months toy Buckeye
accordance Given Hospital
10/5/2015 - Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's 10/4/2015 Date
lbs
Lot
Date recommendation S3005703 Phone: Tolleson, 5447 Yerbrier Client
issued for (623) El S. No.
the Last ID ID AZ Mirage Kennel, 5908
vaccine Nobivac dtdanufaaturer Visit #2 #1 Rabies 680-5597 85353 Rd.
10/12/2015 used Tag K-15-005
on # &
above 10/5/2015 Yerington,
date:- .Eicy.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachem, certify
DVIVI this that Rabies Description 141111
animal Vaccination
has - Vaccine AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Year,„ 11 White Fl Toy Canine Certificate (623) AZ Lower Animal
1605 yrs, 12/1/2002 Brenda 478-9294 85353
in ; 9 Poodle 478-9295 Buckeye
accordance Given months • Hospital'
9/8/2014- Rd,
with , Ste.
the WEIGHT: 101
,:-9/4/2017 Due
manufacturer's Date
6.20
Ibs
Lot
Date recommendation Phone: Tolleson, 5447 Yerbrier Client
Issued for 530057013-,,Nobivaa,"-- (623) El S. No.
the . AZ Mirage Kennel, 5908
vaccine Last #2 ID #1 ID Rabies 680-5597 85353
9/5/2014 Manufacturer Visit Tag Rd. K-14-005
on used • , # &
above 9/5/2014 Yerington,
date: 9/1/2018 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachem, certify .
that Rabies
DVM this Description Vaccination
animal Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 W. Sundance
License: been (623)
vaccinated 3,Xear 5 Black Fl Canine Certificate (623) AZ Lower Animal
yrs, 3 7/2312009 Poodle, Connie 478-9294 478-9295 85353
frady#IrgatewAiie, in Buckeye
accordance Given months Standard - Hotpital
9/5/2014!. Rd,
with Ste.
the WEIGHT: 101
:9/4/2017 Due
manufacturer's Date
lbs
Lot
Date recommendation 9300570B Phone: Tolleson, 5447 Yerbrier Client
Issued for 1." (623) S. El No.
the Last ID ID AZ Mirage Kennel, 5908
vaccine Nobivac Manufacturer Visit #2 #1 Rabies 680-5597 85353 Rd. K-14-005
10/23/2014 Tag
used # &
on
above 9/512014 Yerington,
date. .9/1/2018 Exp. Betty
Date

I
Nancy hereby 2016 xtem Rabies
McEachern, certify
that Rabies
DVM .., this Description_ Vaccination
animal Vaccine
has - . AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 . BIRTHDAY: GENDER: SPECIES: (623) W.
' Year (623)
vaccinated . !"...7 . - , yrs, 8 91512006 Black MI Poodle, Canine Certificate AZ Lower
1605 in '•.: ..Ti _ , 0 COSMO 478-9294 478-9296 85353
.W.1.: months Buckeye Animal•Hospital
accordance . _9/512014 ,Givan. Standard
Rd, _
with Ste.
the WEIGHT: 101
Due
manufacturer's 9/4/2017 Data
67.00
. lbs
Lot
recommendation .9300570t
Date - 4, Phone: Tolleson, 5447 Yerbrier Client
Issued for •• h..„ (623) El S. No.
the "- AZ Mirage Kennel, 5908
vaccine _Nobivac Last #2 ID #1 ID Rabies 680-5597 85353
9/5/2014 -_ _Jianufacturer Visit Tag Rd. K-14-005
used - # &
On
above 9/5/2014 Yerington,
date." Exp.
9/1/2018 Betty
Date
_

