APPENDIX A

United States Department of Agriculture

Agricultural Marketing Service

Fruit and Vegetable Program

Specialty Crops Inspection Division

PLANT SURVEY

PLANT FACILITIES, EQUIPMENT, ENVIRONMENT,

MANAGEMENT AND OPERATIONS

NAME OF PLANT

 

LOCATION OF PLANT

AREA FIELD OFFICE

TYPE OF CONTRACT OR SERVICE

PRODUCT(S) PACKED DURING SURVEY

ANNUAL SURVEY (FINAL) COMPLETED BY DATE

 

OVERALL SANITATION LEVEL ACCEPTABLE UNACCEPTABLE

RECOMMENDED APPROVAL 

EXAMPLE

YES NO CONDITIONAL
LOCATION OF MAIN OFFICE (Complete mailing address, 

including Zip Code)

LOCATION OF PLANT COVERED BY THIS REPORT 

(Complete mailing address including Zip Code)

, , 

 STATUS OF PROPRIETORSHIP

INDIVIDUALLY OWNED

CORPORATION

PARTNERSHIP

COOPERATIVE

OTHER

OWNERS OR OFFICERS

NAME TITLE

MANAGERS, SUPERINTENDENT, OR RESPONSIBLE FOREMAN

NAME TITLE

AUTHORIZED PERSON RESPONSIBLE FOR SANITATION

NAME TITLE

TO WHOM DO THEY REPORT?

 PERSON WITH WHOM THE USDA INSPECTOR IS TO DEAL

NAME

EXAMPLE

TITLE
CODING SYSTEM - CODE MARKING SYSTEM INCORPORATES

COMMODITY

DATE

SHIFT

 TYPE

STYLE

SIZE

 GRADE

SYRUP

PLANT

PERIOD

OTHER (SPECIFY)

INSPECTION SERVICE

WHAT IS THE REASON FOR THIS COMPANY APPLYING FOR INSPECTION SERVICE?

DOES THIS COMPANY INTEND TO USE SHIELDED LABELS OR OTHER APPROVED IDENTIFICATION OF CONTAINERS?

NONE LIMITED EXTENSIVELY

FILL IN THE FOLLOWING INFORMATION REGARDING PRODUCTS PACKED BY THIS PLANT

COMMODITY SEASON COMMODITY SEASON

DEFICIENCIES

DEFINITION OF TERMS

RATING

MINOR (MN) - Do not result in product contamination but are not desirable .

MAJOR (MJ) - May result in product contamination or are highly objectionable .

CRITICAL (CR) - Result in product contamination .

OVERALL SANITATION LEVEL

ACCEPTABLE - No critical or major defects that would have a significant impact on 

product contamination.

UNACCEPTABLE - Plant practices or operations present that result in product 

EXAMPLE

contamination or potential product contamination .
A. SANITATION CONTROLS

YES NO RATING

1. Is there a planned sanitation program that includes an educational training program for 

personnel hygiene and plant sanitation? 

2. Does the plant have an authorized person charged with the responsibility to administer 

an effective sanitation program?

3. Does the plant maintain or utilize a bacteriological laboratory?

4. Does the plant maintain or utilize a pesticide residue laboratory?

5. Is there an adequate program to prevent rodents, birds or animals on the premises, in 

the receiving area, and/or warehouse? *

6. Is there an adequate program to control insects on the premises, in the receiving area, 

processing area, and/or warehouse? *

7. Does the plant contract for a commercial exterminator?

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation'

EXAMPLE
B. PREMISES

 Parking Lot and Yard Surfaces PAVED BLACKTOP DIRT GRAVEL

YES NO RATING

1. Are there significant deficiencies in the general appearance of the premises?

2. Are weeds, trash, rubbish, unused machinery or "junk" a problem?

3. Are there conditions on adjacent properties that could cause sanitation problems?

4. Is there evidence of rodent/insect harborage?

5. Are there offensive odors? *

6. Is there a dust or soot problem? *

7. Is there a drainage problem? *

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
C. RECEIVING AREA

YES NO RATING

1. Is the general appearance satisfactory?

2. Is the area designed to facilitate cleanup?

3. Does there appear to be adequate cleanup equipment available?

4. Is the area free from offensive odors? *

5. Is debris and product refuse removed on a timely basis? *

6. Are there sufficient facilities for handling raw materials in an efficient and expeditious 

manner? *

7. Do raw material storage and handling practices preclude contamination by 

environmental hazards such as rodents, birds and insects? *

8. Are raw product containers cleaned and stored satisfactorily? *

9. Are holding tanks, holding bins, conveying equipment and devices adequately 

cleaned? *

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
D. PLANT CONSTRUCTION AND DESIGN

YES NO RATING

1. Is the general appearance, construction and condition of the buildings satisfactory?

2. Are all exterior openings (including doors, windows, and wall openings) equipped 

with screens in good condition or otherwise protected?

3. Are exterior screen doors self-closing and/or air screens operating satisfactorily?

4. Are floors constructed of materials which can be well cleaned?

5. Are walls and ceilings in good condition and of the type that can be kept clean?

6. Are lights shatterproof or equipped with protective shields?

7. Is there an in-line chlorination or other sanitizing system?

8. Are there sufficient facilities including steam and water outlets throughout the plant 

for cleanup?

9. Is there a rodent-proof storage area for salt, sugar, and other product ingredients?

10. Is there proper locked storage for chemicals, cleaning compounds, and similar 

materials separate from product ingredients and container storage?

11. Is there sufficient lighting to permit efficient operations and cleaning? *

12. Do floors, gutters or drains have sufficient slope and outlets to drain adequately? *

13. Are buildings adequately ventilated so that all areas are kept reasonably free from 

excessive heat, steam, condensation, vapors, smoke, or fumes? *

14. Are there leaks in the roof? *

15. Are there leaking pipes or valves? *

16. Is the tool shop neat, orderly and well maintained? *

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
E. PROCESSING AREA, EQUIPMENT AND FACILITIES

YES NO RATING

1. Is the general appearance satisfactory?

2. Are the equipment and area structures free from flaking paint and rust?

3. Are all product contact surfaces of equipment, containers and utensils made of 

non-absorbent corrosion resistant material that will not affect the product by chemical 

or physical contact?

4. Is the equipment constructed and located so that product contact surfaces are 

accessible for cleaning, maintenance and inspection?

5. Are equipment, containers, and utensils in good condition?

6. Is idle or unused processing equipment clean and located or arranged so as not 

interfere with cleanup?

7. Are equipment, containers and utensils constructed of wood? (If so, for what 

purpose and what is the condition. Show in Remarks.)

8. Are product contact brushes in good condition?

9. Are motors, conveyor belts and drive mechanisms located and protected so that oil 

or grease will not contaminate the product?

10. Are cross belts adequately protected?

11. Are catwalks and stiles properly constructed and located to prevent product 

contamination?

12. Is the area free from offensive odors? *

13. Are containers and utensils used in handling the product cleaned, stored, and 

utilized in such a manner as to preclude an insanitary condition? *

14. Are can cleaners (steam, air or water) on each line for glass, tin and semirigid 

containers?

15. Is the can cleaning system adequate for cleaning containers?

16. Are product belts clean and in good condition? *

17. Are gutters and drains in good repair, functioning satisfactorily, and properly fitted 

with grates and screens?

18. Are plant facilities and equipment satisfactory with respect to absence of slime 

and/or mold buildup? *

19. Are cleanup procedures adequate and supported by: *

 a. proper equipment and materials?

 b. trained and well supervised personnel?

 c. sufficient time to accomplish the work?

20. Are blending tanks, product ingredient pipelines, pumps, and valves cleaned 

frequently (including dismantling if necessary)? *

21. When overflow sirup and brine are used, are they properly handled to avoid 

contaminating the products? *

22. Are window ledges, wall plates, beams, equipment, etc., free from lunch boxes, 

tools, and personal gear? *

* Answer when plant is in operation

EXAMPLE
E. PROCESSING AREA, EQUIPMENT AND FACILITIES (continued)

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
F. WATER SUPPLY

MUNICIPAL PRIVATE BOTH

YES NO RATING

1. Is the plant's water supply approved by a state, municipal or private authority?

2. If yes, name the authority. 

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
G. TOILET FACILITIES

YES NO RATING

1. Is there an adequate number of toilet facilities?

2. Do toilet rooms have independent outside ventilation?

3. Are toilet rooms designed so that they do not open directly into rooms or 

compartments in which processed products are being handled?

4. Are toilet rooms equipped with self-closing doors?

5. Are toilet rooms well lighted?

6. Are there sufficient and proper waste receptacles?

7. Are there signs posted indicating the importance of hand washing (multilingual if 

appropriate)?

