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FACILITY or AIRCRARTE OPERATIONAL UNIT

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ITEMS EVALUATED

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PLIANCE

| DATE
CcOR-

5S.

HEALTH CERTIFICATES

B. PERSONAL HYGIENE
C. TRAINING CERTIFICATES
D.

2.

EXAMINATION BY SUPERVISORS

FACILITIES ANDO EQUIPMENT

A.

DESIGN AND CONSTRUCTION

8.

VENTILATION

c.

FLOORS

D.

INSECT AND RODENT CONTROL

E.

PREPARATION SURFACES

6.

COM.

PLIANCE!

SANDWICHES
GREEN VEGETABLES
FROZEN FOOO
LEFT-OVER FOODS
DISHES AND UTENSILS
HANDLING PROCEDURES

WASHING AND SANITIZING
PRE-WASH

a. WASH (Temperature)

HAND WASHING FACILITIES

c. RINSE (Temperature)

MOP AND BROOM RACK

D. SANITIZING (Temperature or

t.

OUTSIDE AREA

J.

LATRINE(S)

Chemical}
—. LARGE FQUIPMENT /Pors, Pans,
etc. }

FROM APPROVED SOURCES
FOOD

8

WATER/ICE

F.

AIRCRAFT WATER AND COFFEE

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CONTAINERS

STORAGE TECHNIQUE
A.

REFRIGERATORS

8.

FREEZERS

‘.

COR.

RECTED

SERVING LINE (Temperature)

H.

A.

(65 o¢
DATE

POTENTIALLY HAZARDOUS FOODS

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4.

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NON-

TIME

PREPARATION TECHNIQUE

A.

F. UTENSIL STORAGE

3.

DATE EVALUATED

ITEMS EVALUATED

RECTED

FOOD HANDLERS
4.

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FOOD FACILITY SANITATION CHECK LIST

7.

OTHER FOOO CONTACT SURFACES
VENDING MACHINES

FACILITY CLEANLINESS

VEGETABLES

A.

GARBAGE STANDS/DUMPSTERS

BREAD AND BAKERY PROOUCTS

B.

GREASE (INTERCEPTORS

MILK DISPENSERS

Cc.

AIRCRAFT REFUSE HANDLING

DRY STORAGE
NON-FOOD

8.

OTHER

CLEAN EQUIPMENT
WENDING MACHINES

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REMARKS ANO RECOMMENDATIONS /Use reverse, if necessary)

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FOOD FACILITY REPRESENTATIVE
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PREV(Ods EDITIONS ARE OBSOLETE.

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SIGNATURE OF EVALUATOR

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