I .
Nancy hereby 2016 Item
Rabies
McEachern, certify
that Rabies
IDVM this DeScription 11411
animal Vaccine Vaccination
has - r • : AGE: COLOR: GENDER: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: SPECIES: (623) W.
vaccinated Year 2:yrs, White PI Toy Canine Certificate (623) AZ Lower Animal
1605- 0 8/23/2011 Poodle Darcy 478-9294 478-9295 85353
in • months Buckeye
accordance Given Hospital'
/10/2013 Rd,
with Ste.
the / 9 : WEIGHT: 101
2 / 9 Ducar-Date
manufacturer's 6 1 0
lbs
Lot
Date recommendation . . S2.645630 if Phone: 5447 Yerbrier Client
Tolleson; S.
Issued for (523) Ei No:
the ID ID • • AZ Kennel, 5.908
vaccine Nobivac Manufacturer Last #2 #1 Rabies 680L5597 86363 Mirage:Rd. • •
9110/2013 Visit Tag K-14-905
used # &
on
above • 9/1012013 Yerington,
date. 9/3/2013 Exp:.Date Betty
•

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description 1131116
animal Vaccine Vaccination
has - AGE: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: (623) W.
e vaccinated . , Year 8 White MI Certificate (623) AZ Lower
1605 yrs, 6117/2006 Poodle, Canine' Denver 478-9294 Animal
re ID _ 2 toy 478-9295 86353 Buckeye
r)/166 . accordance Givan months Hospital
9/5/20.14 Rd,
with Ste.
the WEIGHT: 101
Due
manufacturers ,9/4/2017 Data
3.20
lbs
Lot
Date recommendation $3005703- # Phone: 5447$. Yerbrier Client
Tolleson,
Issued for (623) El No.
the Last ID ID AZ Mirage Kennel, 5908
vaccine Nobivac 'Manufacturer #2 #1 Rabies 680-5597 85353 Rd.
9/5/2014 Visit Tag K-14-005
on used # &
above 9/5/2014 Yerington,
date. 9/1/2018 Exp.
Date Betty

I
Nancy hereby 2016 Item Rabies
,
McEachern, certify .
that Rabies
DVM this Description 114111
animal Vaccination
Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
(.14,s(Wajel4rellii4,409 vaccinated Year 7 MI Certificate (623) AZ Lower
1605 „ . 9 yrs, 1211512007 Black/White Chihuahua Canine Denzel 478-9294 85353 Animal _
. in , months 478-9295 Buckeye
. accordance Givexi Hospital
10/5/2015 • . Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's .10/4/2018 Date
lbs
Lot
Date recommendation S300570B. #- Phone: 5447 Yerbrier
Issued Tolleson, S. •CljentNo59Q8
for .(621) AZ ET Kennel,
the Nobivac Last #2 ID #1 1D Rabies 68075597 .:85353 Mirage
vaccine Manufacturer Visit Rd. K-15-005 :r'
10112/2015 Tag
used # -&
on
above 10/512015 Yerington,
date. 12/5/2017 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify .
that Rabies
DVM this Description
animal Vaccination
Vaccine
has AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been --3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Year. 9 White MI Toy Canine Certificate (623) AZ Lower Animal
1605 8 yrs, 115/2005 Devon 478-9294 85353
ie Poodle 478-9295 Buckeye
accordance months Hospital
.9/5/2014 Rd,
with . Ste.
the .0 WEIGHT: 101
-/ 4 Due
manufacturers /2017 Date
3.80
lbs
Lot
Date recommarklation.for 33005705 # Phone; Tolleson, 54475. Yerbrier Client
Issued , (623) El NO.
Last ID ID AZ Mirage Kennel, 5908
theyaccine Manufacturer #2 #1 Rabies 680-5597 85353 Rd.
915/2014 Visit Tag K-14-005
used # &
on
above 915/2014 Yerington,
date. 9/1/2018 . Exp
Betty
Date

I
Nancy hereby 2016 Item
McEachern, certify Vaccination
that Rabies
DVM this Description
animal Vaccine
has - AGE: COLOR: BREED: NAME: Certificate Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Year 5 Fl (623) AZ Lower
1605 yrs, 5/212010 White Poodle, Canine Diva 478-9294
. in 5 toy 478-9295 85353 Buckeye Animal-Hospital
months
accordance 10/5(2015 Given
, Rd,
with Ste.
the 10/ 7 • WEIGHT: 101
Due
manufacturer's 4/2018 . Date
,_
lbs
Lot
Date recommendation S300570E tlit.., Phone: 5447 Yerbrier Client
issued --r 7 ., Tolleson, S.
for El l'... (623) AZ El No.-6908
the ril!r37:7- :Nobivac, Last ID ID Mirage Kennel,
vaccine 1,t.C1, ,Jmanufacturer Visit #2 #1 Rabies 680-5597 85353 Rd.
10/12/2015 • Tag K-15-005
used # &
on
above 10/512015 Yerington,
date: Exp.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Ralpies
DVM this Description
Vaccination
animal Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundanee
License: been 3 (623) W.
1605 vaccinated Year yrs, 4 White MI Poodle, Canine Certificate (623) AZ Lower Animal
in 6 3124/2011 Franky 478-9294 478-9295 85353
months toy Buckeye
accordance Given Hospital
10/5/2015, Rd,
with Ste.
the WEIGHT: 101
Due
manufacturers 10/4/2018 Date
lbs
recommendation 83005705 # Lot •
Date • Phone: T011eson, 5447 Yerbrier Client
Issued for (623) El S. No.
the Last ID ID •Al: Mirage Kennel, 5908
• vaccine Nobivac Main4aoturer #2 #1 Rabies 6804597 85353 Rd.
10/12/2015 used Visit Tag K-15-005
on # &
above 101512015 Yerington,
date. Exp.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachem, certify
that Rabies
DVIVI this Description
animal Vaccine Vaccination
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
vaccinated Year. yrs, 8 511/2007 White MI Poodle, Canine Certificate (623) AZ Lower Animal
1605 in ,IL 6 Sidney 478-9294 478-9295 85363
months toy . Buckeye
Zegiewilorl accordance Given Hospital
10/5/2015 Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's _10/4/2018 Date
lbs
Lot
Date recommendation S300570B- , i lk ._.. Phone: 5447S. Yerbrier Client
Issued . ,,, .;,.:., Tolleson, El No.
the for (623) AZ Mirage Kennel, 5908
vaccine ,H.NObiaC Manufactuxer Last #2 ID #1 ID Rabies 680-5597 85353 Rd.
10/12/2015 , Visit Tag K-15-005
used . # &
on
above 10/5/2015 Yerington,
date. Exp.
12/5/2017 Betty
Date

Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description
Vaccination
animal Vaccine
has - AGE: BIRTHDAY: COLOR; GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
1605 vaccinated . Year yrs, 4 MI Pox Canine Certificate (623) AZ Lower Animal
in 11 10/15/2010 Tr-Color Sunny 478-9294 478-9295 85353
months Terrier-Toy Buckeye Hospital
accordance 10/5/2015 Given
Rd,
with Ste.
the Due WEIGHT: 101
manufacturers 49/4/2018 Date
lbs
recommendation .53005705 10 Lot •
Date Phone: Tolleson, 5447 Yerbrier Client
issued for . , (623) El S. No
the Nobivac Last ID ID AZ Mirage Kennel, 5908-
vaccine Manufacturer Visit #2 #1 Rabies 880-5597 85353 Rd.
1011212015 Tag K-15-005
used # &
on
above 101512015 Yerington,
date. Exp.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachem, certify
that Rabies
DVNI C.1",etinegite000#41.4 this Description
animal Vaccine Vaccination
been has 3 - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350W. Sundance
License: _..„• (623)
vaccinated .:.7 :Yea.3.:4.„,. 5 White Fl Toy Canine Certificate (623) AZ Lower Animal
1605 ,7-:, .8 .„ 2 yrs, 6116/2008 Trixie 478-9294 85353
in 21;57, Poodle . 478-9295 Buckeye
accordance :9/1O/2013... .Given months Hospital
. Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's Date
- '_:
lbs
recommendatiOn.fOr S2845630. 4 Lot •
Date . :.. Phone: Tolleson, 5447 Yerbrier Client
IssUed .'_:'i (623) El S. No
the P,7:-,Nobvac. ID ID AZ Mirage Kennel, 5908
vaccine Manufacturer Last #2 #1 Rabies 680-5597 65353 Rd.
9/10/2013 .. Visit Tag K-14-005
used # &
on
above . 9/10/2013 Yerington,
date. Exp.
9/3/2013 Betty
Date

I
Nancy hereby 2018 Item Rabies
McEachern, certify
that Rabies
DVM this Description Vaccination
animal Vaccine
has AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8360 Sundance
License: been .3 BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated Ye,44, ._ . yrs, 6 White Fl Toy Canine Twila Certificate (623) AZ Lower Animal
1605 in , , 9 1111412006 Poodle 478-9294 478-9296 85363
.p,-zy,,P,4, :.! months Buckeye
Accordance Given Hospital
P42,-P1,-- . Rd,
with Ste.
the WEIGHT: 101
Due
manufacturer's „9./9/2014„...,. Date'
'
lbS
Lot
Date recommendation 52845,63,Q #.: Phone: 5447 Yerbrier Client
Tolleson, S.
Issued for (623) El No.
the ID ID AZ Mirage Kennel, 5908
vaccine Manufacturer Last #2 #1 Rabies 680-5597 85353 Rd.
9/10/2013 Visit Tag K-14-005
used _ # &
on
above 9/10/2013 Yerington,
date.- 9/3/2013 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify .
that Rabies
DVM this Description
animal Vaccine Vaccination
has AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been -..3.Yeax BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated o yrs, 8 White Fl Toy Canine Certificate (623) AZ Lower Animal
1605 in 2 6/19/2005 Poodle Vanity 478-9294 478-9296 85353
f../1.0(20 months Buckeye Hospital
accordance
Rd,
with Ste.
the .139/9/2016. Due WEIGHT: 101
manufacturers Date_
lbs
S284 .Lot
Date -5580 Phone: Tolleson, 5447 Yerbrier Client
Issued recommenda0n,for.tha.Vaccine El S. No:
,: (623) AZ Mirage Kennel, 5908
;Nobj.mac. Last #2 ID #1 ID Rabies 680-5597 85353
9/10/2013 Manufacturer Visit Tag Rd. K-14-005
on used .# &
above 9/10/2013 Yerington,
date. 9/8/2013 Exp.
Date Betty
.

I
Nancy hereby 2016 Item Rabies
NicEachern, certify
that Rabies
DVM this Description
animal Vaccine Vaccination
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
1605 '-'061'07rigi;i1:0,44441, vaccinated Year yrs, 5 9/5/2010 White MI Poodle, Canine Willie Certificate 478-9294 (623) AZ Lower Animal
in 1 toy 478-9295 85353 Buckeye
accordance Given month Hospital
10/5/2015 Rd,
with Ste.
the WEIGHT: 101
Due
manufacturers 10/4/2018 Date
. lbs
recommendation 83005705 # Lot
Date Phone: Tolleson, 5447$. Yerbrier Client
Issued for (623) El No.
the Last ID ID AZ Mirage Kennel, 5908
vaccine Nobivac Manufacturer Visit #2 #1 Rabies 680-5597 85353 Rd.
10/12/2015 used Tag K-15-005
on # &
above 10/5/2015 Yerington,
date. Exp.
12/5/2017 Betty
Date

