Freshwater/land-based aquaculture licence under the Fisheries Act - Appendix V: Urgent notification (& 10-day follow-up report) of mortality

This webpage is intended for informational purposes only.

Please email to: AQFF.FishHealth@dfo-mpo.gc.ca

Reporting date and time of this emergency notification:

Farm name and Facility Reference number:

Contact Name:

Phone Number:

Circle the event(s) that occurred which requires immediate attention:

Unusually high fish mortalities (if so – attributed to)
Vet or Lab Diagnosis of Disease Listed in Appendix III (identify pathogen)
Infectious Outbreak (i.e elevated losses) (identify pathogen)
Emergency Fish Health Response required Y / N (if yes – was DFO notified as per licence conditions Y / N )

Part C.
The following details of are to be completed for each individual fish health event:

 

Date that event was discovered:

Cause and/or Diagnosis:

ID or Lot # (of affected fish):


 

Diagnosis:


 

Fish Species and Common Names:


 

Number of Fish on Site (pieces):


 

Were treated fish mixed in with non-treated fish?


Y / N

Estimated mortalities (numbers, volume)


Over ____ (number) days

Recent Escape from lot during reporting period?


Y / N

Harvest from lot during reporting period?


Y / N

1. Name of Drug and Prescription No. (if any)


 

2. Date Treatment Commenced


 

3. Date Treatment Ended


 

4. Treatment Information (withdrawal time prescribed, how applied to animals (in-feed or bath), amount per Kg of feed, etc.) / Response description


 


 


 

Treatment file and details are available at rearing site:

5. Name of Prescribing Veterinarian

6. Name of Person Responsible for Administering the Treatment


 

Signature of Person Responsible for the information of this declaration


Date: