CHECKLIST REPORT OF FLOOR-LEVEL INSPECTION FOR SANITATION AND PEST CONTROL, PREPARED FOR INSPECTED BY LOCATION DATE TIME ‘The items below are to be checked YES of NO to indicate if the guidelines of the NPCA Sanitation and Pest Control Floor- Level Inspection Manual are met. Entries in the right hand column indicate deficiencies which should be corrected. a o NO A EXTERIOR AREAS 1. Absence of pest harborage 1 2. Absence of pest breeding 2 3. Garbage handing systems 3 4. Garbage storage area 4 5. Garbage containers 5 6 Garbage container cleaning 6 7. Trash disposal 7 8. Paving and drainage 8 9, Weed conto! 9 10. Perimeter rodent contol 40. ‘1. Perimeter insect control " 8. BUILDING EXTERIOR 4. Rodent proofing 1 2. Insect proofing 2 3. bird proofing 3 4 Roofs 4 5. Other structures 5 6. Lighting 6 C. BUILDING INTERIOR 1. Walls 1 2. Floors 2 3. Ceiings 3 4 Cleanabilty 4 5. Pits 5 6. Floor drains a 7. Plumbing 5 8. Ventiation =aan a ®. Condensation a 40. Lighting ee eae D. FOOD STORAGE Packaged and Dry Food Storage 1. Pest evidence absent 7 2. Proper storage practice Tamas i 3. Good housekeeping IR" orn a. 4. Emply container storage Taree seer aDamaged Good Storage 5. Segregation 6. Repackaging 7. Proper housekeeping returned goods 8. Adequate handling program Refrigerated Area 9. Pest evidence absent Condensation absent Cleaning satistactory 12, Other E, FOOD PREPARATION AREAS 4. Enclosed areas easily opened 2. Spaces under and behind equipment cleaned 3. Counter and surface areas clean 4, No permanent food storage in preparation area F. DISHWASHING AREA 4. Clean G. GARBAGE AND TRASH AREA (INDOOR) 4, Storage area for receptacles adequate 2. Storage area clean 3. Containers of proper type 4, Garbage containers regularly covered 5. Shows evidence of regular cleaning H. TOILET AND LOCKER ROOMS: Tollet Facilities 1. Adequate for current number of employees Sanitary and in good repair oor setf-closing and does not open into food area Handwashing Facilities 7. Adequate and convenient 8 Appropriate trash receptacles |. LUNCH ROOM 1. Accessible for cleaning 2. Clean J. VENDING MACHINES 1. Easily deaned 2. Pest harborage absent K UTILITY AREAS 1. Clean 2. Pest harborage absent UL TT AT IIL FUN TET NTL VP TT II | TT TTT 10. n 2 aera ReReL. OFFICE AREAS 4. Clean 2. Regular trash removal M, PUBLIC AREAS 4. Floor areas clean 2. Equipment and counters easily cleaned 3. Pest harborage absent INFESTATION ABSENT 4. Rodents. 2. Insects 3. Other EVIDENCE OF PEST ABSENT 4. Rodents 2. Insects 3. Otner REPORT REVIEWED: on wth WE UT TN Tl TV TIE Tl (Date) by (Name) for the client inspector (Manager) for the client REMARKS: