**Form FFC-2b. Chemical Use Log for Clinical Field Trials Using
Aquaflor^7^ as a Feed Additive Under INAD #10-697 - [Aquaflor^TM^
Medicated Feed]{.underline}**

**[Instructions:]{.underline}** 1. Initiate Form 2 immediately upon
receipt of Aquaflor^7^ treated feed.

2\. Each lot number of Aquaflor^7^ treated feed should be used for a
single treatment regime.

3\. A signed copy of Form 2 should be sent to the Study Monitor at the
end of the Study Year.

4\. Original Form 2 should be archived at the investigating facility.

**Quantity on Hand Reporting**

**From Previous Page (lbs): \_\_\_\_\_\_\_\_\_\_\_\_\_\_ Facility:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Individual:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

<table style="width:100%;">
<colgroup>
<col style="width: 11%" />
<col style="width: 6%" />
<col style="width: 6%" />
<col style="width: 14%" />
<col style="width: 9%" />
<col style="width: 9%" />
<col style="width: 9%" />
<col style="width: 10%" />
<col style="width: 10%" />
<col style="width: 9%" />
</colgroup>
<tbody>
<tr class="odd">
<td><strong>Aquaflor<sup>7</sup> Treated Feed Lot Number and %
Premix</strong></td>
<td><p><strong>Date</strong></p>
<p><strong>Received</strong></p></td>
<td><strong>Amount Received (lbs)</strong></td>
<td><strong>Dates Used</strong></td>
<td><p><strong>Study</strong></p>
<p><strong>Number</strong></p></td>
<td><p><strong>Aquaflor<sup>7</sup></strong></p>
<p><strong>Treated Feed Used for Teatment (lbs)</strong></p></td>
<td><p><strong>Aquaflor<sup>7</sup></strong></p>
<p><strong>Treated Feed</strong></p>
<p><strong>Shipped<sup>1</sup> (lbs)</strong></p></td>
<td><p><strong>Aquaflor<sup>7</sup></strong></p>
<p><strong>Treated Feed</strong></p>
<p><strong>Disposal<sup>2</sup> (lbs)</strong></p></td>
<td><p><strong>Aquaflor<sup>7</sup></strong></p>
<p><strong>Treated Feed</strong></p>
<p><strong>On-hand (lbs)</strong></p></td>
<td><p><strong>Inventoried by</strong></p>
<p><strong>(initials)</strong></p></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td><strong>Shipped</strong></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

**^1^ Unused Aquaflor^7^ treated feed that is shipped to another
facility participating in Aquaflor^7^ INAD 10-697 ([Note]{.underline}:
Aquaflor^7^ treated feed can only be shipped to another facility with
prior**

**authorization by the AADAP Office).**

**^2^ Unused Aquaflor^7^ treated feed that is disposed of by burial or
in a landfill.**

**Investigator: Study Monitor:**

> **Signature and Date Signature and Date**