Iotv.c D epA.RT\lENT or LxspecrloNs .{ND APPEALS

EGG ]HL&NB,LERS TI{SPECTICN REPORT

Number of cases ofe*s on hod at ilme af

Attach Restnicted L,abels on ReverseSide of fhis Fonm

tnspection

t6. Candling device- adEquatel. Buildiog: good repair, clean adequarely

n. Scates adequate to determine net

18. Refrigeration units: 45"F or belot'"cleslL Aee ofob.iectionable odors. good

repair3- Adequate sy*emy'removal ofrefise

19. Thermomsters: proYided and accurateffi;f cleanabte materiaLs. floor drains

e pjumUing an0 s€lvage disposal slsten

21. Loose.-packed eggvcascs properlylabeled: Iirrr name and USDA Plant orIicense number

8. Storagc and use oftoxic itemseEe canons ttr sales to reuil food

oTcutons aria cases: do: and

23. Labeling ofBgg cartons: grade- size-

pack date, name, addrcss, plant or license

number10- Adeouate suoply of potable riaxen Td priUtic (t) EI Prtvate (:) G

12. Shell *eshercleatl and saniur}' gondition

ta. Wastr terhpemture at 90oF or above.

Personnel in contact rt'ith shell eggs:t4. S@itizer seray rinsq 4t 50Pim to ?qO/m

Owner or Manager: Inspector:

lowa Dp,panrnasNT' oF .{crucurr[rn-E & ]Laxo StpwanosrrrcEGG HANDLERS M{SPECT'TON REP@R.T

Nwtbu of cases ofeggs onhmdAdne of

irapecfionAttach Restdcted Labels on Reveree

Side of this Eorm

17. Scales adequate to determine ne-t2 Frec from presence ofbirds,

18. Retigemtion uni6:45T orbelow,clea, free of objectionable odorg goodreeair3. Adequate q/sfentEnoval ofreftse

19. Thsmometem: provided and accnrate

6. Plunbingmd seuage disposal system

sink convmieut, hot and cold wafier, 21. Loos+packed eggdcases properlylabeled: fim name and USDA plant orlicmsenumber8. Storage md use oftoxic itms

Nareggcatons brmlesto

23. Iabeling of egg carrons: graIa@-pack dde, aame, addrcsC plant or liceirsentmber, safe handline instructions10. Adquae zupply ofpotabte warer: EI public (l) Bfue e) *

I1. * Clnrsliwaterteston

12. Shetl $ash€r clee strd srnitar.y coa{ffis1

25. Persomel in cmact wita shhell@

13. Wash temperature at oraborq rinsewater l0oF wa$wats

Sanitizerryray to200ph

dryingequipn€nt

Comments:

OqmerorManager:

kiwA DspARrl.dEI\IT or Acnrcur,ruxB tiI;+P StrwaibsurrEGG AN{DIERS INSPECTION RE.PORT

Ninbq of cases o{eg on,pg1ldryeo{

insp@lon

No', ,?y*?.

Attaeh Restricted Lalels on RevclseSide of t"iis X'oim

# @***

, 9. Str.ol*m

6. Phutbing mdAclvage disposal sy$sh

cmvenien! hotmd cold wder'tourels

& Stor4gp- md irse ottoxio itsscarensand dsW dryund

of warter: E Pubfic

Il. r Chrretrwdertston

12 Sell uasher clem aidsnitary condition

i3. WashtgryffiIro at90T orabovq rinsewasb $aterat5qirhb200pto

of,c,hloiineIs,.Egg'{rYing eguipnenc'maindned . ,

Iowe DspAntMsNT or Acnrcur'runE & Lero SrswARDsHrp

EGG HAI{DLERS INSPECTION REPORT

(vr",hlbe riResicted

Junbo )(L tI M sNnnboofcaaof

egs onhanddttmeofbtspeAton

Attach Refficted Labels on ReverseSide of lh" fom

4. Floors cleaooble naterials' floor

e pturnUing ma seutage dispasal sJIsEm

ffirronvateqt, hot and cold wder,

torrels

8, Storage mduseofioxic it€ms

9. Storage ofcartons and cases: and

uAen trPublic

ll.' trsonfile

12. Shell washer clm urd mnihry co'ndition

n Wffi tetnp€rature at 90T or above'

10:F wash

14; Smitizer ryraY rinss d

15. F.gg equipnent clemmd

i:E itair*Fodrepaii, olam, adequaelyf7. Seles adequate to determine n€t

lE. Retigerdion mib:45oF orbelow,cleaq fue of obiectionable odory good

reeak3. Adquts €'Boval ofrcftse

19. Thsmometers: provided aad acsuraie

21. Ioose-packed eggJcases properly

hbdee firn nare md USDA Plmt orlicense number

22. Ne$, egg crtons fur sales to

23. Iabetiug of egg @rfons: grade,pack doe, namer addrpsq plamt or licenseiurUq.. og" SaryIling instructions

26. Persomel fu c@ct with shell eggs:

s^6aplrd.Hrlx l;ccare- ta,ri-.\Inspector: J-,fra,A&Z,4Tv t y:l . t z'

OumerorlVlanager:

i:.t:_

:*',

,,:li-i:.i.

,:-r .f i:

:.

l3l. ':tr!n

convenierf, hot and old wifier,

& Snifagp mil use of toxio it@s

$orage ofcafmns qqd cases:

l'li,;

water: tr Rrblic(l) d,Piivde

ll.-* Cfou@:sdEr

iz. SnAt wster olm ad mitrv conditioil

wash rred99Tol dnsl01F warmerthan wash

14. sprryfusat toz008/nofchloriDet5. rl-gg equfum€*demand

,4

)r

V

Comments:' f*f utu.!" Ai re* ,n. Pu* d l.o Lr,r*hrr Tu*'h #t *,r*.gA**-&'

Iowe DppenruBNT OF ACnrctrr,rwns e LAND strlMAnpsnrp

EGG HANDLERS INSPECTION REPORT

Nm$qofcasaofegs onhanddtbteof

tnsputlon

Attach Retricted Labets on ReverceSide of this Fom

1. Buildin$ gpod rePair, clan,17. Scales adeouafe to determins ret

18. Reftigeruion rmin: 451F or below,cleag fre ofobjecdonable odorq goodrspair

2" Fre from prcmoe ofbird&

19- Th€mometffs: providsd and scsurate

21. t,oose*ar*ed gScases ProPrtYlahele& firm nams atrd USDA Plant orIicensenumber

23. Iabeling of eg cartotrs: grade, $ze'packdam' nmg addrq plantorlicensenumba, safe handling instructions

Persomel in comctwith shell eggs:

3. Adequde irffism/-removal of refuse

6. Plumbing md se$"ag;e disposl Estem

E. Storage md usg oftoxio itenos

,. storagp;fcartons and cases: dry aod

clem

10-Adequafie

12. Setl smsh€r clem md wiary condition

rmpa-&rcat90?Forl09F qrarm€r rh84 smsh wder

14. Smitizer sprray rinse 4ofc&Iorine

to2Wo

15. Ilgg equipnaf cleanadmaintafucd

tr Priva0e (2) *

Record

OulnerorManager: Inspector:

JUL

und dfAND StBwenpsnrp

EGG HATIDLEBS INSPECTION REPORT

p6oflnspeotion: A_ q*is tur$E$'/

n "r** &os* B*u*Fn *q e^IAl{atrdl€rs Liq

8"irqhr{uagq l/ffi$^yffi aftxl No.

cttY K\'**^[tc{A ftffisr c@tv tr?aev; c

Co!4yiNo.

'fianberofcataofegs onhmdatttuie"of

@ryecttotl

Attach Resfficted Labels on RevelseSirle of tnis f'orm '

6:,Ptrobiag md su,age di$posql qrstsnad€qU&7. IIad sink convenient hot ald coldwatsr,

8., Stor?gp'and use of mxis itqs.9. i:arOnsmdcdses: dryand

:ti !.ctrsin ,'"L.

,10.

I

12, Shell wusher cleatr @d qitary condition

13. Wash lgryerdured 90T orruttrinenthait umsh

'14 Smitizer spray riDse d 50plh0 to 2Ohrtnof15. Egg {ryingmaintalned

(l) tr Privde(2) *

Comments:"SIE*,*---ila;.& ;'t t$, er*,n u*"*r, kE rv**' u* wrlA *.&- &:

s'€t6,r.t 5e$d.5 I .6

OwnerorMlnagenI'}, * tL')l u!1* r {:xtltm,5 I4qpector:

' : oF,&GRICrIL{gxp e LeNo SrpwenpsrrpIowe. DrpanranrNr

EGG UAITOITNS INSPECUON REP()RTd&61

Iasp€ction: &ad* f S

&enlt * &V** h,fia,:a*^."j FJ.* J'l**rt f*lr"lq$b - $&a:ru

REsilricie{tEo

IrDboJT U>

xL.freo

L^,$(,6

t{e

sfianb*ofeasqof

e*c onhq,{dttryeof' : *rypeaton

Attach Rotrist€d Labels on ReverseSide of this Fom

rodents .

pr6ac€ of birds,

3. Adsqude sJM/:moval of rsfirse

4. Floorsof naiErial$ floordrains

5.

6. Plimbiiig ad sesege dispqslsJqteq

. Iland sinlc convenien! hot and q/def,,

8. Stdr4gs md uso of toxio items

9. Storage ofcarons and cases: dry and

to. wder: trPublic(l) @ Privatr *for nrirde wsttnir..dde t€6fie& m-la;ll. *

12. Shell wrishet clem axl vni6y condition

temp€rare at90"f'ortltan srash

spayrinsed! b2@ptn

r.ngg{riing md

Record (100

:\'lqra it ut,Aer 'u^' ) tAo"s "nE tu} noqrts A/otA.i;.* [ 0n9** tr&,-'rear*q{'{ " [6 fia* aeg #;,5f *io*]{-rIf, Ca->lr6 fr*"{-n S- 38,n - S3: F,e**,$t*d " 5\*c^ CsaE&\c,L' J€^ +;o5 tru aet-o--o "

hgur{rtao" ,& ?aa

. ",@

OWiiEr or Iv[anager: Inspector:

\ cq*t. t$ Oev;d*&,\

etueffiM@1

,b&?o

::,' Mmbqofcases of .

eggs onhotdot lmeoftnspulon

.:Attach Restricted Labels on Revense

Sido of this Forin.' '

3, AdequAte $&ryr€moval of re$$of nafiqials,l

5;

6.Ptrmbing md ssttego syqtsm

hot ad coldqider,smulry ll,vvtil! pruvluw .

8. $orage ad usc of toxio ite,ms

9; Slpragcsleaii . '

d ess: dry and

IOll. * Gm@rul&telt12. SheU i,agb€r cleam md Santfy cdndition

Wash tempsrdulq at 90T orfO6F wnrmerttarrqmsh

14. ffi spay rius t soplm to 200ptoc&lorine

tEgg@CequiPmot cleo antl

wM tr Priblic (l) B Pfided819,

Inspeotor:

Iowe DepentMENT or Acnrcur-tuRE & Lmro StswARDsErp

EGG HAI{DLERS INSPECTION REPORT

Nmfia of casas ofegt oahodattlneof

Wedfon

Attach Restricted Labels on' ReverseSide of this Form

presmce of birds, insestc

3. Adequde q&ml€,lqoval of refuse-

dffiinEp{ seuraee dispog.l sYstem

ffi conienienq hot md cold waler,

tourcls

E. Storage and use of oxic items

Sorage of erons and cases:

clem

10.

ll. * rntprte*on file for

12. Shell waher olem md mitry condition

rcrysmre CfrFF orabove'than

14. Smitker sPfaY rirso atofchlorino15. Eg

d6etde&

t ifinil rePah,clean' adequaf€ly17. Sqks adequate !o determine net

18. Re&igwation units: 45oF or belo%clean, tee ofobjectionable odors, good

repair

21. Loose-pac&ed eggilcases Fop€rtylabele& firm nrc md USDA Plant orlimsenumber

22. New eggcartons fosles to

ZC. Labeling ofegg ctrtotrs: grade, slze,

oackdae, ssm€5 addrEss, plant or llcense

nnmber, safe handling instructionspubnc(l) trPrft/de(2)'

26. P€rsonnel in csntactwith shell eqgs:

Inspetor:OqmerorMaruger:

Iom'DrpenruEr\r1r oF Acnrcur,ruRrg & Laro SrswARDssrpEGG HANDTERS INSPECTION REPORT

Mnnberofeosa ofegs onlwtdatttne of

fuspealanAttach Restricted Labels on Revorse

Side of this f,'orm

cases: dry md

q&tffion12. Shell u/a$s clem d mitry condition

13. Wash tempofirrc d 90pF orwatei looF t&enrygsht4 Smitiza spfay rinso d 50p/m ro

Eggdrying cleao md

9. S@rageclem-

tr Prfuafie

18. RetigerAion unie 45T or below,clea, fre of obJecdonable odom, goodrepair3, $dequoe s;flshm/rcnroval of refirse

19. Ihsmonetem: pmvided and accurate

6. Plqmbing and serfage disposal rystem

21. la9s9+acked eggVcases propulylabsl€& firm name and USDA pGotbrIicmsenumber8. Stor4ge md lib oftoxic ifems

22. New €g cartons formles toffi23. Iabeling of eg cstoos: graOq Sze,packd&, nmg addrssq ptamoriicm."Ember, safs ftandlin g instructions

Personnol in conactwitti shdEs

Iowa DBpanriupNT oF AcnrcurruRrs & Lexo stnwanosrrrpEGG HANDLERS INSPECTION REPORT

N{Vb* qlcasa afery onllqla@s of

o-Ptruibhg@conv€mignq hot md cold u@,

8; Stogge and irse of toxic items

Songe of ertons aad cases: andclean : .r. t::

Attach Rsfifctcd Labels on RevereeSide of tlis trom

10.

I1. r12. SheU vtash€r clem "nA saiitar), condition

tqp$ahrc at 90lF or above,0t'cmrm€rthatrwash

{irryidnseatS&/ero

15.Egg gquipmsrid@atrd

ddetcsbit

Cbmmemfs:

[,-1t.

Ejrrt *:li ha'n4,aeA +r, c"flrf ,F-l Lrra.ha, oa g*e3;13t

ru

qyneror{+qr: ,:\

nowa DupanrmpNt'oF.Acm"lcuurun,E & n anuo Srsw*npsmlp

EGG ffiAI{IDI,ERS NSPECT]I@N REPOR.T

Nmtbu ofcases ofegs onhmddtlme of

inqedion

Attech Retricted Labels on ReryereeSide of this Fom

l. Building: gpod repair, cleaq adequaf€btv€uted 17. Scales adcquate b determine net2. Free from presace of birdc fusecttrodma

18. Refiigcrfiion rmits: 45'F or below,clem. free of objectionable odors, goodrepair3. Adequde systemlremoval of rdrse

19. Thermometers: provided and accurate

6. Plumbing and se$age disposal system

7. I{and siDk convenient hot and cold water, 2 1. Losc-pasked eggJcases propsrlyhbebe fina na+q6d USDA Plmtlicasennmber UWVIWAS8. Storage md use of toxic itms

23. IaSiug of egcartons: grade, slze,pack defu nane, addrcq plat or licose

10. Ad€suate surplv of poable wM Etrfirblis (l) tr hivate (2) rI l. r Grretr waner td on ffIe for rrirde wstem. date tde&

12. Shell cmsh€r dm and witry condition

13. Washtqpar4rcat9mor

26. Personnel in conacl with shBU cses:14 Saritiaer sprry rinse at s0prtn to

15. Eeg dryiBg equipmmt clean mdmainained

.I ..:

Iowa DgpARTMENT or Acnrcur,rune g Lervp SrBwanpsrrriEGG HAF{DI,ERS N\EPXCTION REPORT vJ0

Nunbq'ofcofe*ofeggon@lqttneof

insp,eaitlon

6, Ptunbing md seqmep disposal" srlqn

donvenimthot'and cold' r,rasr,

-

E. Storags md use of bxic items

9- Stor.tigg-

10;Adiur@urcts*onffle

|2',Sliell waihencl€m f,d $a+lElry conditiap

I qeuc t90$ orgbove, riilseuffi t0oFwanhrrttant4, dn$-d50t/sto200p,ttrofdloriner5: deomdmdnhined-

Side rif thfu'Form

$rggro{$anagpc\.

"'3..

nowa DgpaRT'MENT' or .Acrucurr,trqE & llawp Su.ewanpsmmEGG HANDiL]DRS NSPECT]I@N REP@R.T

Numbu of casat of .

eggs onhandatttmeofiwpedlon

Attach Rqtricted Labetrs on ReverseSide of this Eornn

17. lcales adequae to dersmine net

I 8. R€eigcration rmits: 45oF or below,cleal fiee ofobjectionable odorg goodreeair3. Adequae sysleuohemoval ofrefi$e

19. Thermometers: provided and accume

6.-Plumbiag md sewago disposal q6tem

7.IIed sink convaien! hotfuf, colAwder,21. Ioose-packed eggVcases propalylabeled: firm name andUSDAplaotorIicenseilmberE. Storagg and use oftoxic itm22. New qgg crtons for sales to t€tail

23. Iabeling of egg cartons: gra0affipack date" namg addrEss, plamt or liceusenumbetr, safe halrdlinq instructions

10. Adequate srpply of poeble uatu: tr publtc

wscu t$t on file br prfude system" da$e ffi

Wash terrpranue t 90T orabove,

Pea:onnel in conagwith she[ eggs:t4.ofr

sprEr at 50p/m to

15. Egg equipment

,' i. ":

ibwd.Drpl,mrumrr oB AcRrcrrLTrrRE & Larvo SrewARbsrilp' r,, l*,' :':,, . :,

|EGG HAI{Dr,EBS TNSPECTION REPORT

Mabuofcaq$.ofeggp on@Qdttrueof

itaj@lbn '

Attach. Rstricted Labels on RevelsC

3, :Mequa@ systr/r€moval of refirsil

4. Floors of

clan6. P, ltmbing aid sE rgge disposal $/st€m

convenienq hot md cold wafer,mwels

Ei Sto{gepimd usb ofbxioittms9. SE-age ofpBfb,Ds "ind m!e$;

1C vaet nnrnieI 1. t Clrrmt wds test on file for

t?. Stell uilDlhgiclem ard wiqry condition

-

13. Wqqb tsmpErafqe at fl)9F orwater IOIF14. Smitizgr *i6qy rinse at 5$p/m b 200prhof c.hlorine

dryingeqlri mt cledumd

Record 100

Owneror

:1 -

,,$: -,* *B IowA DEPARTT,GNT or INspecuoNs errn Appnar,sr:, . .;,., .EGG r,rns nvsPnCrroN REpoRT

r&stri@d

Jumlto )(L L M s

]ftqqbq..;af'cqies of 'egp onhmdritimeof. Attach Rstricted Labels. oi Reve*i.:

w Side of this'Foinn

Comment3:

JUN I5 Z0i$

NtuTt$ggf,casas of

ll; P.$pbing bnd seuxagg d.i.Sbps! srrnema49gnde:,...,,,. ,:,., .' .' ,'r,,,r ., ,

'7. IImd sink convenient hot and cold waer,mitarytowels provided

8. S@agead irse oftoxic itias

Attach Retricted Labels on ReverseSide of l\is X'orm

9,'S---t eofga$ns'and 6es: dry aud

ul*ei.EI Public

: : : :i.-- i

l2i Stell wi$Ei cleq ard Witry condition

13. wa$ lpryBti$t-rr9 490T bra6ovo! rhse;umtdr.loe^F

14,$ $,ryriisiat5S/nto2@h

t5; Feg {rrinstqr&qqft cleq md

nowa Dsp.sRT'nduNT oF .Aom.rcur,r'unE & n awp SrpwenpsmmtrGG HIAND]LER.S INSPtrCT'X@N REPORT

€ctoa:fr\ r".,1 1 :r ..-,.-p

InsoectorNo.' :t(:fNarmeot.ttfm? \ _

HT'-\, -.,a<L'.^i\- F ^#H€FEEY'{Ao,,€s \crY{ [ \,4 +.u t.*,* Mmagq I PtonoNumb€rI Em" .sLP '3.8 i-'I JSDAP]artNo,

Citv r- '\k\r u-V,..,-TioCrcre{? r"r> Comtv

SS\.t*-'L.o **n*"9 q (

Nwtbu of cases ofe*s onhonddttm.eof

inspealon

Attach R.estrieted Labels on RevereeSide of this f,'om

NO IN OUT NA NOl. Building: gpodrcpair, cle4 adequatelyvated

76-

L7 Scales adequate to de0ermine net2. Free from presace of birds, insed$rodats

18. Refiigeruion rmi6: 45T or below,d@, Aes of objectionable odorq goodrepair3. Adequde sysfsn/removal of refirse

4. Floors of clemable nafqials, floor drainsorovided fifneeded) 19. Ihermomet€Es: provided ad accurae

5. Floors. walls. ard ceilineclean 20. Transportation vehiclesclmandeodr€Dair6. Plumbing and seumge disposl Elstem

adesude7. Hand sink conveuieqt hotmdooldwaer,ianitsrt towels rvmvided

2 l. Loose-packed eggycass properlylabele* firm nane and USDA Plmt orlicense number8. Storage and use offoxic items

9. Somge of ertons and cases: dry aodclm

22. Nery egg cartons for sales to retail foodstors

10. Adequato srpply ofpotable rmter: tr Public (t) divme (2) *

e3. Iabelfug of eg csrtons: gpde size.paf,& date, Bug addrcsS plant or licensenumber, safe handling instructions

t I . t Current wafrr tet on file for orinate wslrm. dare t6ted: $^,.- - . \ ?,ar''i 24. Adequde records mainhined

12. Shell unrsher clean urd mitary coadition 25. Resfrictedltrcdible eggs proplyhudled

13. Wash teinpanre at 90oF or above, rinsewater lOeF wrmer fran tpash uat€r

:rftB.-$ffisrryi

f 4. Samitizer spray rinse at 50p/m b z@frof&lorine

26. Personnel in conact with sheil eggs:good hygienic practicec dm cloftes

15. Egg dryfug equipmeofi clear mdmaintained

27. Demonsfidion of knowledgc: candltitgndina weiebfus, washine and sanitdiorr

Comments:

l'.1'"r-l,rr,':t: r: llr-i :

Iowa, DrpanruErrrr oF AcRrcrrr.TirRE & LaND Srrwanosrrp

. EGG HANDIJRS'IN,SPECIION REPOR.T4+, ,s, l ,

Dffioflnspectionir^ .-' dd"'Y-t{No' . .ry#

,., ,ys d)

ry &e^sfr,p eqF"-{'*^* IAl{mdlss Ltoer

"rfl ref, 5Addross . ^--& Ald,tf> L)aeri4$a ffie, get*4' lffiSry-b#ees

USDAPlmINO.fr g[5

Ctry " rt- d)W"N,*k rJ-€rd*/AZio(hrc.trG{"tg0

-coffiv #*r*uff l,

. Mnrtwofcosesofeg;gsonWatfueof

irtspabn

. 1..:'. :

Attach Rstristed Labels .on RwerseSide of this Fomt .

mdselmgsditposlrym

7. Iland sink: hot and oold wder,toweli

8; Stofage md useoftoxic itms . ':

StQlage ofcalpns and cases: dry' :clean

10.

t.

12, Shelt urasber clem md mi6y condition

tsnPqttrcatqFHorrhan vash- uater

spr6y rin_s9 d s0p/mtochlodne

i 15. eqqipmor cleanmd

uratff: tr Public (l) i rer*

Coinments:

Iowe DrpentMsNr or Acnrcur,runB t Le'rvo SreweRDsurp: EGGEANDLERS INSPECflONREPORT

Mofln@tion S- T_ is InseeebrNoi t,*lsNameor*nn

i{*ro,#r*n #,d* &- F**, & tr* {%*#*ul'''q IA IIadIss HrcriuselFh se"$#-iAddrw ' n ?r

Je-75- Uaar,'9Pe ffim* &&*e l&ffi]*We -s&&a ,f d:) Jr ,

Cilv n',flb"a""!,tk Je6"rcqztoL:ode' _'Te--H 3a

Cdidy , j ,rfft:ra{€1€ k

CoetyNoj '

Nrmbt ofcasex ofonlryd dqE of:

,. inspedlon

Attach Restricted Label*on ReyereeSide of this f,'orm

shlc q@v€ni€nl hotmddrels

8, Stp[-agp nnd usq o-f to:do itet'rs

9, Sfriragc ofcartons and cases:

I0. Adeoiute siioulvof1-llc\rrrelrtuatsrtdonfile

f2. mell irusher"fean unA miW conditioo

reqi ure at90$ orabovc' rinm

equipmeffi clemmdof&lorine1rEesEmaintained

. ii.s;r'

f,

.:.fowa or Aemcurryry * ranb SrBwexosrrrp

EGG EAI{D.LERS INSPECTION NPPONT

No.,JN

q

citv TlDCdra'{-la g L

Uolmy 6Ld)'s * No. :,

Ntqbq of cases of .

egsonlwnd attime of.-:-....': r-i_

Attach Restricted Labels on Reveme.;; ir , ' ,Sid, gf:thi$trorih, "

3.Adpqri@i4. Floon

7..,,ff$ $$.i{lniartim$ hoi md

S'S,rcgge pit rtse.oftoxic items

l2 Shell wsher clem and sanihry condition

13., Pa$ teqlFrurc ar S09F oi@riqle*4di l0f,F{ddsrftanumsh$d€r I

' lr. :