t
Nancy hereby 2016 Itern Rabies
McEachern, certify
that Rabies
DVM this Description
animal Vaccination
Vaccine
has - AGE: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: (623) W.
vaccinated 11 White Fl Poodle, Canine Certificate (623) AZ Lower Animal
1605 atleLiitage yrs, 6/16/2004 Willow 478-9294 85353
in 3 toy 478-9295 Buckeye
accordance Given months Hospital
Rd,
with '• Ste.
the Due WEIGHT: 101
manufacturer's ,a0/4/2018 Date
lbs
Lot
Date recommendation # Phone: Tolleson, 6447 Yerbrier Client
Issued for S300570B..:!•..Nobivac. at, (623) El S. No.
the Last ID ID AZ Mirage Kennel, 5908
vaccine Manufacturer Visit #2 #1 Rabies 680-5597 85353 Rd. -
1011212015 Tag K-15-005
used # &
on
above 1015/2015 Yerington,
date. Exp.
12/5/2017 Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description 141111
Vaccination
animal Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
vaccinated Year 6 White Fl Canine Certificate (623) AZ Lower Animal
1605 6 yrs, 312412010 Poodle, Honey 478-9294
in - toy 478-9295 85353 Buckeye
accordance Given months dew Hospital
10112/2015 , Rd,
with Ste.
the Due WEIGHT: 101
manufacturers -10/11/2018 Date
lbs
Lot
Date recommendation S3005705 # Phone: 6447 'Client
Tolleson, S. Yerbrier
Issued for (623) El No.
the Nobiva Last ID ID AZ Mirage Kennel, 6908
vaccine :Manufacturer Visit #2 #1 Rabies 680-5597 85363 Rd. - -
10/12/2015 used Tag K-16-005
on # &
above 10/12/2015 Yerington,
date. Exp.
12/5/2017 Betty
Date

.1
Nancy hereby 2016 Item Rabies
McEachem, certify
DVM ( this that Rabies Description
Afli Vaccination
if animal Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
irg:341,090// vaccinated , Year yrs, 8 White MI Toy Canine Lark Certificate (623) AZ Lower Animal
1605 in _ 8 12112/2005 Poodle 478-9294 478-9295 85353
months Buckeye
accordance ...9/5/2014- Given Hospital
Rd,
with Ste.
the Due WEIGHT: 101
manufacturers 9L4/2017 Date
5A0
lbs
Lot
Date recommendation 33005705 # - Phone: 5447 Yerbrier Client
Issued for (623) Tolleson, El S. No.
the ID ID AZ Mirage Kennel, 5908
vaccine Nobivac Manufacturer Last #2 #1 Rabies 680-5597 85353 Rd.
9/5/2014 Visit Tag K-14-005
on used # • &
above 915/2014 Yerington,
date. 9/1/2015 Exp.
Date Betty

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description
animal Vaccination
Vaccine
been has -23 AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350W. Sundance
License: (623)
1605 "Aistpneggiew4401 Vaccinated Year 13 1/6/2002 White Fl Poodle, Canine Mitze Certificate 478-9294 (623) AZ Lower Animal
• • in 9 yrs, 478-9295 85353
t]. ikqiVen months toy Buckeye Hospital
accordance
6/12)201,5 Rd,
with Ste.
the 7 WEIGHT: 101
Due
manufacturer's 4y/11/2018 Date
lbs
Lot
Date recommendation S30057015,,, #, Phone: 6447 Yerbrier Client
Issued 7 Tolleson, El S. No.
the for , (623) AZ Mirage Kennel, 5908
vaccine Manufacturer Last 1D#2 #1 ID Rabies 680-5597 86363 Rd.
10/1212015 Visit Tag K-15-005
used # &
on
above 1011212015 Yeririgton,
date. Exp.
12/5/2017 Date Betty

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that 'Rei:des
DVM this Description
Vaccination
animal Vaccine
inegee;(4017 has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Pax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
I sawg. vaccinated Year. 8 White Fl Canine Ms. Certificate (623) AZ Lower Animal
1605 • 2 yrs, 6/19/2005 Poodle, Et 478-9294 478-9295 85353
in . months Mini Buckeye
accordance Given Hospital
9/10/2013. Rd,
with Ste. -7;
the WEIGHT: 101
Due
manufacturer's 9/9/2016 Date
lbs
Lot
Date recommendation S2845630 Phone: Tolleson, 5447 Yerbrier Client
Issued for (623) El S. No.
the blanuf Last • ID • ID AZ Mirage Kennel, 5908
vaccine #2 #1 Rabies 680-5597 86353 Rd.
9/10/2013 acturer Visit Tag K-14-005
used # &
on
above 911012013 Yerington,
date. 9/3/2013 Exp. Betty
Date

Nancy hereby .2016 Item Rabies
McEachern, certify
tweeil2e: that Rabies
DVM this Description
Vaccination
animal Vaccine
has - AGE: BIRTHDAY: COLOR: GENDER: BREED: SPECIES: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been 3 (623) W.
dorl vaccinated Year . 1 Fl Fox Certificate (623) AZ Lower
1605 10 yr, 10/19/2011 Tr-Color Canine Patsy 478-9294 Animal
in Terrier-Toy 478-9295 85353 Buckeye
accordance .9,410/20 Given months Hospital
Rd,
with 3 Ste.
the i WEIGHT: 101
Due
manufacturer's y9/2016 Data
lbs
Lot
Date recommendation 7 S2845630,, Phone: Tolleson, 5447 Yerbrier CIient
Issued for „ (623) El S. No.
the . ID ID AZ Mirage Kennel, 5908
vaccine .Nobivac Manufacturer. Last #2 #1 Rabies 680-5597 85353 Rd. -
911012013 . Visit Tag K-14-005
used # &
on 9/1012013
above Yerington,
date. 9/3/2013 Exp. Betty
Date

I
Nancy hereby 2016 Item Rabies
McEachern, certify
that Rabies
DVM this Description lbpiUI
animal Vaccination
has - Vaccine AGE: COLOR: BREED: NAME: Fax Phone: Tolleson, 8350 Sundance
License: been 3 BIRTHDAY: GENDER: SPECIES: (623) W.
Year 5 MI P. Certificate (623) AZ Lower
1605 8 yrs, 12/15/2007 Tan/White Chihuahua Canine 478-9294 85353 Animal
yaccinated_ip,Appordante Diddy 478-9295 Buckeye
Given months Hospital
9,410/2013 Rd,
with Ste.
the Due WEIGHT: 101
9/9/2015
manufacturers Date
-•••
lbs
Lot
Date recommeRgatioiWtheof 3284563.0 Phone: Tolleson, 5447 Yerbrier Client
Issued (623) El S. No.
, Last ID ID AZ Mirage Kennel, 5908
j.actrip 1-4nufacturer Visit #2 #1 Rabies 680-5597 85353 Rd.
9110/2013 Tag K-14-005
used # &
on
above 9/10/2013 Yerington,
date.: 9/3/2013 Exp. Betty
Date

I
Nancy hereby 2016 Item
Rabies
McEachem, certify
that Rabies
DVM this Description
animal Vaccine Vaccination
‘-tigeosfin
has 3 - AGE: COLOR: BREED: NAME: Fax: Phone: Tolleson, 8350 Sundance
License: been BIRTHDAY: GENDER: SPECIES: (623) W.
vaccinated . Year..,_ _. 8 MI (623) AZ Lower
1605 _ yrs, 1211/2005 Black Poodle, Canine Certificate 478-9294 Animal
in 9 Schnott 478-9295 85353
months Mini Buckeye
accordance Given.., Hospital
9/10/2013 Rd,
With , Ste.
the _ WEIGHT: 101
Due
.9/9/2016
manufacturer's Date
lbs
Lot
Date recommendation 7:',4-1 9284563.0,..: f.1 ,, Phone: 6447 Yerbrier Client
Issued - • for ' • E: -;/.:,':';'-' Tolleson, EI S. No.
• the . ' - _-''' ,• (623) AZ Kennel, 5908
. . .:.• vaccine - . .-'5•:(:' Nobivac, .„--,.14a.nufactuser Last #2 ID #1 ID Rabies 680-5597 85353 Mirage '
9/5/2014 '. . Visit Tag Rd. K-14-005
used # &
on
above 9/10/2013 Yerington,
date. Exp.
9/3/2013 Betty
Date