Title Page
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Site conducted
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Conducted on
sarfeses
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Location
Note
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1-Food contact surfaces- Low Care Areas
*Less than 50 RLU= Pass / 51-99 RLU= Caution/ More than 100 RLU=Fail
2-Food contact surfaces- High Care Areas
*Less than 10 RLU= Pass / 11-29 RLU= Caution/ More than 30 RLU=Fail
3-Hands
Less than 60 RLU= Pass/ More than 60 RLU=Fail -
Noted:
*Pass= Cleaned and sanitized well
*Caution = Cleaned but not sanitized well
*Fail= Not cleaned and not sanitized properly
ATP
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Section
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Area-Low care/High Care:
Surface Swab
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Surface Name
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Result
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Status
Hand Swab
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Staff Name/B.No
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Result
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Status
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checd by:
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Verified by: