Critical Control Point Inspection

Authority Chapters 3717 Ohio Revised Code
 Name of facility
  		 Licsense holder
 
 Address:   
                  		 Category/Descriptive
 
 License no.
                   		   Date
  --		  Inspection Time (min)
     		  Travel Time (min)
     
  Comments:
   Temperature Log

Food item		 Indicate state food is in
(receiving, storage,
preparation, cooling
holding, reheating, etc.)

Temparature

Food item		 Indicate state food is in
(receiving, storage,
preparation, cooling
holding, reheating, etc.)

Temparature
                   
                   
                   
                   
                   
                   
                   
Inspected by
 R.S./SIT #
 Licensor
Canton City Health Department
Received by
 Title
 Phone