Winnipeg SOP 2-3: Chemical Usage Verification Log

• Site conducted

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• Winnipeg SOP 2-3: Chemical Usage Verification Log

• Prepared by

• Location
  Address

• Select the date and time of inspection.
  Check the concentration of the QUAT sanitizer in each location before the start of production using QT10 or QT40 QUAT Test Strips.
  The concentration of the fruit & vegetable wash should be checked using Antimicrobial Fruit and Vegetable Treatment Test Strip. Record your results and initial.
  Both the QUAT and Sodium Dodecylbenzenesulfonate/Lactic Acid concentrations should meet the minimum requirement indicated.
  If the concentration is too low, check to ensure that the jug of chemicals are not empty.
  Otherwise, the chemical supplier should be contacted immediately to adjust the dispensing equipment.
  Record your results and initial.
  Record corrective actions taken in the slots provided where necessary.
  Plant Manager should verify daily.
  

Morning Checking (AM)

• Date and Time of Inspection

  Date

• Processing Room - Dish Sanitizer (2-Compartment Sink) (Minimum Requirement: 200 ppm QUAT)

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Processing Room - Hydrochem Floor Sanitizer (Minimum Requirement: 400 ppm QUAT)

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Processing Room - Vegetable Wash Disinfectant (Minimum Requirement: 0.75 - 1.00 oz/gal)

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Foot Dip (Front Entry) (Minimum Requirement: 400 ppm QUAT)

• Empty the foot dip and refill with sanitizer at 400 ppm. Ensure that the sanitizer is reading 400 ppm prior to filling the foot dip.

• Corrective Action(s)

• Re-test

• Foot Dip (Receiving Area) (Minimum Requirement: 400 ppm QUAT)

• Empty the foot dip and refill with sanitizer at 400 ppm. Ensure that the sanitizer is reading 400 ppm prior to filling the foot dip.

• Corrective Action(s)

• Re-test

• Dish Room - Dish Sanitizer (Dishwasher) (Minimum Requirement: 200 ppm QUAT)

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Dish Room - Ultra San (Dishwasher) (Minimum Requirement: 50 - 200 ppm Chlorine)

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Inspector Initials

  Sign

Afternoon Spot Check

• Date and Time of Inspection

  Date

• Spot Check Location #1

  Select Processing Room - Dish Sanitizer (2-Compartment Sink) Processing Room - Vegetable Wash Disinfectant Foot Dip (Front Entry) Dish Room - Dish Sanitizer (Dishwasher) Dish Room - Ultra San (Dishwasher) Processing Room - Hydrochem Floor Sanitizer Foot Dip (Receiving Area)

  • Processing Room - Dish Sanitizer (2-Compartment Sink)
  • Processing Room - Vegetable Wash Disinfectant
  • Foot Dip (Front Entry)
  • Dish Room - Dish Sanitizer (Dishwasher)
  • Dish Room - Ultra San (Dishwasher)
  • Processing Room - Hydrochem Floor Sanitizer
  • Foot Dip (Receiving Area)

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Location #2

  Select Processing Room - Dish Sanitizer (2-Compartment Sink) Processing Room - Vegetable Wash Disinfectant Foot Dip (Front Entry) Dish Room - Dish Sanitizer (Dishwasher) Dish Room - Ultra San (Dishwasher) Processing Room - Hydrochem Floor Sanitizer Foot Dip (Receiving Area)

  • Processing Room - Dish Sanitizer (2-Compartment Sink)
  • Processing Room - Vegetable Wash Disinfectant
  • Foot Dip (Front Entry)
  • Dish Room - Dish Sanitizer (Dishwasher)
  • Dish Room - Ultra San (Dishwasher)
  • Processing Room - Hydrochem Floor Sanitizer
  • Foot Dip (Receiving Area)

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Spot Check Concentration #1

• Root Cause / Corrective Action(s)

  Select Empty chemical jug - Changed / refilled chemical jug Other - Contacted chemical service provider

  • Empty chemical jug - Changed / refilled chemical jug
  • Other - Contacted chemical service provider

• Re-test

• Place a "DO NOT USE" sign on the chemical dispenser. Inform staff and contact chemical service provider.

• Inspector Initials

  Sign

• Reviewed by Plant Manager

  Sign