Pest Inspection Sanitation Report

• Location Name

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• Mice

  No

  Yes

  N/A

• Cockroaches

  No

  Yes

  N/A

• Flies

  No

  Yes

  N/A

• Stored Product Pests

  No

  Yes

  N/A

• Rats

  No

  Yes

  N/A

• Ants

  No

  Yes

  N/A

• Birds

  No

  Yes

  N/A

• Other

  No

  Yes

  N/A

Food Preparation

• Equipment clean?

  Yes

  No

  N/A

• Appliance drip pans clean?

  Yes

  No

  N/A

• Floors clean?

  Yes

  No

  N/A

• Sink drains clean?

  Yes

  No

  N/A

• Counters/Tables clean?

  Yes

  No

  N/A

• Food stored in pest-proof containers?

  Yes

  No

  N/A

• Perishables stored in refriderator?

  Yes

  No

  N/A

• Garbage removed daily before closing?

  Yes

  No

  N/A

• Spillage cleaned regularly?

  Yes

  No

  N/A

• Standing water?

  No

  Yes

  N/A

• Plumbing leaks?

  No

  Yes

  N/A

• Gaps around/under doors or windows?

  No

  Yes

  N/A

• Pest proofing need?

  No

  Yes

  N/A

Storage Areas

• Floors clean?

  Yes

  No

  N/A

• Floor drains clean

  Yes

  No

  N/A

• Food stored in pest-proof containers?

  Yes

  No

  N/A

• Spillage cleaned regularly?

  Yes

  No

  N/A

• Items store 6" to 8" off of floor?

  Yes

  No

  N/A

• Items stored 12" to 18" away from walls?

  Yes

  No

  N/A

• Stock rotated?

  Yes

  No

  N/A

• Clutter?

  No

  Yes

  N/A

• Pest proofing needed?

  No

  Yes

  N/A

Receiving

• Floors clean?

  Yes

  No

  N/A

• Clutter?

  No

  Yes

  N/A

• Empty boxes stored away from kitchen?

  Yes

  No

  N/A

• Pest proofing needed?

  No

  Yes

  N/A

Exterior

• Garbage cans cleaned weekly?

  Yes

  No

  N/A

• Garbage cans have lids?

  Yes

  No

  N/A

• Garbage area clean?

  Yes

  No

  N/A

• Garbage removed at least weekly?

  Yes

  No

  N/A

• Gaps under/around doors?

  No

  Yes

  N/A

• Area is trash and weed free?

  Yes

  No

  N/A

• Standing water?

  No

  Yes

  N/A

• Pest proofing needed

  No

  Yes

  N/A

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