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I 
r Exhibit C. — Selected forms used in the milk-inspection service of the District of 
Columhia. 
r APPLICATION FOR PERMISSION TO BRING OR SEND MILK INTO THE DISTRICT 
OF COLLTMBIA. 
INSTRUCTIONS TO APPLICANTS. 
1. The act to regulate the sale of milk in the District of Columbia provides 
that no person shall bring or send into the District of Columbia for sale any 
milk without a permit so to do from the health officer of said District, and that 
such permits shall be issued subject to the following conditions : 
That none but pure and unadulterated milk shall be, with knowledge of its 
impurity, brought into said District. 
That in the management of the dairy farm upon which the milk is produced, 
or of the dairy at which the milk is collected and stored prior to shipment, 
the applicant shall be governed by the regulations of the health office of the 
District of Columbia, approved by the Commissioners of said District, issued 
for dairies and dairy farms in said District, when said regulations do not con- 
flict with the laws of the State in which said dairy or dairy farm is located. 
A copy of the regulations above referred to is herewith inclosed. 
The said dairy or dairy farm may be inspected at any time without notice 
by the health officer of the District of Columbia or his duly appointed repre- 
sentatives. 
2. This application should be made out in ink and signed with your full name. 
If applicant is a married woman she should sign her own name in full and 
insert her husband’s name in the space provided for that purpose. 
3. To insure the freedom of your dairy herd from tuberculosis it is advised 
that it be tuberculin tested and suitable disposition made of reacting animals. 
In no other way can its freedom from tuberculosis be demonstrated. If you 
desire to have the tuberculin test applied sign the accompanying blank form 
of agreement for that purpose and return it to this department. It will then 
be transmitted to the Bureau of Animal Industry, and your herd will be tested 
without cost to you. This test should by all means be made, thereby removing 
a source of infection to your well cattle and protecting the persons who con- 
, sume your milk. 
, 4. Under the law no permit can be issued until after the health officer is satis- 
I fled that the milk from the dairy farm to which the permit relates will be brought 
I into the District of Columbia for sale and distribution without danger to public 
I health. Immediately after the flling of the application, however, if it be in 
\ proper form, the applicant can lawfully bring or send milk into the District 
I of Columbia and can continue to do so until after his application has been 
acted upon by the health officer. An inspection of your premises will be made 
8 as soon as practicable after the flling of your application. 
8 5. Application for a permit, and the acceptance of a permit, each binds the 
[ applicant and licensee to compliance with the conditions stated above. Viola- 
i tion of said conditions renders the permit voidable and unless satisfactorily 
I explained will result in the cancellation of the permit on the books of the 
I health department. 
Wm. C. Woodward, M. D., 
Health Officer, 
