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DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION NAME AND LOCATION OF DAIRY FARM

DAIRY FARM INSPECTION REPORT

INSPECTING AGENCY

POUNDS SOLD DAILY PLANT PERMIT NO.

Inspection of your dairy farm today showed violations existing in the Items checked below. You are further notified that this inspection report serves as notification of the intent to suspend your permit if the violations noted are not in compliance at the time of the next inspection. (Refer to Sections 3 and 5 of the Grade "A" Pasteurized Milk Ordinance .)

COWS
1. Abnormal Milk:
Cows secreting abnormal milk milked last or in separate equipment ............................................................................. (a) Abnormal milk properly handled and disposed of ..................... (b) Proper care of abnormal milk handling equipment .................... (c)

Cleaning Facilities Two-compartment wash and rinse vat of adequate size ............ (a) Suitable water heating facilities ................................................. (b) Water under pressure piped to milkhouse ................................. (c)

TRANSFER/PROTECTION OF MILK
14. Protection From Contamination:
No overcrowding ....................................................................... (a) Product and CIP cleaning circuits separated ............................. (b) Improperly handled milk discarded ........................................... (c) Immediate removal of milk ........................................................ (d) Milk and equipment properly protected ..................................... (e) Sanitized milk surfaces not exposed to contamination .............. (f) Air under pressure of proper quality ......................................... (g)

6. Cleanliness:
Floors, walls, windows, tables and similar non-product contact surfaces clean .......................................................... (a) No trash, unnecessary articles, animals or fowl ........................ (b)

MILKING BARN, STABLE, OR PARLOR
2. Construction:
Floors, gutters, and feed troughs of concrete or equally impervious materials; in good repair .................................... (a) Walls and ceilings smooth, painted or finished adequately; in good repair; ceiling dust-tight ............................................... (b) Separate stalls or pens for horses, calves, and bulls; no overcrowding ........................................................................ (c) Adequate natural and/or artificial light; well distributed ............. (d) Properly ventilated ..................................................................... (e)

TOILET AND WATER SUPPLY
7. Toilet:
Provided; conveniently located .................................................. (a) Constructed and operated according to Ordinance.................... (b) No evidence of human wastes about premises ......................... (c) Toilet room in compliance with Ordinance................................. (d)

15. Drug and Chemical Control:
Cleaners and sanitizers properly identified ................................ (a) Drug administration equipment properly handled and stored ..... (b) Drugs properly labeled (name and address) and stored ............ (c) Drugs properly labeled (directions for use, cautionary statements, active ingredient(s)) .................................................. (d) Drugs properly used and stored to preclude contamination of milk or milk product-contact surfaces .................................. (e)

8. Water Supply:
Constructed and operated according to Ordinance.................... (a) Complies with bacteriological standards ................................... (b) No connection between safe and unsafe supplies; no improper submerged inlets .................................................................. (c)

3. Cleanliness:
Clean and free of litter ............................................................... (a) No swine or fowl ....................................................................... (b)

PERSONNEL
16. Handwashing Facilities:
Proper handwashing facilities convenient to milking operations ............................................................................ (a)

4. Cowyard:
Graded to drain; no pooled water or wastes .............................. (a) Cowyard clean; cattle housing areas and manure packs properly maintained .............................................................. (b) No swine .................................................................................... (c) Manure stored inaccessible to cows .......................................... (d)

UTENSILS AND EQUIPMENT
9. Construction:
Smooth, impervious, nonabsorbent, safe materials; easily cleanable .................................................................... (a) In good repair; accessible for inspection .................................. (b) Approved single-service articles; not reused ............................. (c) Utensils and equipment of proper design ................................. (d) Approved CIP cleaned milk pipeline system .............................. (e)

Wash and rinse vats not used as handwashing facilities ........... (b)

17. Personnel Cleanliness:
Hands washed clean and dried before milking, or performing milkhouse functions; rewashed when contaminated ............. (a) Clean outer garments worn ....................................................... (b)

MILKHOUSE OR ROOM
5. Construction and Facilities:
Floors Smooth; concrete or other impervious material; in good repair ... (a) Graded to drain .......................................................................... (b) Drains trapped, if connected to sanitary system ........................ (c) Walls and Ceilings Approved material and finish ..................................................... (a) Good repair (windows, doors, and hoseport included) .............. (b) Lighting and Ventilation Adequate natural and/or artificial light; properly distributed ..... (a) Adequate ventilation .................................................................. (b) Doors and windows closed during dusty weather ..................... (c) Vents and lighting fixtures properly installed ............................. (d) Miscellaneous Requirements Used for milkhouse operations only; sufficient size ................... (a) No direct opening into living quarters or barn, except as permitted by Ordinance.......................................................... (b) Liquid wastes properly disposed of ........................................... (c) Proper hoseport where required ................................................ (d) Acceptable surface under hoseport ............................................ (e) Suitable shelter for transport truck as required ......................... (f)

COOLING
18. Cooling:
Milk cooled to 45°F (7°C) or less within 2 hours after milking, except as permitted by Ordinance.......................................... (a) Recirculated cooling water from a safe source and properly protected; complies with bacteriological standards .............. (b) An acceptable recording device shall be installed and maintained when required ....................................................................... (c)

10. Cleaning:
Utensils and equipment clean ................................................... (a)

11. Sanitization:
All multi-use containers and equipment subjected to approved sanitization process (Refer to Ordinance) ............................. (a)

12. Storage:
All multi-use containers and equipment properly stored ........... (a) Stored to assure complete drainage, where applicable ............. (b) Single-service articles properly stored ...................................... (c)

PEST CONTROL
19. Insect and Rodent Control:
Fly breeding minimized by approved manure disposal methods (Refer to Ordinance) ............................................................. (a) Manure packs properly maintained ........................................... (b) All milkhouse openings effectively screened or otherwise protected; doors tight and self-closing; screen doors open outward ................................................................................. (c) Milkhouse free of insects and rodents ....................................... (d) Approved pesticides; used properly ........................................... (e) Equipment and utensils not exposed to pesticide contamination ........................................................................ (f) Surroundings neat and clean; free of harborages and breeding areas ...................................................................... (g) Feed storage not attraction for birds, rodents or insects ........... (h)

MILKING
13. Flanks, Udders, and Teats:
Milking done in barn, stable, or parlor ...................................... (a) Brushing completed before milking begun ................................ (b) Flanks, bellies, udders, and tails of cows clean at time of milking; clipped when required ............................................. (c) Teats cleaned, treated with sanitizing solution (if required) and dried, just prior to milking .................................................... (d) No wet hand milking ................................................................. (e)

REMARKS

DATE

SANITARIAN

NOTE: Item numbers correspond to required sanitation Items for Grade "A" raw milk for pasteurization in the Grade "A" Pasteurized Milk Ordinance.

FORM FDA 2359a (10/08) Edition

PSC Graphics: (301) 443-1090

EF