| Vendor Name | |
|---|---|
| Date | |
| Location | |
| Inspector |
| Item | Yes | No | Remarks |
|---|---|---|---|
| Hands washed and clean | |||
| Clean and appropriate clothing | |||
| Food stored properly | |||
| Utensils clean and sanitized | |||
| Work surfaces clean | |||
| Garbage disposed correctly | |||
| Protection against pests | |||
| Safe source of water | |||
| No signs of illness |
| Inspector Signature |
|---|