8. Do hand washing facilities include hot and cold water, soap, and individual towels or 

forced air hand dryers?

9. Are toilet rooms clean, dry and of good general appearance? *

10. Are all toilets, sinks, and faucets in good working condition? *

11. Are waste receptacles emptied as necessary? *

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when the plant is in operation

EXAMPLE
H. WAREHOUSE AND STORAGE FACILITIES

YES NO RATING

1. Is the warehouse in good repair?

2. Are the packaging, labeling, and storage areas neat and orderly?

3. Are empty containers protected from dust and other sources of contamination?

4. Are materials and supplies stacked in a manner to permit sanitation inspection?

5. Is the condition of storage areas adequate to protect the finished product, materials, 

and supplies from the elements?

6. Are there adequate facilities to cool and maintain the raw product when necessary?

7. Are there adequate facilities to refrigerate or freeze the finished product as required?

8. Are there temperature-recording devices located in the freezer facilities?

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when the plant is in operation

EXAMPLE
I. WASTE DISPOSAL

(refers to waste areas in the plant and on plant premises )

YES NO RATING

1. Is there an adequate number of waste disposal containers and are they made of 

materials suitable for the intended use?

2. Are waste containers in good condition?

3. Is the general appearance of collecting area satisfactory? *

4. Is the frequency or removal of the waste timely? *

5. Is drainage suitable in all area(s) *

6. Are waste disposal containers cleaned regularly? *

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
J. LABORATORY FACILITIES

YES NO RATING

1. Is the location, size, heating, cooling, and ventilation of the laboratory sufficient to 

provide a good working environment for the inspectors?

2. Is the USDA-approved lighting available for color scoring?

3. Is adequate space and inspection equipment available (including microscope and 

other appropriate specialized equipment)?

4. Does the laboratory meet basic safety requirements?

5. Are properly equipped grading stations available for line checks?

6. Is the laboratory used only by USDA and quality control personnel?

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
K. PERSONNEL

YES NO RATING

1. Do employees wear suitable clothing, including effective head coverage? *

2. Are employees working in the processing area free from unsecured jewelry 

(bracelets, dangling earrings, etc.)? *

3. Are employees working in direct contact with food, free from infected lesions or 

skin diseases? *

4. Is gum chewing and all uses of tobacco limited to designated areas away from the 

processing areas? *

5. Are other personal habits such that they will preclude contamination of the food? *

6. Does plant management provide for personal comfort and assistance, such as: *

 a. A lunchroom?

 b. A first-aid station?

 c. Suitable working condition of temperature and humidity?

DEFICIENCIES

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

* Answer when plant is in operation

EXAMPLE
DEFICIENCIES (CONTINUATION SHEET)

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

This continuation sheet may be used for any section of the plant survey.

EXAMPLE
MANDATORY CHANGES REQUIRED IF CONDITIONAL APPROVAL WAS GRANTED

ITEM

Letter and 

Number

DEFICIENCIES

CONTINUATION SHEET FOR:

MANDATORY CHANGES REQUIRED IF CONDITIONAL APPROVAL WAS GRANTED

ITEM

Letter and 

Number

DEFICIENCIES

EXAMPLE
ANNUAL SURVEY (Preliminary)

CONDUCTED BY: APPROVED BY:

INSPECTOR'S SIGNATURE DATE SUPERVISOR'S SIGNATURE DATE

ANNUAL SURVEY (Final)

CONDUCTED BY: APPROVED BY:

SUPERVISOR'S SIGNATURE

 

DATE OFFICER'S-IN-CHARGE SIGNATURE DATE

 

Auditor

EXAMPLE
FOLLOW-UP SUMMARY SHEET FOR DEFICIENCIES

(List deficiencies noted on previous survey. If corrected, note date corrected)

ITEM

Letter and 

Number

DESCRIPTION PROPOSED 

CORRECTIVE

ACTION DATE

DATE 

CORRECTED

CONTINUATION SHEET FOR:

FOLLOW-UP SUMMARY SHEET FOR DEFICIENCIES

(List deficiencies noted on previous survey. If corrected, note date corrected)

ITEM

Letter and 

DESCRIPTION PROPOSED 

CORRECTIVE

DATE 

CORRECTED

EXAMPLE
Number ACTION DATE

EXAMPLE