Title Page
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Document No.
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Conducted on
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Personnel
Meat Pack
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IN-USE?
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Wire Conveyor
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Team Member Initials
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Time of the Corrective Action
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Check if an ATP swab was taken.
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Enter Corrective Actions Taken and Additional Swab Results
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Turkey Bagger<br>
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Team Member Initials
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Time of the Corrective Action
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Check if an ATP swab was taken.
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Enter Corrective Actions Taken and Additional Swab Results
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Koch Vacuum Packager
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Shrink Tunnel
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Conveyor
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Netting Tubes
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Tipper Tie Machine
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Tables (Define the table in the event a deficiency is identified.)
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Tubs (Define the tub in the event a deficiency is identified.)
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Stapler
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Flip-flop Vacuum Package Machine
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Slicer
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Team Member Initials
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Date of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Floors
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Team Member Initials
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Time of the Corrective Action
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Drains
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Team Member Initials
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Time of the Corrective Action
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Walls
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Team Member Initials
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Time of the Corrective Action
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Ceilings
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Team Member Initials
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Time of the Corrective Action
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Electrical Cords and Outlets
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Team Member Initials
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Time of the Corrective Action
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Water hoses and reels.
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Team Member Initials
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Time of the Corrective Action
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Lights
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Team Member Initials
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Time of the Corrective Action
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Cooling Units
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Team Member Initials
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Time of the Corrective Action
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Trash Cans
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Team Member Initials
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Time of the Corrective Action
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Metal Detector
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
T-570
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IN-USE?
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Flip-Flop
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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T-570
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Time of the Corrective Action
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Team Member Initials
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Urschel
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Tables
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Tubs
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Utensils
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Cutting Boards
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Carts
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Drains
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Team Member Initials
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Time of the Corrective Action
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Walls
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Team Member Initials
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Time of the Corrective Action
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Cooling Units
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Team Member Initials
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Time of the Corrective Action
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Electrical Cords and Outlets
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Team Member Initials
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Time of the Corrective Action
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Ceiling
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Team Member Initials
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Time of the Corrective Action
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Metal Detector
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Team Member Initials
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Time of the Corrective Action
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Floors
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Team Member Initials
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Time of the Corrective Action
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Trash Cans
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Team Member Initials
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Time of the Corrective Action
Smokehouse Area
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IN-USE?
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Smokehouse #1
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Smokehouse #2
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Smokehouse #3
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Smokehouse #4
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Smokehouse #5
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Smokehouse Loading Area
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Team Member Initials
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Time of the Corrective Action
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Smokehouse Unloading Area
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Team Member Initials
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Time of the Corrective Action
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Socks
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Team Member Initials
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Time of the Corrective Action
Misc Areas
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IN-USE?
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Meat Pack Hall - Is the foot sanitizer operating?
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Team Member Initials
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Time of the Corrective Action
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Meat Pack Hall - Is dry sanitizer applied prior to employees entering the area?
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Team Member Initials
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Time of the Corrective Action
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Meat Pack Hall - Fryer Vents
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Team Member Initials
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Time of the Corrective Action
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Meat Pack Hall - Fryer Hood
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Team Member Initials
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Time of the Corrective Action
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Meat Pack Hall - Fryer
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Meat Pack Hall - Is the ramp area free from trash and in good condition?
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Team Member Initials
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Time of the Corrective Action
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Meat Pack Hall - Scale
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Meat Pack Hall - Conveyor
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Team Member Initials
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Time of the Corrective Action
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Was an ATP swab taken?
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Enter Corrective Actions Taken and Additional Swab Results
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Cart Wash Area - Is the area clean and free of trash and/or other debris?
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Team Member Initials
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Time of the Corrective Action
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Smokehouse Auxillary Area - Is the area in good condition and free of standing water, trash, and other debris?
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Team Member Initials
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Time of the Corrective Action
RECORDS VERIFICATION:
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Verification Signature:
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Date/Time:
Footer
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Did USDA conduct a Pre-Op inspection?
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Outline any deficiencies noted by the inspector.
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Has the area been released to production?
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What time was the area released?
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Detail why the area was not released.
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Date and Time the Audit is completed
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Employee Conducting the Audit
