PDF of Inspections from 14 Apr 2009

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9088490701
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US Dcp9rtlll.l:nt of A~iculturt
FOOD SAFElY AND INSPECTION SERVlCE
TYPE OF NONCOMPLL&.NCE
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---_._----
.. -.. - .....
l"ONCOMPLJANCE RECORD CONYINIJAY10N SUUT
...
... --.
\. DATE
2. RECORD NO.
.-
----.~-
-_.._---_ __..- _---_...
04114/2009
....
4. TO (Name o.nd TiUt)
0009·2009·12156
..
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P.01
__ ----- ._----_
[J
Food Safety
..
Other Consumer Plotcclion
.
3. ESTABLlSllMENI' NO.
- ............-
--_."---,,._-. -- .... -_...
17776 MIl
'
S. PERSQNNf.LNOTIFIED
Mohammad S. Malik, President, President/GM
Mohammad S. Malik
6. RF.LEVANTREGULi\.TlON(S)
416.4(d)
7. SECTIONIPAGE OF EST. PROCEDURE PLAN
- ...
I '"HACCP-''' ·· .. ·..·-r
SSOP .-
__.. -------_._--- - .__... _-._- __ _--- __ __ ,-----_
..
S.lSl' CODE
OlC02
..
SSOP - Monitoring
=->----~>=--=---~--=---~
10. DESCRIPTION OF NONCOMPLIANCE
SSOP page 7
..
..
.
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9. NONCOMPUMICE CLASSIFlCATION INDICATORS
-._ ....
.-.=. ..,.;.~-=-~--=--~~-~~--~~~
were also immediately retained with US Retained tags, numbers B38863256 and B388632257.
(b) (6)
the kill floor manager, was notified both times of the noncompliances, and that he would be receiviog a
Noncompliance Record.
.
1bis noncompliance is in direct violation of the regulatory requirements of 416.4(d), which states that "product must be
protected from adulteration during processing, handling, storage, loading and unloading, and during transportation from
official establisrune/lts."
Mr. (b) trimmed the grease spots under my direct suporvision. and the carcasses were released.
(6)
This(b)
document serves as written notification that your failure to comply with this regulatory requirements oou ld result in
additional
(7) regulatory or administrative action.
(C)
._-----,--- -_.. -._-_._,-_.----. __. --.... - ..
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
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SEP-97-19
TUE
93:99
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(b) (4)
9999499791
P_92
The reQuest (Ot' this ;nf~ation lCj; voluntary. II ~ nsedecJ _lD monnOi defects fOlJnd In lhi.s InsP8C1.ion £ystcrtl. tt 19 used by FSIS to dsiGnT1ino wh~lh(:r
eslabllshmenls ere In compliance. 9 CFR 301 3I1Q 9 CFR 381, FORM APPROVED OMB No, 0583-0089, OMS OISCLOSURE STATEMENT: Public
reporong ourden rot II\IS rollectloo 0/ Infonmal/orlls esUtOOl«I ~ Q,'e'Gge 7 minute, per "'"pon .... Including \11. ~m. /0••;>viewln,;j IMlructioflS, .ea,ching
existing data .OU=. gatl'leMng end m.linlalnJn9l11e data needed, and completing end mvlewing the COlleclJon o'ln'ormation. Sand comment. regarding this
, burden esljmate or sny o\I1er
or II\ls oollection or informatlon. Including 8uoo. .U"". fOr reduOing thi. bunden. 10 D<lpartment of AgriCIJilure. CIGa,ance
qtfj£"!',..c~IR_M. Ro<1,,!,_ 4:o~:::Y-,-~aohing\O!',-QQlO~~:, ~.nd 10th. Off~ ,,,-, In.f~rm~ti,~n ana R~~I~~ A!!.ai~".Q!'ioo or Ma~a([~meN ~n!'L~1.
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liS ~anmeot of AgrieulLu,e
FOOD SAFETY ANP INSPECTION SeRVICE
TYPE OF NONCOMPLlANCE
["~J food
NONc.oMP~!AN~ !l:.tCO~D
1 DATE
2,RECORD1'IO
02/\012009
0002-2009-13309
[J
s.rcty
OthCf Consumer Protection
3, ESTABLlSffl-IEl'IT NO
17776 M /1
4. TO (Name and Tille)
S PERSONNEL NOTIfIeD
Mohammad S. Malik. PresidentiGM
Mohammad S. Malik
6. RELEVANT REQUlAnON(S)
416.4(a); 416.4(d)
HACCP
7. SECTIONlPfl-GE OF EST. PROCEDURE PLAN
OTHER
ssor
SSOP/Pgs. 7 and 9
-. .•.. ---..
9. NONCoMrUANCE CLASS[f!CAnON INDICATORS
~
8. rsPCODE
,
SSOP - ImpleDJt\ntation
01C02
- ..
.
10. DESCRlP'1l0N OF NONCOMPUANCE
At 11:00 a.m. on 2110/09, while performing procedure 01C02 (operational sanitation), I observed the follDwing
noncompliances;
1. A goat carcass in the 3rd cooler was found to be adullerated with a piece of "rail dust," measuring approximately III 6" x
\/4." I immediately notified the floor manager, (b) (6)
who trimmed the carcass under my supervision.
2. Plant employees at the skinning and dehorning stations did not wash their hands or sanitize their tools aller handling
hides and horns and before touching the next carcass in line. The floor manager was immediately notified. (b) (6)
proceeded to retrain the entire kill floor workforce on proper dressing procedures under my direct observation.
3. The sterilizer at the sticking station was not
functioning properly, and the water temperature was found to be 8S degrees F. An immediate regulatory control action
was taken--U.S. Rejected Tag No. B36921218. Mr. Malik, the plant owner, was informed immediately, and the killing
procedure was suspended.
.
.
'~ ... '
These improper processes and procedures del)'lonslrate failure to comply with plant sanitation standard operating
procedures (SSOPs) as well as 9 CFR 416.<\(a) and (d), The planrs operational SSOP reads that (b) (4)
(b)(6),(b)(7)(c)
d/o, JXI.35 ,,!9 (·FR.
12 PLANT MANAGEMENT RESPONSE (Immediate BCtlon(!)):
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IS. DATE
EMPLOVFF.
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US DtP31tmC1l1 of ASl'I~ulluN
rOOD SAFETY AN/') INSPECTION SF.RVICE. .
NO!'lCOMPLlANCE RECORD CONTINUATioN SliEET
I. DATE
2. RJ!CORD NO
rx I Food S.fay
02/10/2009
17716 Mil
P.93
lYPE OF NONCOMPUANCE
I:
Other Consumer Protection
3, ESTAlILlSHMENT NO
0002-2009-13309
4. TO (Nanle and Title)
5. I'!;RS01'JNEL N011FJED
Mohammad S. Malik, PresidenUGM
Mohammad S. Malik
6. R£L£VAW REGUL,>. 1'ION(S}
4\6,4(a); 416.4(d)
7. Sf.CTiON~PAG£
of·EST. PROCEDURE"PLAN ..__..... r
I"ssop' .
HACCI'
. T' OTHER
SSOPlPgs. 7 and 9
8 lSI' COD!;
9. NONCOMPLIANCE CLASSIFICA TlON INDICA TORS
OlC02
SSO? - Implementation
..
'"
.
.
---.~
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10. DI!SCRJPTION OF NONCOMPLIANCE
(b) (4)
(b) (4)
Regulation 416.4(8) states that "all food-contact surfaces, including food-contact surfaces of utensils and equipment, must
be cleaned and sanitized as frequently IlS necessary to prevent the creation of insanitary conditions and the adulteration of
product." The fact that knives and sawblades could not be sanitized with (b) egree water, as written in the SSOP as the
(4)
sanitizing me-thod, demonstrates clear violation.
Regulation 416(d) states that "product must be protected from adulteration during processing, handling, storage, loading,
and unlOading at and during transportation from ofticial establishments."
Presenoe of an adulterant on finished product in the cooler indicates violation.
These noncompliances, indicating actual adulterati.en and the potential for contamination or cross·contamination of
carcasses, may have serious deleterious public health consequences. The ingestion of "rail dust," its actual composition
unknown, or any chemical and/or pathogeniC biological agent that may be transferred due to cross·contamination, could
lead to illness.
A similar noncompliance wag documented on NR 0013-2008·12156, written on 1210112008, WIder ISP Code 06001. Plant
management responses indicated that a new heating element was installed in the sterilizer, and that they would monitor
equipment more efficiently to assure good working condition.
This document serveS as \\Titten notification of your failure to comply with regulatory requirements which could result in
additional regulatory or administrative action.
(b)(6),(b)(7)(c)
OlSTit-mUTlON: Oriw"" &. I Copy 10 E'lnb'i'~IT1C1'I, I c.,py 10 In,pc<!OT
Pose l of 1
SE~-07-10
TUE
03:04
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(b) (4)
9099490701
P.09
'hi.
TM request for tl'iIs loformauon 1& voJunta/'f. His needecl 10 MOnllor delecls found In
Inspection 'Y'tsm. II is vee<! by FSIS'" delermine wMlhor
establishments are In complianoo. 9 CFR 301 and 9 CFR 381: FORM APPROVED OMB No. 06B3-00e9. OMB OISCLOSURE STATEMENT: Publ,c
repOrting burden r0111115 collection of IMormalion Is estlmalod to average 7 !\1inul~8 IXlr r~.pon..,. Ineluding "'91im9 for ,evlawfng InslJuotloos, seardling
",,"ling data 60u""',. oalMring end mainlalnlng l!1e data needed, arod eomple!lng ana reviewing the OOllection or information. Send oomm&nls regarding this
burden estim3ta 018n~ other aspect 0( this collection of information. Including sugGestions for redUCIng this OOrden. to Department or AgriCult'Jre, Clear.nca
OffICer, OIRM, R09!\1 404-W. Washi!\Q[OO DC 20250 end-'~l!l,I!. Offree of In'o']!e~oo e~.~tl'Qulatory Altai'}. Offioe of M3n~Mmsn..l8nd B·~L __.___ .. _
US Dep>rtmt~l
or Agrlrulru[~
TYPE Of NONCOMPLIANCE
___ ._. _. FOO~ ~;g~~l:i:i¥~~~R~~~._._.. _____ ._.
~
1. DATE
2. RECORD NO.
3. ESTABLJSHMENTNO.
021.2312009
--_
...... _-----4. TO (Name and Tille)
0007·2009-13584
Mohammad s. Malik, PresidentlGM
Q..~~l CO~~l~I_~~~i~ll
17176 Mil
5. PBRSONNEL NOTIFTED
, ...
6. RELEVAN'f REGULATlON(S)
_--.._----....
416.1; 416.4(b)
.
._----(b) (6)
---_ .. ----- -- .........
Kill Floor Manager
---_.
.... ------..-.......---r--:---------,---..-----...--....
-"._-
.-
Food Safety
7. S£CTIONJPAGE 01' liST PROCEDURE PLAN
ssor
HACCP
OTHER
._ _ _ ".~~OP p?:.~..___._...
----_
..... _----------9. NONCOMPUANCE ClASS!F1CATlON INDICATORS
06DO 1
FACILITY· Product Based
----_
..... ----..... _---_._,----'--.- .------......,,-10. OESCRlPTtON OF NONCOMPLIANCE
-_._.--_._-.... -----
8.ISP CODE
On 2·23·2009 at 0730 hours, while perfonning an unscheduled ISP code 01B02 (pre-operational sanitation) procedure, I
that the underside of the viscera inspection table was contaminated with fat, blood and residue from the previous
day's kill. The plant preoperational sanitation checklist indicated that all areas were found to be acceptable before starting
operations. (b) (6)
was immediately notified of my [mdings, and a regulatory C()ntrol action was initiated. I
applied U.S. Reject Tag No. B36921255 to the aforementioned table.
ob.~erved
At 0800 hOllrs J was notified by the plant that the deficiency had been conected and the underside of the table had been
cleaned.· I rechecked and released the viscera inspection t.qble at 0815.
Contamination of any surface, in this case the underside, of food· production equipment is considered to be an insanitary
condition. With this, there is the potential for direct or indirect contamination of product, which could lead to illness within
the general popUlation.
This noncompliance directly violates the plant's sanitation standard operating procedures, which state on page 3 that "1bese
----~-
---.--~-----=---
... .
~""' .-~.
(b)(6),(b)(7)(c)
I/IIs(JrM by 3{J~.j andl(Jf JS/.3J ,,/9 CFR
U .....(b) (6) --I"'7"W-·1~-~-~··"'--~·~~'~-71&", ::::--::..? ".<£.J
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1<-"~1 / tJ..~ d~D
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(b)(6),(b)(7)(c)
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9139949137131
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The mQ,lJe-s1 rcr this infonflatlon is VOlu"tary, It /6 nEK'ded to monrtOf dc:l'ecla foul'\d In tnl9 tn'O~ootiol'l eyt-tam. It ill u9.&1 !:Iy FatS to oetemina """'et.h~r
e"abli.hmonl•• '" in compll.nce. 9 CFR 301 and 9 ~R 381. FORM APPROVEO OMS No. 05(lJ·ooaG. OMS DISC\.OSURE STATEMENT: Public rooOl1.lng
burdM rot'thi'6 tXluecUon d in rormatlofl is estimated to ~!'Je 1 minutes per responSQ, Including the time lor reviewinC instructions, searching exi'Stina data
fiOU~~, R~tMrlng of'\d I'THllnttllnina (he (lata nceded, and ool'1'10lcting end ~vic"""ng trlC oo!1edior"l or inform.~tion, Send oo",menLa mc"rdi"g this burden ."tirnaLe
01' any other aspect d this c:oneetion of Inrorml:ltlon. 1f1C1uClIng '6ugSlt:Stk)(11:I rlJl r~Ji.llAr.·.l ~/'Ji! tlurd~/'t. to Dcpartmont or Agriculture:'. ~"'NRnrl'l nmcer, OIRM. ROQITI
~_~ WashinQlon. LX..,; 1Ul~: 8f1d tott'l6 O[!l~urlllrlo..!I'II~')Ut;n !Ii~d neglJlol.ory "ff3j~_O~NJnaap.mpnt ~ru:Lfu!i!OJlL_._____
. _...._. __
US DepJf1mml of Aericuitlm!
TYPE 01' NONCOMPUANCE
'FOOD' AlIll'TY ~ lin mr.-rr:r:nON Rl',RVlId
1(O!,(CO~IPLl~CF
TO (Nlrno: Mnd 'lill,.;)
P~I""V
,---,.------
17776 Mil
._-------------_
....----_..•
I rr..R r.nN"N1\l , NOTIFIED
Moh~mm~rI ~, M~lik. PI~~i~~o,t
Mohammad S. Mabk, p,,,.ldellt, Pre.idctltJGM
,.
0
l'La'tat.'l'
---3-.-=-ES·TABLlSHMENT NO.
, 0002-2010·12151
01126/2010
~.
M
RJ<CORf)
2. RECORD NO.
LOATE
.Ni RF!'.Ill A\I\)Nt.~1
416. U(C); 416.4(a)
----
HACCP----·-TSSQi>--------r--::o71',:::m=R:--··---·---
7, SEC110NIPAGE OF I!Sf. PROCED~ PLAN
Prc-Op Sanitation
8.ISPCODE
9. NONCOMPLIANCE CLASSIFICATION ItJ))ICATORS
OlB02
SSOP . Monitoring
10. DESCRIPllOtJ OF NONCOMPlItJ'TCE
Tf)rlR),
ar 07; lOAM. After tl)c plant was released for reglllBtory inspccljOll, I chose to perform elfO(;tjve procedure code
ajJJ<,!;t. I tooted this facility with Plsnl SUI'''' vi,v. (b) (6) (b)
I fOUlld rc~idue fl"om a pT€viuus cloy> J.JJ",J,h·,rlon on rhe
(7) (C)
lorge carc8.s:'J :liphHi..u~ ~a.\f'r a.l U~c.l-'v •.ol wh..el.e. tl\e "lado
sooo through UUJ uhdJ( o.";J~f'I ihr; rru.,itt"r, wlla UIlll1\f",iU'h\~'l.r
~l~lh3
W.l Lu"b .1.11 J.lo.!.I.,l,1'!JllI!.l .~ ....j Gr." tJ .. ,eo lru~.e IJ.t lbn hlnl10 gllltlW. I U·"i'l',f'r:'I.1 ilJ,..- 1'1"111,, 1"1'1·"·,,, ~nl-'''I''lilnlo.110fl g,ng f9\U~tJ
no mention of the reSidue. IlJ.e J<.elcvanl J:<egulations rererencc:d Mdt", 416.4(a) ..ll [vv..J vvnlad .urfACC~ J11uot b" ""niti2~d
or
as Qften as necessary to prevent the creation of insanitary conditions and the adulteration of product., 416.13 (e) each
official establishment shall monitor dailY the lmplementa1jon of the procedures in \)le Sall;laliOl\ SOP's. Thi" I.k'~u,uMt
serves as wlittell nOlification that your failure to comply with regulatory requirements could result in additional reg\.l\al.OI'Y
or adminiwative actions,
_._..._---.
11 SIGNA1'l.lRE OF fNSPEClION PROGR,\M EMPLOYEE
(b)(6),(b)(7)(c)
_._._. __.- -----.--_.-----_.
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(b) (6)
It. f'L,\NT MANAOEMENT R.£,?roN~t (lmmodi." .otion(.»:
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17.1.1ATE
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__.
SEP-07-10
~2:48
TUE
PM
(b) (4)
9088490701
P.03
Thn rgQ"QrI 10' Ihil Inrnrm~'inn I~ vclunlarv. II" n9f:Oeo to ",UI"'," u~'''''''' ,~, 'u,,' .".• L._~ __ U_ ..••. L ..l. III. " " ' htl iili In ~IIlrmin8 wl'\rth~r
•• ~.I..U\.\IA1\1"'11l1 oompll:¥". Y r i~t1 illl1 nnll ~
I ""iM A' 'I 'II\'V' " r,Ma Nu. o,o~.nnm rll~n nrr.r.1 OIiUR. 'H~.TFMFiI!·F P"hlin
repotting burden fOf" this coJlec1Jon of infOrmation Is es[)mate<J 10 averagtt 7 f"!llut.,, vt;r ree~"x, U'1U1UUUrw J,.. U",_ k.... , ... 1.... :,1.6 lJ\A"UMllnO. OQClfT)1'llrll1
exisUng deta ""uroes. gathering 3IId maintaining the data needed. and oompleung and reViewing 111. eoltectiOf'l ollnlormation. Send comments regarding lhis
I"" d,,,, 1,1 1;1\1 ". nr Inv nlhrr n~nAr.t gl lhii WJI\?iM fA InlormaUOfl. including svooestiOI19 for raduclng1l1is buroen. to DepaM1<lnt of Agrlcultutl>. ClearanUl
9f[toor. OtRl!'I. Rool1! 404-W, wa!lhiJ'\gton ..
~&-L!)U: ana lOUIe: VII1\,A:S u, 1'''1V''''a... '''";~.• ,oJ " .. " .. 1... \__ « ".IIJ..lt.l,.!,.Q.!!I.!!..!!!!~!I.!!.!.U.!"~~r"Il"l' lodllul1!tBt
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ct
WPE OF 'NONCOMPLIANCE
US Deparunenl of Agriculture
FOOD SAFETY AND INSPECTION seRVlCE
NONCOMPLlANCE RECORD
I~ Food Safely
0
L
-----I. DATE
2. RECORD NO.
3. ESTABUSHMENTNO.
03/0112010
0006·2010·16619
17776 MIl
4. TO (Name tI/ld Title)
S. PERSONNEL NOTll'IED
Mohammad S. Malik. President, President/GM
(b) (6)
Other Consumer Protectioo
Production Supervisor
6. RELEVANT REGULATION(S)
416.2(b)
~--.
7. SI5CTlONIPAGE OF EST PROCEDI..iRE PLAN
HACCP
-- .._-.._,...---SSOP
--r-'-~-
OTHER
...- . .-.. -
Page 3 SSOP
..----, ......---.--------.---.--"...- ..
8.1SPCODE
~
9. NONCOMJ'llANCE CLASSIFICATION INDICATORS
0lB02
--._._-_
..-._---
10. DESCRll'T10N OF 'NONCO~LlANCE
SSOP - Monitoring
----.------ ...._---,-------- .----.. -._-_ ........
At approximately 0900 am while perfonning procedure 01 B02 the following ilems of noncompliance were found:
I. The large metal doors opening to the pens were covered with fecal material left over from a previous days Idll.
2. The t10rescent light directly oyer the inspection area was full of water and not working.
3. The beef head station was missing metal screws where the rack altacbes to the table creating a safety issue.
4. The inspector's sink cut-off valve would not cut·off.
The noncompliances above do not meet regulations 416.2(b) and 416.1. Another simular NR(201 00002) was written on
1/26120 IO. This document serves as ""'Titten notification that your failure to comply with regulatory requirements could
result in additional regulatory or administrative action.
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
SEP-07-10
TUE
02:49
PM
(b) (4)
..
9088490701
P.04
T1'Ie 1"C'Y.:W8S\ tor thi5 if'lfOrl'r"l6tiOfl is "OlunlSry. It i~ needed to mO(ljtQ( Cler~ founClln mla InsoectiQn eyatem. 11 ~ used "Y F6\S 1" CI&termina wt'.C"tl\er
eetahll,hmenls arolo ""mpilenC<!. 9 CFR 301 0'08 CFR 381. FORM APPRov~D OMS No. 0583-0089. OMS DISCLOSURE STATEMENT. Public r""onlog
01.Jr~e!"\ fer \hi" collection of information is (1st/mated to a\lQ1aoe. 7 minut~ per res~on$e:. IlicJudinQ thQ time ror !'eIllGWing IMtrualcns, searchmg sxistl(\O data
ol'!lIJp:.e.S;, Q'other;fl9 end meintoining U,\e dete need~, and ooiTlpieung nl"ld relliel.v1ng tOe oollectlOn 01" Ir'lh:lrm:slion. SQnd oommenl8 reo:)rd!1'Ig thle burdf3n e5limste
or any othGf up«t Of lnia Cf.ltlGCtiOl' OIlnformatiOf'i. lnClu(lIng £iuagestlona for rnduclr\g Il'II8 b'JrdM, to Departml:/'lf Of Agncultur~. Clearance Officef'. OIRM. Room
4~:W, we.~.nlQ.a.E!L...Q£l£?~.Q,: and lothe Offjeil of Inrormat1pn and__FL4"QY~!O~ AlfC1i!.s.....Offi~ of Man~!le:nHm.t~~nd BEJc10el. .'
.___ ... _ .__.
US Dcpsr""co' of Aerieul"".
FOOD SAnTY AND INSPECTION SERVICE
__ . _.. , _ _._1'1,O_:;C_OMPLLANCE REC9",RD=-_ _
I. DAle
2. RBCORDNO.
03104/2010
TYPE OF NONCO»!PUANCE
F~d 3.r.'Y
0 _--- .. -_._._.. - - -..~_---,
----"=-...
3. ESTABLISHMENT NO.
17776 Mil
0007-2010-12151
----
~.
4. TO (N.me 'nrt Tille)
Mohammad S, Malik, President, Pre9identiGM
. --. -----. __ . --"." ---.. ".. _--¥--
PERSONNEL NOTIfIED
(b) (6)
6. RELEVANT REGULA110N(S)
416. \3 (c)
1·'·H.lCCP- ..--- ··-!7.SoP----------roUiER .. ---.---SSOP.
_ . _ _ _ _ _ •_ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _
8
T~l'
--.
rnnP
,.
__._---,--01902
- MQnilOling
._._
__._.-._--...._-------_
S~O!l
10. DiSCRIP110N OF NONCQM),U AN(~F.
' - r 1 ' · r ,- - - - -
I,
N()N<.:"~U'l..lA:.cr CLMsrfICA110}lI}ij)ICATOR.'l
..
lod~y,
...
03/04/20 I 0 at UI :2U AM, while per(omnng pre-operalional ,ouil.t)v,\ ("<!'Geti"nih" j"ull(JwUlI!S '''u~ v1-,t~rv.d:
W}\I1o IDopooting lhi. [~"llily f<" ani1.,ry r,nn,lili,,,," willi Plu"r ~Ut1~rfi~9r (b) (6) (b) it
obr,A(Vfln th~t the heef
splittins saw had rc.i<lue [,(Jut" Jl,CViOUl days production. Thore \V3S f3t :lOd
(7)muscle
(C) residue on In" hJ..1rl~. hlRnc guideR,
h8ndle. pOWL'!' cora ana nou~lnS.1 reviewed dJc Vl.ul.:. .,.a.t,l~ 1,'~-vP" •• t;o!<J\~J ~u\lli\el\\nt;on and found no m@ntionof
tn~ resldue. The "~W W", • • "il,,-oJ ".. 01 .~,Iv."j t.l • """u"y oG.,dition, in my V'.'~HC'. ,,) l R"~1I1~tnry r~l\nTfI)! AnTinn
W6~ .)ot neu"".~'. The rclovant regulatton listed, 416.13(c), Sl~te.~: P,Rnh nffici.! c.li1uli.L..l\¢!)1 $b,~l.llnonitor doilV the
;"'I'k",~ •. l"l;~ .. vCtl,. r-.... oIu ... Lo>. tho eonitatioo ,)(W'. Thi. nnnm1rnt '",.vr.~ M ....Tiltr,]1 norification thllt V\)~t !~I,urc II,)
"emply with r"I!"1.t"'Y "'11Tircmr.)Ii, ,;olu)'ll~.\ult in ~dditi~!l(11 tCj1,ulatol'! or adrninistntive action •.
"'(I,
P••t Similar NR. - Previous lneff.clive Plant Actions: Plant nOled to more closely monitor the sanitation SSOP'~
ineffective in preventing recurrence.
f'R: 1-21)10
\l~lcJ
1126,'2010
(b)(6),(b)(7)(c) ~--
11. UI!;!'-ATUIu.: vI' INSl'llCTION PROGRAM EMf'tOU' r.
(b)(6),(b)(7)(c)
-_._--------- .....
""if fir" 'fu.o\v ,,,Jva.; ci fIJ'" ';f/" w
E,. 3M'
o1~J",)1 .M7 "~M"" #t '~J;""II~IIJ
12. PL;'NTMAi:iAGEMF.w·IREspQNsE ([mnledi,le ;etiol1(s»)
,.....f.wt(1
'eJ'·'''f.'
__
._-..__ .
.c ",,,IIM ~"'I i
J~
A~.1 1o'~A,I(I·U "'-....."
--------.
I:. PLMT MANAGEME!-l! KJ::'WU"',,, li\u1ho, plsnncd .dion(.H·
iv-:t.l ""'--FJ_ J •.•-.!. t: de-'"M I'I~
<,.ccw,- e&'4.011 q.~~.-dh;f;2~~·
__._-- ..
t tlf~ rom.
~ ~ 'it
, ...... " ..
'Y L;r
..
71 .........:.
"_'/..[111'
... _.
__..... _.
fi<'~~.-:~~'4J!-:.~-e~:till-...-(-J--#-·· ;j.~r .,LI... "
'~&LI~1'1" III
----------.-.~---.---
(b)(6),(b)(7)(c)
__.----- _-.-_
,( -I....
",'1-.....11
b.n"!-, ';;r;.· ..;::~~=1.P.-..f
"-'~
d"
11(
r;(I'i f .6 '"~t t..,(
ttq
"", .. ~',·t;,.'.
(7'" f
II("<f,(t..
SEP-07-10
TUE
02:51
pn.
(b) (4)
9088490701
P.06
The requesl to<" thii InfOfTTlBljon Is voluntary. h i3 needed 10 monilo< defects found in tnl. in.peenon eysrem, Ill. ueed by FSIS to deteM"lns whether
eslaDUSnmen"l am In compliance. 9 CFR 301 and 9 CfR 381. FORM APPROVED OMB No. 058:>0069. OMS DISCLOSllRE SfATEtJENT: PublIC
reporting burden ror Ill,s OOlieCtlor> ",o,lu"".I,"" I. e.dm.led lu uv~'u,,~ 7 ""nu'" por ""r:v:w". inrJlJrtlng 1hQ tim. for n;>vif'Winn IMfnJr.tions. ~~"'~i~
existing data SOUI"CAl', gall1enng and maintaining the data needed, and com~leting and revl .... ng tho oonection of Infonmation. Send commMis reg.rding IllIS
burden eSllm3te or any oll\9r aspect 01 this ""II.,.).Iu" <.llnfolm.tion, Including cU9getljon.1or ~udno !hi~ ~urden, 10 Deparunenl of AgnCIJltvne, CI~rance
9..!!l~.el, OIRM, 1!00000.04·W, We8hing~QC 2<l250: end Iothopffrce of tn~aijon end ~egvlal!><y Afla.L"', Oflioe of Managemenl '!M Bu<1g~L ..... _.
'IYPE OP l'IONCOMPLlANCE
US Department of Agriculture
..--." ...
FOOD ~~Ei6=';'Slf~g~~V1CE
--.,~---.,.-
1. DATE
.. -
2. RECORD NO.
06/0412010
4. TO (l'Iamc and Til1£)
-----~..
0016-2010-16813
._--.---"---.
--.. -._....__.-._.-..17776
Mil
....
__._
...
~-.--
--~
-'.'-'-'-_..
5. PERSONNEL NOTIFIED
6. RELEVANT REGUI..ATlON(S)
_-
Mohammac;\ $. Malik, President
.---.--- ..
" - - - " - - - ' - - '..,.-'._-.- ·-"--··--···T
7. Sr;CTIONIPAGE OF EST. PROCEDURE PLAN
I HAcer
--------... _---_.,----- _...
..
8.!SP CODE
0
Food Safety
Other ConSllrll<l Protection
.... _-- ---_ ..._--..
,----.- ..
3, SSTABLTSHMBNf NO.
S. Malik, President, President/OM
-Moltd'Hu)ad
... _---------,,,
------- ._.......
416.13(a)
LXl
SSOP
·'--"--1-'OTHER-- ..--.•._--.-
-
SSOP p, 3
--------._..__ .., .. _._--
9. NONCOMPLIANCE CLASSifICATION INDICATORS
01802
-------_
... -
...
SSOP -Implementation
-~.-----.
10. DESCRIPTION OF NONCOMPLIANCE
----_ ...
----, .,-------
Today and at 0705 hours while I was perfol1lling the pre operational sanitation procedure for the kill floor according to this
scheduled procedure, I observed the followiog non compliances:
I-The beef split saw (whicb will used today for today'sbeefkill) was contaminated with grease dry blood from previous
operation, also the blad~ was rusted (product contact surface).
Regula.tory control action was taken by tagging the saw with the US Reject tag No. B 369213657.
2- 1bree aprons for the plant's employees (product contact surface) were found to be contaminated with dry blood. These
aprons were Rejected with the US Tag No B 366921358.
On che.:king the ssop's plant procedures, it was mentioned th~ (b) (4)
(b) (4)
(b) (4)
3·The strilizer tempurature in the killing area was 160 degrees, Rejcted with the tag No. B 27518738
The aforementioned non compliaces may be potential for product contamination/adulteration and that could be of public
health. significances.
(b) (6) the kill floor manager observed these non compliances and was notified ofrecieving a non compliances record
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
--------.
(b) (6) (b) (7)
(C)
'=:::--<'.
-...:....-:r-~:'l'"
p
C.e - I!))'"
.I (,. b'qA"v("~
(b)(6),(b)(7)(c)
It r ;
==-----.
..:~._._=
d;jfi ....-J',_'-- ., ,......" ~ i f.c •• ''J c..{, J.c-'d,t-. ;;:<..
.. "/4.- .. ~~I f-t''' '" S ""d"·/'(J.-.c!J- 0 • .(; 1r4~/ t:o /' 1.,,'.leI,
13. rLA.!'IT M.<lNAGEMENT RESPONSE (further plan~ed action(s))
It
~ #-
SEP-07-10
TUE
02:53
P~
(b) (4)
9088490701
.._ _ _ ·________ ·_________.__ .· __ ..__ .··__
U~
rooD SAFErY AND INSPECTION SBRVICI':
. ,
·~·_,.a._·_'·
u<panment OJ I'gr\cuhu.o
__NO!.'£~~~~_~.COR.D C~NTJl"!!E~ON
I. DATE
2. Rt:CORDNO.
S~I!ET " _.. '
06(0412010
-------_._._--_0016-2010-16813
.. ---- - - - . -
4. TO (N arne and Tjlle)
... "-..
P_07
_ _·- . __,_ _ _ _ _ _ _,..-_..___ ".
T'II'II1i
'Vi
OF l>lONrI'lMPl.t ... NrF.
]
_. _____~.1 Food S.r.e~_._....l",,~~O~c:r p~~~~~~_" .. _
3 ESTADLfSHMfNTNO
"-,,
17776 MJ 1
--.. ------_
... -----,,--_. __ .
..
5. PERSONNEL NOTTFlED
Mohammad S. Malik, President, PresidentfGM
Mohammad S. Malik, President
,._---,._---,,--_ .. ---_.'---
6. RELEVANT REGULATION(S)
4\6.13(a)
i-S~C::rIO~/PAOE OF EST,
PROCepURE
piAN --IHACcP ,-- -- --TSSO;---" '---TOTHER-.----,------...-,---.
--_ ....-_._--- - - -.. ----- ---------_. __ .. _-"
8. ISP COOI3
SSOP p, 3
----,,---,---- -_._---.
9, NONCOMPLIANCE CLASSll'1CATION 1NJ)ICATORS
SSOP - Implementation
OlB02
..
----======-----~,----==-----==,,~---==,~.----==------===-------~~----~
10 DESCRIPTION OF NONCOMPLIANCE
(NR) for the plant failure to comply with the Regulatory Re~ujrements of 416.13(a) which states "each official
establishment shall conduct the pre operational procedures in the sanitationSOP's before the start of operations.
------------_
..--,--,---- -------- ------..,-------- --------"._----,
Ll. SIGNATURE OF INSPEC110N PROGRAM EMPLOYEE
(b)(6),(b)(7)(c)
---, ----
.
PSIS FO'RM 54<)0-" (119&)
kcplacC'$ FSlS Fonn
S400~4
. --..
'--...
-------. -----,---,---,-------------_._--_
...
Original '" I Olpy E"llIblJ'l1inenr. I
I"'peel'"
(<)/97), ....hlch rn1ly be 1J:Iot:d un'IiJ ex.h.J.l1l:.ltd ('1198)
D1STPJll\!'nO~l:
Pa2'! 2 of 2
til
Cop~ to
ccr
137113
TUC
132:53
rM
(b) (4)
':)13004':)137131
r.(lO
Tne re-Q,uest for 't1!$ !nrormationIs ....oluntary. It i~ needeo to monitor oefects round in thi:, insceclion 15Yliterrt 1118 used by FSIS to determine wt'lethar
"~rAhl"M'Mr:I ara In OC<1lpll.,,,,,, a CFR 301 aM 9 ern 381. FOR~ I\PPROVED OMS No. 0583,ooM nMA nll\(';LQSURE STAT~~ENT: PuOiic
repoJ"Ung burden 'or lhls colleo6on Of Inrom'lallon Itl eMimated 10 eVGr3QQ 7 mInutes per r~spons.a. IncJudlnQ (hw Umo f\..M
!l:\lj"wll"J
In!t!\Jctiona.
~QreniJ'\9
e)(islirtg da\a souroee, gatne-fiOQ 8r"d ms'lnLalnll"lO the d.ale needed. and eomp~tinoJ and revieYJIng the IXllJacbon 01 infotmaOoo. Send O')mmQnts regarding trli$
bvroen ••timo,. or any other 86ped olll1ls ool\6clion '" iolOf1l\a1lon, inciudil'oQ luoge.bon" 10< MCucing this burden. 10 Department of AlIneul\u",. Clearance
O"'cer~QIRM !3...09~~:W, Wa.hl~l!1on. DC 20250: and loth_ Office O!.ln.lqrmabon.8nd RogulatQfY Affai'" Offica ()f Management en~~_m~L .. ____._
US Department of Agl'lcuHure
FOOD SAFETY AND rNSPECTlON SERVlCE
.________ '' .•-~ONCOMPLl~I''CE RECO~~•. "".
I. DATE
2 RECORD NO.
"" .. ,,,-,
17776 MIl
0021·2010-1G974
06/30/20\0
4.
TYPE OF NONCOMPLlANCE
.
. .. ~ ... F~_S~:e.ry__ .. '--__ Other Consul1'cr PrOlOCt;On
3 ESTABLISHMENT NO.
TO (Namc and Title)
j, PERSONNEL NOTIfiED
(b) (6)
.... Mohammad S. Malik, President, President/OM
'~~""~~;;;~iCE'iiMff:~GUO:TION(S;-'---'--' -...... -._.
416, 13 (a); 416.1 J(c); 416.3(a)
--_..
1. SECTIONIPAGE OF EST. PROCEDURE Pu.N
HACCP
supervisor
.-.--.--....,...--------.--r---SSOP
OtHER
•
_ _
PreOp: 6
~._ • • _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • • _
••
_._. _ _ _ 6 '
9.IJO~aOMrLlA}JCD CtAH[]lICATlO~ll)IrorcATOv.S
6, l~~ I..UUt.
OlD02
SSOP " Monitoring
----10, DESCRIPTION OF NONCOMPUANCE
On 0.6(30110 at approximately 07:10 while conducting a scheduled PBIS ISP 01B02, preoperational sanitation verification,
I observed a noncompliance, While inspecting the establishment's knives and scabbards I obserYed dried blood from the
previous shift's production on three knives and two scabbards. I immedia1ely infonned th~ floor superYisor, (b) (6)
Tella, o(the noncompliance. (b) (6) immediately restored the equipment to a sanitary condition. The presence of the
.' :.~.;insariitary·.equipment is noncompliant.of 416.3(a), 416.13(a) and 416.13(c) as the equipment had not been adequately
inspect'ed ~ pl:r the establishment's SSOP.
This document serves as written notification that your failure to comply with regulatory requirement(s) could result in
additional regulatory or administrative action.
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
You t.J,.~ hcrtbYu,f.,fll!.J of"fOJJf nglll to tJpptollhiJ decisIon
__
~
12 PLANT
01 d~/[!It(J/cd
by 306.j rlr'ld/or 38/.JJ 0/9 CFIl.
r--~~;;r:
·~~
,"",-.
ilL
I'",
/C11;~ A ~.~ $e'. "jill_(o{.
'71-~"-'~J.-uj .,.,~I .J"'I<- ' / ' ) " ' - . ' ~""-
1-",,;:
... _ _ _ _
MANAGEMENT RESP01-ISE (Immediate 8erion(')):
_ _ _ _ _ vl'. _________ .....-N .............
(b) (6)
..<::., .//
H~e-,'
~,.I,·;..'o,. "&~t. o!.d ~-/-
I, r
i
u..ro!',
m:...
o'
1""___ ,
ILl..; ......
'~"'Cl- C/C' ,'A
a..p_I'I<
(b)(6),(b)(7)(c)
DtSTRIBUTION: Originl\l &. I C()py to ESU.bli$,hm,"m. I Copy 11,) In.5p'clcr
p,.,
I, of 1
SEP-~7-1~
~2:36
TUE
(b) (4)
PM
The _ I lot Ihis lrlform/!lIOn Is voluntJry . • III neecIe<IlD
9~8849~7~1
P_~2
monnord_ lCUM I" IllIs in_pactiO!' syOle",. "l' used by FSIS to """'m""" """"Iher
es13bfLShmMIS are In compliance. 9 CfR aoland 9 CfR 381. FORM APPROVED OMB No. o.se~89. OMB DISClOSURE STATENlEfIIT: PUbliC
repOOiflQ t>lJrd<!" !'or mIS CO!IectIOO 01 inform8!!On Is estlroofed \0 IIV'CrlIge 7 minutes per re-..ponsc, IncIu<!lng !he time for "'~n9 ins~uction£. ooarc.tJlflQ
exl&tlng data ~$. ga111enng and maruining the (let9 needed, and rompoleUr"l9 aM revIewing the c:ofleetio" or Inrormation, SerxI comment' rega:-ding this
bu"'en eslimate or MY other aspocl ol iI1is collection Of~. including G'.lOO.s!iOO' fot redudng 1/1'3 burden. to 0Gpa11m""1 01 Agrirolture. Clearance
0lfi~r,.
9!RM, Room 404-W,.'!N_a~iI\gIon, DC< 202.50:
~_.
and "",e O(lk:e cllnlC¥'mation and Regulstory AIfa~. ()ffiOO 01 ManBgemenl end Budgel
US J)cparuncnt of Agriculture
FOOD SAFE1'Y AND INSPE(,'TION SERVICE
NONCOM
. 1'1.I ANCE RECORI)
_ _ _a ••
_~.
_ _ _ ._,.,
________ •
TVPE OF NONCOMPLIANCE
•
. · . _• • • . _ • • •
k
[1
Food Safety
',·.X.-._'.1
• • • _ _. _ • • • • •
Ot!tu Conslilucr Protection
_ _ _ _ • • • _ _ _ _. ' _ , . '
I nATE
2. RECORD NO.
3.lSSTAflI.ISHJl.fENTNO
OS/2412010
0015-2010-16974
17776 MIl
, _ . _ - - ••_
4. TO (Name artd Title)
5. PERSONNEL NOTIFIED
Mohammad S. Malik, President, PresidentiGM
Mohammad S. Malik, President
•••
_
6. RELEVANTRLGULATION(S)
416.l2(d)
'" !-.
R50P
.-., '"
-.~
··---···'j'·-OTH£R-·
8
81SP COOF.
9. NONCOMPI.IANCE Cl.ASSIFlCATlON INDICATORS
OIAOI
SSOP - Basic
10. D1'.<;CRIPTION OF NONCOMPLIANCE
On 05/2412010 at approximately 14:00 bours while conducting a scheduled PBIS ISP OlCOtt observed a noncompliance.
(b) (4)
_
~
.... _ _ _
.
-
.
~
.
r
=
.
,
"
.
.
.
.
:
.
:
.
__ .. _ _ _ _ ·_ _
· .
.
-
~
:
.
:
.
;
.
;
:
:
...
~
~
~
,
~
,
~
~
-
-
_____..';..
.. ___.. _ _ _
______ .. =.... -:--...... . ..4" ... " .....
11. SIGNA 1'lJRE OF INSPECnON PROGRAM EMPLOvu.:
.
The SSOP states(b) (4)
" 416.12(d) requires
that a frequelJcy for every procedure in the SSOP be specified. •As often as necessary" does not contain how often the
procedures will occur within a given period oftjme and therefOfe is not a frequency. I immediately informed Mr.
Mohammad Malik of the noncompliance.
This document serves as written notification that your failure to comply with regulatory requirement(s) could result in
additional regulatory or administrative action.
(b)(6),(b)(7)(c)
..
tOIJ. an hucby od";s(I.(l u/W!lrrlgJJr to app«allhi.r d~'MjM aA dllltftfl'M by ,106.$ end'fJ! J8f.J5 0(9 CPR.
_____ -...;;.::;::-.,-_____
"
__" • .._" .. _,_.-:.·,M_ . ._ - - . -_ _ _ ...
12. PLANT MANAGEMEl'TT RESPONSE (!nun.diale o,l;on(,)):
~
-----~-:;-:
~;.:.=
... '.
._._-'=".-._----.. . .,. . ' :' --..-- .....---..
• __
' . .;.;..=-- _ _
••• - :..
-:.:;.::'~
~---"_;·
_ _ _ .,;,.e•.• "
~--.---
...
~--.,-
13. PLANT MANAGEMENT RESPONSE (further plonned action(s))
.'i _ _ _
--~----,.,=.:~-:;;':"'--.
~.=o~
..
_
...
;~,:.,..:"
"",,--.. -.,.
----.-~.'__:'.~
- .. -.-.
Tbb documeQt ;It.ncs as writtC'Q aotiJiC'Jlrloa tbat your railuN to ~omp1y W"it)t. rct.tJ1:tlory requl"rnrnt(~) tabId mult in IdditiolJlirl rti,U.lalory or &!h:J'\ini~tt.uNe atdoD.
tS. DAn;
14. SIGNAT()RF. OF PLANT MANAOEM<''NT
L
---=.~--.---.-""
... _--- ....
16. VERmCATI('lN SIGNATIJRE OF INSPECTION PROGRAM F.MPtOYBF
... _------_.........
FSIS
row HOO ..4 (7198)
._---_.. _._-----
R.pl", .. fSIS for.... 5·100-4 (9191). ~1\i'h M'Y be uSod
unr~
""""",,,ed (7"18)
ntSTRIBUTlON: Original & I Copy to EsL,bli,htneol, 1 COpy", inSll<CIOI
Pag. I of 1
SEP-07-10
TUE
02:37
PM
(b) (4)
9088~90701
P_03
The request for thit informatlOr'l19 vOluntary. It is needed to monitor defects found in this in!pection system. It is U$c:x1 by ~SIS to determine wl'1elhGr
establishments are In compliance. 9 CFR 301 enel9 CfR Sa,. FORM APPROVED OMB No. OM3-00e9 OMB DISCLOSURE STATEMENT: Public
reporting Durden ror II1IS oo~ecllon of informa1iOf1 IS esnmaied lO average T minut.s per r•• p"".H, including 111. time fO" ",Yiewing iM!rudIOno.•Mrching
existlng data sources, gathering and maintainil"O tt"Ie dala needed, and compla:t'ir'lQ l'lf'ld reviewIng the ooOeetio" of it'IfOrMs1JOn. Send comments. regarding this
~ur<len eS\lmate or any other e&p4lCl or this col!ectlon 01 infO!T!1ation. Including sU9llestion9 for reducing II1ls burden. to Oepartm&nl 0' Agriculture. Clear.n""
9fficer. OIRM. Room 404-\y•. Wa.hlnstion. DC 20250:
IOtIle Off,'!!'. qfJ!,!~a.!!.oJ'_~!'~.I'!~ula\ory Affairs, Office Of Ma"i',ll~ffi~m and B~~I~._._...
"n.g
US Department of Agriculture
FOOD SAfETY AND INSPECTION SERVlCE
__.__ "'_ _" .!~ONCOMrLL\NCE ~COIl.O _ _. __.. _ _ ..
I. DATE
2. RECORD NO.
08/1012010
0027-2010-16974
~"
Mohammad S. Malik, President, President/GM
.:..~-~-.-.--.-~--
o
~ Food Safety
Other Consumer Protection
J. ESTABLISHMENT NO.
M /1
- -17776
-.._---_._.'---'-- ._._.__ ....
5. PERSONNEL NOT(fIED
(b) (6) -_
Floor Supervisor
_._---_•.•.•.....
---_. ----.-..._-.-_ ..
4. TO (Name and TiUe)
TYPE OF NONCOMPLIANCE
..
.•
6 RELEVANT REGUJ.ATION(S)
416.2(30); 416.3(a)
--.. .. _-----,
-,.---- .. __...
IIACCI'···----rssoP
7. SECTIONIPAOE OF EST. PROCEDURE PLAN
Ol'HER
_-----._ - ..... .
..•.
._---SSOP
------------
9. NONCOMPLIANCE CLASSIFICATION INDICATORS
8.1SP CODE
OlB02
SSOP - Monitoring
----_._._ ..... .
---------------------------~----10. DESCRIPTiO!' OF NONCOMPLIANCE
On 0811012010 at approximately 07:30 bours while conducting II. schlXIuled PBIS ISP 0lB02 I discovered a noncompliance.
jobserVed more than eight flies in the slaughter a(ea with at least three restiIJ8 on food contact surfaces. The presence of
flies inside the food processing a(ea and flies resting on food contact surfaces do not meet the regulatory requirements of
416.2(a)apd 416.3(a), respectively. I immediately infonned(b) (6)
floor supervisor, of the lJoncompliance and
took a regulatory control action by placing US Rejeded Tag II 836921237 to the knocking box. At approximately 08:00 r
was infoimed that the area wa
r re-inspection. I found that the a(ea had been returned to a sanitary condition.
removed the tag and informed(b) (6) of my actions.
This document serves as written notification that your failure to comply with regulatory requirement(s) could result in
additional regulatory or administrative action.
-~=
..
,~---~===----=~----- =.=~---
11. SIGl'IATURE Of INSPECTION PROGRAM EMPLOYEE
(b)(6),(b)(7)(c)
(b)(6),(b)(7)(c)
...
..-
=~----~.-=
.
--.,-~.-
.____. . ____. c?~~_f!! /.J-!! ~.___,..
-~.--,-----=------=------~---
13. PLANi MANAGEMENT RESPONSE (fiJrthor planned action(s»:
..-:.:.:.~~
"--'::-
'
.-~
._-
-
.
~~-.
.~-~~
Tbll d()(UMut serve as wrltttD DotirtC:at~D [hat )'Clur r.~ure to C'Omply witb Noglllarory requj~G:L~t.(,) tould remit in IIOdil;Dftll regulatory Of .IIdmlnl!ifl'atJ...;e ,ch(J.n.
-------_.14. SIGNATURE OF Pl.ANT MANAGEMENT
__ • _ _ _ _ w' -
i6. VERlflCATIOl-l SIGNATURE OF INSPECTION PROGRAM EMPLOYEE
------_..
_ . _ ••• _ _ _ . _ _ _ _ _ _
,---_
...--.-...
- . - - - . - •. - - . - -
IS. DATE
---~-.---."'.----.-,
17 DATE
_-_._.._--..-.. , - - - - - - - - - - - - _ .__
.. _---,-'.
DlSlRlBUTION: (),jgln.1l & I Copy to E,loblj'Mlcllt I Copy '0 In$!'C<I<Ir
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