Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
1.0 PREMISES
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1.1 CLEAN DOCK AREA
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1.2 SWEEP FLOOR
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1.3 PLANT WASHROOMS
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1.4 OFFICE WASHROOMS
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1.5 LUNCHROOM TABLES
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1.6 LUNCHROOM MICROWAVE
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1.7 LUNCHROOM REFRIGERATOR
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1.8 LOCKERS
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1.9 SHELVES
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1.10 OFFICE FLOORS
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1.11 LUNCHROOM FLOORS
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1.12 OUTSIDE PREMISES
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1.13 OFFICE SHELVES
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1.14 WAITING AREA
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1.15 OFFICE & LUNCHROOM LIGHTS
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1.16 WINDOWS
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1.17 COUNTER TOPS
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1.18 WALLS
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1.19 INSPECT SOAPS / SANI.
2.0 SHIPPING AREA
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2.1 CLEAN DOCK
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2.2 SWEEP FLOOR
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2.3 CLEAN BOX AREA
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2.4 CLEAN GARAGE DOORS
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2.5 WASH FLOOR
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2.6 TIDY UP BOXES
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2.7 CLEAN DRIVER DOOR ENTRANCE
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2.8 CEILINGS
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2.9 LIGHTING
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2.10 PRODUCTION ROOM
3.0 PRODUCTION ROOM
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3.1 FLOORS
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3.2 WALLS
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3.3 CEILINGS
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3.4 REFRIGERATION FANS & UNITS
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3.5 TABLE TOPS
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3.6 DRAINS
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3.7 LIGHT FIXTURES
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3.8 SINKS
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3.9 PAPER TOWEL DISPENSERS
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3.10 KNIFE SANITIZERS
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3.11 CARTS AND TROLLEYS
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3.12 DOORS
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3.13 DRAIN COVERS
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3.14 SOAP DISPENSERS
4.0 DAILY EQUIPMENT
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4.1 SLICER
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4.2 NEEDLEE
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4.3 KNIVES / STEELES / CLEAVERS
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4.4 CUTTING BOARDS
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4.5 MIXER / GRINDER
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4.6 TENDERIZER
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4.7 SCALE / PRINTER
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4.8 VACUUM PACK
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4.9 TUMBLER
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4.10 KNIFE SANITIZERS
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4.11 SINKS
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4.12 MEAT SCRAPERS
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4.13 TABLE SCRAPERS
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4.14 BASKETS
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4.15 GARBAGE BINS
5.0 PRODUCTION ROOM
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5.1 SLICER
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5.2 NEEDLER
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5.3 KNIVES / STEELES / CLEAVERS
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5.4 CUTTING BOARDS
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5.5 MIXER / GRINDER
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5.6 TENDERIZER
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5.7 SCALE / PRINTER
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5.8 VACUUM PACK
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5.9 TUMBLER
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5.10 KNIFE SANITIZERS
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5.11 SINKS
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5.12 MEAT SCRAPERS
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5.13 TABLE SCRAPERS
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5.14 BASKETS
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5.15 GARBAGE BINS
6.0 NON-DAILY EQUIPMENT
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6.1 MEAT STRIPPER
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6.2 SAUSAGE STUFFER
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6.3 PATTY MACHINE
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6.4 AUTOMATIC BREADER
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6.5 BAND SAW
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6.6 200 LB TUMBLER
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6.7 INEDIBLE BINS
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6.8 MIXER
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NOTES:
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DATE:
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CLIENT SIGNATURE:
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PCI SUPERVISOR SIGNATURE: