v. S. Department of Agricdlture, Bureau of Animal Industry, 

 Dairy Division. 



SANITARY INSPECTION OF CITY MILK PLANTS. 



Owner or Manager Trade name 



City Street and No State 



Number of wagons Gallons sold dailj' < „ 



Permit or license No. Date of inspection 190 . 



SCORE. 



Perfect. 



Allowed. 



REMARKS. 



MII.K ROOM. 



Location 



Construction — 



Floor 



Walls and ceiling 



Drainage 



Cleanliness 



Liglit and ventilation.. 

 Equipment — 



Arrangement 



Con.structioil — 

 Sanitary 

 Durability 



Condition 



Cleanliness 



3I 

 4j 



MII.K. 



Handling 

 Storage 



SAI.KS ROOM. 



Location 

 Construction 

 Equipment 

 Cleanliness 



12 1 

 8( 



Cieneral appearance 

 Protection of product 

 Cleanliness 



Total 



10 



10 



15 

 10 



15 



20 



10 



10 



100 



Stinitary ctinditions are . . Excellent 

 Suggestions' by inspector 



Signed 



Oood 



Fair 



Poor 



Inspector. 



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