Tip of the month sanitary design form


Risk Assessment:  Sanitary Design / Food Safety Inspection   

Date: Facility Location:  Manufacturing         Department:     

Equipment or Process:

Equipment Status: New Modified Other

Yes No Yes No

Maintenance Department Review: Manufacturing Department Review:

Quality Assurance Department Review: Sanitation Department Review:

Engineering Department Review:

Area Inspection

Yes No Yes No

Environmental Hazards - Food Safety, Quality and Legality Concerns

Dust, Floor, General Housekeeping Addressed if found

Adjacent Equipment or Overhead Hazards

((Condensation Drips, Catch Cloths in Place

Adequate Area Lighting

Electrical Disconnects Not Blocked

Egress Established & Not Blocked

Equipment Inspection

Yes No Yes No

Ergonomic Issues Addressed Hazards & Warning Signs Posted

Adequate Machine Guards Pipe & Hose Fittings/Connections Tight

Energy Sources Proper Connections No Sharp Edges

No Dead Ends found Controls Are Labeled

Equipment Secured To Foundation Emergency Stops Properly Located

Controls Accessible Access Panels Fastened

Indicating Lights Work Safety Interlocks Work

Emergency Stops work Electrically Grounded

LOTO Connects In Place & Procedures Developed Equipment Maintenance/Setup Procedures

Equipment Tech Manual Available Operator Training Completed

Equipment Cleaning Procedures / Sanitation Planned Maintenance Identified

Sanitation Cleaning Training Completed JHA's Developed

Self Draining Equipment Easy Access for Cleaning

Soft Angle vs. Hard Angle Piping for Allergen Control Equipment Contact Surfaces Suitable for Food


Proper Ventilation & Utility Air

All Deficiencies Corrected Engineering



Quality Assurance


Equipment Ready For Use Engineering



Quality Assurance Pre inspection and swabs taken

Sanitation Machine Cleaned Three time ,broken down for inspection no issue




Quality Assurance