Pre-Operational Inspection: Forming Equipment

• Conducted on

  Date

• Prepared by

• Which protein is this pre-op for?

  Select Chicken Duck Lamb Salmon Turkey Venison

  • Chicken
  • Duck
  • Lamb
  • Salmon
  • Turkey
  • Venison

• The Forming Equipment must be free of meat and chemical residues, be organoleptically clean and pass ATP Swab testing before production can proceed.

Is the Following Equipment Clean & Sanitized?

Misc. Equipment

• Small Totes

  PASS

  FAIL

  NOT IN USE

• Buckets

  PASS

  FAIL

  NOT IN USE

• Mega Bins

  PASS

  FAIL

  NOT IN USE

• Carts

  PASS

  FAIL

  NOT IN USE

• Garbage cans and casters

  PASS

  FAIL

  NOT IN USE

• Tables

  PASS

  FAIL

  NOT IN USE

• Utensils

  PASS

  FAIL

  NOT IN USE

• Floors/Drains

  PASS

  FAIL

  NOT IN USE

• Ceiling/Walls

  PASS

  FAIL

  NOT IN USE

Mixer

• Dumper

  PASS

  FAIL

  NOT IN USE

• Grate

  PASS

  FAIL

  NOT IN USE

• Mixer Blades

  PASS

  FAIL

  NOT IN USE

• Hopper

  PASS

  FAIL

  NOT IN USE

• Tubes & Pipes

  PASS

  FAIL

  NOT IN USE

Strip Line

• Extruder Head

  PASS

  FAIL

  NOT IN USE

• Conveyor

  PASS

  FAIL

  NOT IN USE

• Tubes & Pipes

  PASS

  FAIL

  NOT IN USE

CO2 Mixer

• Dumper

  PASS

  FAIL

  NOT IN USE

• Hopper

  PASS

  FAIL

  NOT IN USE

• Grates

  PASS

  FAIL

  NOT IN USE

• Exit Flaps

  PASS

  FAIL

  NOT IN USE

Thinker Line

• Dumper

  PASS

  FAIL

  NOT IN USE

• Hopper

  PASS

  FAIL

  NOT IN USE

• Cutter

  PASS

  FAIL

  NOT IN USE

• Conveyors

  PASS

  FAIL

  NOT IN USE

"Furry Republic" Equipment

• Hopper

  PASS

  FAIL

  NOT IN USE

• Conveyor

  PASS

  FAIL

  NOT IN USE

ATP Swabs - Swab 5 different surfaces in this area. Results must be below 300 RLU

• Location of swab #1

  Media

• Swab #1 results

  Media

• Location of swab #2

  Media

• Swab #2 results

  Media

• Location of swab #3

  Media

• Swab #3 results

  Media

• Location of swab #4

  Media

• Swab #4 results

  Media

• Location of swab #5

  Media

• Swab #5 results

  Media

Organic

• Organic ?

  Yes

  No

• Concentration of QAC in ppm.

  0 ppm

  1+ ppm

• Production Lead has been notified and re-sanitation is in progress. QC will create a new Pre Operational Inspection Form and a re-check will be completed.

• Please take a picture of the QAC test strip results.

  Media

• Concentration of PAA in ppm.

  0-99 ppm

  100-160 ppm

• Production Lead has been notified and re-sanitation is in progress. QC will create a new Pre Operational Inspection Form and a re-check will be completed.

• Please take a picture of the PAA test strip results.

  Media

• Boiler Blowdown Conducted?

  Yes

  No

• Contact Maintenance to perform boiler blow-down.

• Concentration of QAC in ppm.

  0 ppm

  1+ ppm

• Production Lead has been notified and re-sanitation is in progress. QC will create a new Pre Operational Inspection Form and a re-check will be completed.

• Please take a picture of the QAC test strip results.

• QC Initials:

  Sign

• Notes & Comments:

Record Review

• Record Review:

  Sign

Revision Log

• 11-09-20 Version 2 Added BOL Information GG

• 12/12/20 Version 3 Removed BOL input. Added protein input KB

• 03/24/22 Version 4 Added Venison to protein list GG

• 04/13/22 Version 5 Added Ceiling/Walls