Information
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Conducted on
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Prepared by
PUMP ROOM
Is the Following Equipment Clean & Sanitized?
MISCELLANEOUS:
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Bowls?
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Cooling Units?
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Walls/Ceiling?
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Doors (Entry/Exit)?
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Floors?
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Drains?
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Hand Wash Sink?
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Product Sink?<br>
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Electrical Outlet?
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20-50ppm Chlorine Solution?
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Boot Foamer?
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Turkey Chute?
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V-Mags?
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Green Aprons?
PUMP ROOM:
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Cure Injector?
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Cure Injector Needles?
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Cure Injector Tank?
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Cure Injector Filter?
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Cure Mixer?
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Cure Mixer Tank?
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Cure Hoses?
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Injector Slide-Out Table?<br>
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Brisket Table?
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Netter?
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Stapler?
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Scales?
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Conveyors?
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Meat Racks?
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Tubs?
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Dip Sink?
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Injector Fall-Out?
ATP SWABBING
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Were ATP SWABS TAKEN?
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RESULTS:
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SIGN:
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DATE/TIME:
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VERIFICATION:
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DATE/TIME:
RAW ROOM
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Is the Following Equipment Clean & Sanitized?
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Roll-Stock Machine & Associated Parts?
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Urschel & Associated Parts?
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Tumbler & Associated Parts?
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Tumbler Filters?
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Hand Wash Sink?
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Equipment Sink?
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Soap Dispenser?
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Hand Dryer?
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Tables?
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Cutting Boards?
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Utensils?
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V-mags?
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Tubs?
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Doors?
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Walls/Ceiling?
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Cooling Units?
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Lights?
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Floor?
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Drains?
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Electrical Plugs?
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Hoses/Cords?
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ATP SWABS TAKEN?
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RESULTS:
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QFS INITIALS:
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DATE/TIME:
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VERIFICATION:
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DATE/TIME:
