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pdfFORM APPROVED OMB NO. 0580-0013: According to the Paperwork Reduction Act of 1995, no
FORM FGIS 952-2 (01/18) Expires January 2021
SANITATION INSPECTION REPORT
(OVERPACKER)
agency may conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 00580-0013.
The time required is estimated to average 1 hour per response and 1 minute of recordkeeping, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information.
SANITATION INSPECTION OF (Name and Address of Plant)
INSPECTOR
DATE INSPECTED
PLANT OWNED BY (Company or Individual)
INSPECTOR ACCOMPANIED BY (Name and Title)
GENERAL TYPES OF ITEMS INSPECTED
SANITARY DEFECTS
I. PACKING MATERIALS
Assigned
Defect
Points
CRITICAL
C. Not stored under sanitary conditions.
III. DISPOSAL OF WASTES
A. Floor drains not functional not properly trapped.
4
5
5
C. Insecticides or rodenticides are handled so as to contaminate
the product.
VI. STORAGE FACILITIES
4
3
3
C. All waste not collected and disposed of at frequent intervals
nor in a sanitary condition.
4
A. Toilet room opens directly into packing or storage areas.
5
B. Doors not self closing and tight fitting.
3
C. Absence of sign directing employees to wash hands.
3
D. Absence of hot or cold water, soap, or hand-drying facilities.
5
E. Toilet rooms not properly vented to the outside.
5
Inspector
Defect
Points
V. CONTROL OF INSECTS AND ANIMALS
B. Insects, birds, or animals present in plant.
B. Dry wastes not collected in suitable containers conveniently
located throughout the plant.
IV. TOILET, HAND-WASHING, AND DRESSING
ROOM FACILITIES
Assigned
Defect
Points
A. Rodent harborages or insect-breeding places places present.
II. LIGHTING
A. Insufficient lighting in areas where inspection and
examination are performed (50-foot candles).
SANITARY DEFECTS
5
A. Not free from adulteration.
B. Shows evidence of insanitary conditions or deterioration.
Inspector
Defect
Points
A. Storing methods do not minimize deterioration nor
contamination.
CRITICAL
5
B. Storage facilities not clean, sanitary nor in good repair.
3
C. Shelves, cabinets, or dunnage not used where necessary to
prevent contamination or deterioration.
5
XIV. PERSONNEL
A. Not free of communicable nor infectious disease.
CRITICAL
B. Not free of infected cuts, open sores or other lesions on
exposed parts of the body.
CRITICAL
TOTAL
0
Plant operations are considered to be insanitary if one or more
critical defects are found or if the plant receives a score of
21or higher.
REMARKS
Use reverse side of this form for additional remarks.
Name of Inspector
Date
CLEAR FORM
PRINT
FORM APPROVED OMB NO. 0580-0013: According to the Paperwork Reduction Act of 1995, no
FORM FGIS 952-2 (01/18) Expires January 2021
SANITATION INSPECTION REPORT
(OVERPACKER)
agency may conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this information collection is 00580-0013.
The time required is estimated to average 1 hour per response and 1 minute of recordkeeping, including the
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Expires January 2018
SANITATION INSPECTION OF (Name and Address of Plant)
INSPECTOR
1
4
5
DATE INSPECTED
PLANT OWNED BY (Company or Individual)
INSPECTOR ACCOMPANIED BY (Name and Title)
2
6
GENERAL TYPES OF ITEMS INSPECTED
3
Assigned
Defect
Points
SANITARY DEFECTS
7
I. PACKING MATERIALS
CRITICAL
C. Not stored under sanitary conditions.
8
Assigned
Defect
Points
SANITARY DEFECTS
4
5
B. Insects, birds, or animals present in plant.
5
5
C. Insecticides or rodenticides are handled so as to contaminate
the product.
II. LIGHTING
VI. STORAGE FACILITIES
A. Insufficient lighting in areas where inspection and
examination are performed (50-foot candles).
4
III. DISPOSAL OF WASTES
3
A. Floor drains not functional not properly trapped.
B. Dry wastes not collected in suitable containers conveniently
located throughout the plant.
3
C. All waste not collected and disposed of at frequent intervals
nor in a sanitary condition.
4
IV. TOILET, HAND-WASHING, AND DRESSING
ROOM FACILITIES
A. Toilet room opens directly into packing or storage areas.
5
B. Doors not self closing and tight fitting.
3
C. Absence of sign directing employees to wash hands.
3
D. Absence of hot or cold water, soap, or hand-drying facilities.
5
E. Toilet rooms not properly vented to the outside.
5
Inspector
Defect
Points
V. CONTROL OF INSECTS AND ANIMALS
A. Rodent harborages or insect-breeding places places present.
A. Not free from adulteration.
B. Shows evidence of insanitary conditions or deterioration.
Inspector
Defect
Points
A. Storing methods do not minimize deterioration nor
contamination.
CRITICAL
5
B. Storage facilities not clean, sanitary nor in good repair.
3
C. Shelves, cabinets, or dunnage not used where necessary to
prevent contamination or deterioration.
5
XIV. PERSONNEL
A. Not free of communicable nor infectious disease.
CRITICAL
B. Not free of infected cuts, open sores or other lesions on
exposed parts of the body.
CRITICAL
TOTAL
9
Plant operations are considered to be insanitary if one or more
critical defects are found or if the plant receives a score of
21or higher.
REMARKS
10
Use reverse side of this form for additional remarks.
Name of Inspector
11
Date
12
Instructions for Completing FGIS‑952‑2
1. Name of plant and physical address of the sanitation inspection.
2. Name of the company or individual that owns the plant.
3. Type of items inspected.
4. Name of the inspector performing the inspection.
5. Date of inspection.
6. Name and title of plant personnel that accompanied the inspector during the
inspection.
7. Assigned Defect Points. This column contains pre-assigned individual defect
points. The range of points assigned is based on the importance of the defect item to the
maintenance of good sanitation in the plant. For example, the defect item “Presence or evidence
of rodents in plant,” is assigned a point range of 0 to 5; whereas, “Waste not properly stored or
contained,” is assigned a point range of 0 to 3. The most serious defects do not have assigned
defect points but are listed as “critical.”
8. Inspector’s Defect Points. In this column rate the individual defect item based on your opinion
as to the relative potential for product contamination. If the item is clean and presents no
sanitation problem, assign 0 defect points to the item. If the item is relatively clean but not perfect,
assign 1 or 2 defect points to the item. If the item is insanitary or presents a clear hazard to
sanitary operations, assign the maximum defect points possible for that item. Score critical Items
as either “pass” or “fail.” For example, the item “Presence of live insects in processing or product
storage areas (two or more)” is a critical item. When any type of insect is present in the number
indicated, it is a critical defect.
9. Total the Inspector’s Defect Points. If the SIR score meets or exceeds 21, consider plant
operations insanitary. A plant may not have any critical items but their overall sanitary condition
is so poor that they should discontinue processing and have a general cleanup or initiate a
maintenance program. Evaluate plants in this condition based on their total SIR score.
10. Explain critical defects in the “Remarks” section to clearly describe the conditions observed.
11. Name of person that performed the inspection. .
12. Date SIR completed and signed..
Immediately after completing the SIR, give a copy to the plant representative. This copy is the
plant’s written notification of the conditions found.
Contact Information
Patrick McCluskey, Chief
Field Management Division
Policy,Procedures, and Market Analysis Branch
[email protected]
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |