P t 3 - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1.0 PREMISES

• 1.1 CLEAN DOCK AREA

  Yes

  No

  N/A

• 1.2 SWEEP FLOOR

  Yes

  No

  N/A

• 1.3 PLANT WASHROOMS

  Yes

  No

  N/A

• 1.4 OFFICE WASHROOMS

  Yes

  No

  N/A

• 1.5 LUNCHROOM TABLES

  Yes

  No

  N/A

• 1.6 LUNCHROOM MICROWAVE

  Yes

  No

  N/A

• 1.7 LUNCHROOM REFRIGERATOR

  Yes

  No

  N/A

• 1.8 LOCKERS

  Yes

  No

  N/A

• 1.9 SHELVES

  Yes

  No

  N/A

• 1.10 OFFICE FLOORS

  Yes

  No

  N/A

• 1.11 LUNCHROOM FLOORS

  Yes

  No

  N/A

• 1.12 OUTSIDE PREMISES

  Yes

  No

  N/A

• 1.13 OFFICE SHELVES

  Yes

  No

  N/A

• 1.14 WAITING AREA

  Yes

  No

  N/A

• 1.15 OFFICE & LUNCHROOM LIGHTS

  Yes

  No

  N/A

• 1.16 WINDOWS

  Yes

  No

  N/A

• 1.17 COUNTER TOPS

  Yes

  No

  N/A

• 1.18 WALLS

  Yes

  No

  N/A

• 1.19 INSPECT SOAPS / SANI.

  Yes

  No

  N/A

2.0 SHIPPING AREA

• 2.1 CLEAN DOCK

  Yes

  No

  N/A

• 2.2 SWEEP FLOOR

  Yes

  No

  N/A

• 2.3 CLEAN BOX AREA

  Yes

  No

  N/A

• 2.4 CLEAN GARAGE DOORS

  Yes

  No

  N/A

• 2.5 WASH FLOOR

  Yes

  No

  N/A

• 2.6 TIDY UP BOXES

  Yes

  No

  N/A

• 2.7 CLEAN DRIVER DOOR ENTRANCE

  Yes

  No

  N/A

• 2.8 CEILINGS

  Yes

  No

  N/A

• 2.9 LIGHTING

  Yes

  No

  N/A

• 2.10 PRODUCTION ROOM

  Yes

  No

  N/A

3.0 PRODUCTION ROOM

• 3.1 FLOORS

  Yes

  No

  N/A

• 3.2 WALLS

  Yes

  No

  N/A

• 3.3 CEILINGS

  Yes

  No

  N/A

• 3.4 REFRIGERATION FANS & UNITS

  Yes

  No

  N/A

• 3.5 TABLE TOPS

  Yes

  No

  N/A

• 3.6 DRAINS

  Yes

  No

  N/A

• 3.7 LIGHT FIXTURES

  Yes

  No

  N/A

• 3.8 SINKS

  Yes

  No

  N/A

• 3.9 PAPER TOWEL DISPENSERS

  Yes

  No

  N/A

• 3.10 KNIFE SANITIZERS

  Yes

  No

  N/A

• 3.11 CARTS AND TROLLEYS

  Yes

  No

  N/A

• 3.12 DOORS

  Yes

  No

  N/A

• 3.13 DRAIN COVERS

  Yes

  No

  N/A

• 3.14 SOAP DISPENSERS

  Yes

  No

  N/A

4.0 SPICE ROOM

• 4.1 CLEAN DOOR

  Yes

  No

  N/A

• 4.2 SWEEP FLOOR

  Yes

  No

  N/A

• 4.3 WASH FLOOR

  Yes

  No

  N/A

• 4.4 EMPTY GARBAGES

  Yes

  No

  N/A

• 4.5 SCALE

  Yes

  No

  N/A

• 4.6 TABLES

  Yes

  No

  N/A

• 4.7 EMPTY SHELVES AND CLEAN

  Yes

  No

  N/A

• 4.8 INGREDIENT CONTAINERS (LARGE & SMALL)

  Yes

  No

  N/A

• 4.9 LIGHTING

  Yes

  No

  N/A

• 4.10 INGREDIENT SCOOPERS

  Yes

  No

  N/A

• 4.11 WALLS

  Yes

  No

  N/A

• 4.12 CEILINGS

  Yes

  No

  N/A

5.0 FREEZER / FRIDGE

• 5.1 DOORS

  Yes

  No

  N/A

• 5.2 FLOOR

  Yes

  No

  N/A

6.0 PRODUCTION ROOM

• 6.1 SLICER

  Yes

  No

  N/A

• 6.2 NEEDLER

  Yes

  No

  N/A

• 6.3 KNIVES / STEELES / CLEAVERS

  Yes

  No

  N/A

• 6.4 CUTTING BOARDS

  Yes

  No

  N/A

• 6.5 MIXER / GRINDER

  Yes

  No

  N/A

• 6.6 TENDERIZER

  Yes

  No

  N/A

• 6.7 SCALE / PRINTER

  Yes

  No

  N/A

• 6.8 VACUUM PACK

  Yes

  No

  N/A

• 6.9 TUMBLER

  Yes

  No

  N/A

• 6.10 KNIFE SANITIZERS

  Yes

  No

  N/A

• 6.11 SINKS

  Yes

  No

  N/A

• 6.12 MEAT SCRAPERS

  Yes

  No

  N/A

• 6.13 TABLE SCRAPERS

  Yes

  No

  N/A

• 6.14 BASKETS

  Yes

  No

  N/A

• 6.15 GARBAGE BINS

  Yes

  No

  N/A

7.0 DAILY EQUIPMENT

• 7.1 KNIFE SHARPENER / HONER

  Yes

  No

  N/A

• 7.2 TRAYS

  Yes

  No

  N/A

8.0 NON-DAILY EQUIPMENT

• 8.1 MEAT STRIPPER

  Yes

  No

  N/A

• 8.2 SAUSAGE STUFFER

  Yes

  No

  N/A

• 8.3 PATTY MACHINE

  Yes

  No

  N/A

• 8.4 AUTOMATIC BREADER

  Yes

  No

  N/A

• 8.5 BAND SAW

  Yes

  No

  N/A

• 8.6 200 LB TUMBLER

  Yes

  No

  N/A

• 8.7 INEDIBLE BINS

  Yes

  No

  N/A

• 8.8 VEHICLE

  Yes

  No

  N/A

• 8.9 MIXER

  Yes

  No

  N/A

• NOTES:

• PCI SUPERVISOR SIGNATURE:

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