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DEPARTMENT OF HEALTH AND HUMAN SERVICES FOOD AND DRUG ADMINISTRATION
TEST NO.

MILK PLANT EQUIPMENT TEST REPORT
TEST TESTED FREQUENCY (X or NA)

TEST
Indicating Thermometers (including air space): Temperature Accuracy Recording Thermometers: Temperature Accuracy Recording Thermometers: Time Accuracy Recording Thermometers: Checked against Indicating Thermometer Flow-Diversion Device (FDD): Proper Assembly and Function (HTST and HHST) 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 Leakage Past Valve Seat(s) Operation of Valve Stem(s) Device Assembly (micro-switch) Single Stem Device Assembly (micro-switches) Dual Stem Manual Diversion - Parts (A, B, and C) (HTST only) Response Time Time Delay Interlock (dual stem devices) (Inspect) Time Delay Interlock (dual stem devices) (CIP) Leak Detect Flush Time Delay (HTST only as applicable)

(See Reverse for Working Notes)

RESULTS OF TEST

1. 2. 3. 4. 5.

3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 3 months 6 months 6 months 6 months 6 months 6 months 6 months 6 months 6 months 6 months 6 months 3 months 3 months 3 months 3 months Daily by operator (HTST) Adjusted product holding time if applicable Daily by operator

6. 7. 8. 9.

Leak-Protect Valves: Leakage (Vats only) Indicating Thermometers on Pipelines: Thermometric Response (HTST only) Recorder-Controller: Thermometric Response (HTST only) Regenerator Pressure Controls 9.1 9.2 9.2.1 9.2.2 9.2.3 9.3 9.3.1 9.3.2 Pressure Switches (HTST only) Differential Pressure Controllers Calibration Interwiring Booster Pump (HTST only) Interwiring FDD (HTST*, HHST and Aseptic) Additional Booster Pump Interwiring (HTST only) With FDD With Metering Pump

10. 11.

Milk-Flow Controls: Cut-in and Cut-out Temperatures (10.1, 10.2*, or 10.3*) Timing System Controls 11.1 11.2.a 11.2.b 11.2.c 11.2.d 11.2.e 11.2.f 11.3 11.4 11.5 Holding Time (HTST, except Magnetic Flow Meters) Magnetic Flow Meters (HTST only) Flow Alarm (HTST, HHST and Aseptic) Loss of Signal Alarm (HTST, HHST and Aseptic) Flow Cut-in/Cut-out (HTST only) Time Delay (after divert) (HTST with a FDD located at the end of the holding tube) High Flow Alarm Response Time (All Magnetic Flow Meter Systems) HHST Indirect Heating HHST Direct Injection Heating HHST Direct Infusion Heating

12. 13. 14. 15.

Controller: Sequence Logic (HHST and Aseptic) (12.1* or 12.2*) Product Pressure-Control Switch Setting (HHST and Aseptic) Injector Differential Pressure Injection Heating (HTST*, HHST and Aseptic) Electro-Magnetic Interference from Hand-Held Communication Devices (HTST, HHST and Aseptic)
*For HTST systems with the FDD located downstream of the regenerator and/or cooler section.

REMARKS (If additional space is required please place information on the back of this Form or on a separate page.)

PLANT

IDENTITY OF EQUIPMENT

LOCATION

DATE

SANITARIAN

NOTE: This Form is a supplement to the Milk Plant Inspection Report, FORM FDA 2359, and these tests are in addition to the equipment requirements for which compliance is determined by inspection. (Refer to Appendix I of the Grade "A" Pasteurized Milk Ordinance.)

FORM FDA 2359b (10/08)

(PREVIOUS EDITIONS ARE OBSOLETE)

PSC Graphics: (301) 443-1090

EF

Notes

FORM FDA 2359b (10/08)