Free 2359l - Federal

U.S. Department of Health and Human Services Food and Drug Administration Milk Products Plant Date of Rating

STATUS OF MILK PLANTS
(INCLUDING DRYING AND CONDENSING MILK PRODUCTS PLANTS, RECEIVING STATIONS AND TRANSFER STATIONS) Sanitation Compliance Rating 1

ITEMS OF SANITATION
Containers and Equipment Pasteurization
Bottling Capping

Temperature Recording Charts

Personnel Cleanliness, Protective Clothing

Handwashing Facilities

NAME OF PLANT (MILK PRODUCT/ PASTEURIZATION/ FILLING AND CAPPING)

Pounds Processed Daily (100# Units) 3 X Total Debits2

Pounds Processed Daily (100# Units) 3

Indicating and Recording Thermometers Time and Temperature Controls

Milk Plant Cleanliness

Regenerative Heating

Adulteration Controls

Container Filing, Capping and Sealing

REMARKS

Doors and Windows

Walls and Ceilings

Storage of Clean Equipment Storage of SingleService Articles

Toilet/Sewage Disposal Facilities

Construction and Repair

Separate Rooms

Bacterial Count*

Protection From Contamination

Coliform Count*

Sanitary Piping

Water Supply

Surroundings

ITEM
WEIGHT

1 1

2 1

3 2

4a 1

4b 1

5 3

6 3

7 4

8 2

9 3

10 3

11 3

12ab 12c-f 13

14 2

15a 15b 3 5

(1)

16abc

(2)

16b-c 3

16d 16e 10 4

17 5

18 19 5

20 1

21 22 1 2 5* 10*

5

5

3

4

15

TOTALS

Footnotes:
1 Sanitation

2

Compliance Rating = 100 ­

Total Pounds Processed Daily (100# Units) 3 X Total Debits 2 Total Pounds Processed Daily (100# Units) 3
3

Total Debits for each milk plant, receiving station or transfer station is the sum of the weights of the Items violated. ( NOTE: Any Item or subitem violated, indicate by placing the debit value (weight) of that Item or an "X" under that Item.) Total Pounds Processed Daily are calculated in 100# Units.
PSC Graphics (301) 443-1090

*Used only when not in compliance. Pro-rated by product.

FORM FDA 2359L (10/08)

(PREVIOUS EDITIONS ARE OBSOLETE)

Total Debits2

Sanitization

Ventilation

Cleaning

Vehicles

Lighting

Cooling

Floors

EF