Pnblic(l) trPrigp1Z1*

t4, ErqY44soaSop/nto2ryillof15: Egg dry.in-$ gqgipmlrrt'cl€anEd

Record (100

Commeirts:

InspEctor::1 -: , r' , I:, r-t

, ,t'.ie

f;--- -€--.-f.-t {

Iowe DrpenrrurNr or AcnrcrrLTURE el,lrvo StrwetpsnrpEGG ErIIIDLERS INS]ECTION REPORTj* :d'

Yry ,ffi*i,* &tsd-sNraqbq dnaw ofWP onhN:atq?e of

trrspdibn

':Attach Restricted Labels on Reveree

Siale of thisfol{i

lllmd-Siili

8:.Stdr4gp m$luse oftoxig itmqand cases: dry and

I0.,Aitesude surplV of water: tr Rrblic(I) Efrinate(4*ll, i C\idrmt.ir&tston

iZ sneU uri$. srrctsm aC miaqy condition

13" Wash ery+ry-asg d S:F or aborg @$xer logFiilfr*mrnulash warrz* /e11,14: Sariffiir #wchliriine15, Egg @l/ing pquipnenr clan

Record (100

Comments,, $* - /* & {o*/*6 €?a S".& €w*.g* E we*Ns -

@sr or l{an-ager:'ffi*@f

fuspctor: fffp

nowe DrpaatrvrpNT oF,4.om,rcuarunn & n A.ND Su'pwanpsxup

trGG EIANI'DT,ER.S NNSPECTIIONI REPORT

R6tsicted

Jumbo )(L L M s

Nwtber ofcases ofeW onhodathneof

inspaion

Attach Restricted Labels on R€verseSide of this Form

17. Scales adeqilrte to dElermine net

18. Reftigercion uni6: 45T or below,clear" free ofobjectionable odorq goodrepair3. Adequate rystem/removal of refirse

4. Floors of clemable matsials, floor drains19. Ihermometem: provided and accrnare

6. Plumbing and seurage disposal syste,m

7. Iland sink corverrient hot aod cold water, 21. Loose-packed eggs/cases properlylabele* firm name aud USDAPIant orliccnse number8. Storage aad use oftoxic items

9. Stonge of cartoas and cac: dry and egg cartons for sales to

23. Iabeliug ofeg cartons: grade,pack datq namg addresg plant or licensentmber, safe handlins instructionswater: E hrblic(l) Wt*** Q\ *

12. Shell unasher olem dnd mnitary condition

13. Wash temp€raarc at 90T orabovg

26.Pe$omel in comdwith shelqggs:14. Saoitiza spray rinse at 50p/m to

Commenfs:

Owner or l!{anager:

|(}

Iof-rya DepARrrrE{lt:or eeffcuriulp * Lero Srpwanpsnrp

EGG.HAI{DIJRS INSPECTION REPORT

T'SDAPId

No

Mmbaofcos*ofeggq on hiytd.dtfne of

fuspeA'nn

tl

Attach Restrictd Labels on ReveneSide of this X'orm

Jtestnctod

ftnto XL3

L M s

| 6. Plumbing md ser+age dnposal sJrstem

7. Ilqal.sinl$ conyeni€nt hot aid aold @trt|r'lulafJ:rl}Y$r!tp.IovroEu :, .'8. S-torage audirse oftoxic i(e. l

pqrtons and.q{sel: &y and

l0rAdqqate uaen,tl Public BntmelZl*Il;t.C1lr mtwaMtcton12. Shell *asher clem and i*anigry condidon

3.:Wash tsryer6rc t901F orabo&, dnse0$ warmq thim rrash r+ater

[4, Erryritss ats0p,htoof,chlorine15. Egg drying €quipm€nt clean md

Coriments:S: h}o ,&nn**q:ke"rrxf,ar', T<sk (@ Edrs_, /r\,r+ b" SWg.I

"fi-

){r{trddka t'{eht\s *e. nr+{;.f heuor 'tie@6!e h6,*}B;". (t$Tdu\

Owqer orlVlaqagen

! ,r-. ''i.Iowa DspaiiiMriNr ou AcRrddiu-nr t LAND SrsitrARDsurp

EGG EAIiIDI,]ERS INSPECTION REPORT

tpspector

IA?ae.D Fooa&

Ntofi*ofcasas ofeW onlry4dWef

inspection:

Attach netricted Labels on RcverseSide of this f,'om

Resfricfied

Jumbo XLOfl

L M s

6. Plumbing md sewge disposl E/stem

rru,7' Egd dqls.convemieut, hot

8. Stbmd; md'rise of toxic itms9. stOPgq Pfgai@nsadd cas€s: drY

ofmableuater: trPublic ,&nirme(z)*wntrtgonfile'for

l2;She[ wsher cltp md snimry coadition

13. Wash tmpFr?firy€ at 909F or abpvg rirsei"af€n l0qFrrremerr'hen wash uratef l

spray rinse at 50p/m to 200phuruu1jlle .'15. Egg drying equipntrfi clm md

-.Comments:

ift+rt.;ldials*$x,oH&eo-,*,'h.-6fi[?et.o-*r.^sflt",rn,,.h"+v.n" r*r&! , Hf;x{rfio! S.}{" s"; & n^*Sa.L,

'/t

;#17 ^

. l, ,,r:;.

oumerorl\4anager:

t!

.!r .r J/ gfuz*A*a,'*,!",- i{-rffi{ Inspector:

l' ,"' ,,#,y

H*&"d.*e

nowa DppantnapN' oF.4.oxrcur.r'u*E & naxu srrwaaosmrpEGG HAND[,trss ${sptrcr,xoNT rREp6rRC""

jUL iJ 5:' e[''-'

Nwtb* of eases ofeggt on hand deqze of

inqrectton

lT.Scatesadeql@m-deremG18. Refrigeration rmi6: 45"F or below,cleap tp ofobjectionable odon, gCIoi3. Adequae rystem/removal ofrefirse

4.Ftoorsofct@19. Thermomet€rs: provided and accuaie

2 l. Loose-packed eggVcases properlyPb"b& firm aame aua USDA ptmt orlicense nunber

22.Newegffifoffizr..I{rylins@pacrdate, !a9 e, addrts, plant orlicasenuurber, sfe handling iristructions

26. Personnel in "oilart@@;;Sood hj€i€,nic dractic€s, clean doths?

9. Srclean

6. Plumbiag md sE lage@;sd s,4sbo

z{ana{*co@8. Storage md use oftoxio items

cartons and qses: dry

watstest on

12, SheII unsher den and sanltary conditioa

tempcafrrre at90oF or rinset0s' tbqq wash

14. SanidzerqprayGErf c.hlorinei5. Eeg clem and

(I) trPrft/ate

Record I00

uner orl\daq4ger:

-Inowa Drpam,rnapNT oF Aoslcur,rtrnE & llawp Sr.swanosnmEGG ffiANDLERS INISPECTI@NREP@RT

'

Nunber of cases ofegs on hmd dfime of

inqeaton l-- ffi?H lowaru*ey Far,,I E.'h d .,S FindtlreFaroorrFaceloolI- Fr:;q f;r:,:g ,.*T*i##.#T;

12. Shell qxash€r ct€an and mnitary condition

tenpcatureatffiorEffi14.ofr

spray rirse at

cleas md

l:lr{diog gooa r"p"ir, "l"ro"

ud{@vetrted

tz. salesaoquaoeEffiiiil

1,1.1{t*r1igl *irc, asr oiu"loilclee, fi.@ of objectionable odors, good3. Ar$u$e V*en/rmoval ofrefirse

19. Thermomerers; provided and accurafe

o.rmnring@

ilItrffiH"#ffifffit8. Storage ud use ofioxic ihssto4geo@

z.Neweescarro;E;GGEm'

23,Labe_liag@!1c,{

ture, s@e addrcsq ptarr oriicens"safe handlingii.t octio,

Zlrnro@toI

fimerorMan4gec

1+qeque$t@ipiriovaorrenrse-4.'Floors of

5.

f;Ill*,rcqds@ffi

E S@ge and use oftoxic itemse-storageof cartoEEE'G:Ay-clean

12 Shell washs clcan and sanitary conditionr.w.lt@waterloBnr €*ttansilashnarer- ----

Iowe DnperrrunNr or Acnrcur,trlRE & Larvu Srsw4,BDsrrp

SE+gg.E#UDrERstrGphaE6fr'ffi ,ffi :

uqten trhbltc ffirivaerzi*

q

*AB

14*--r-hm

-bmtlF}

14ryrtusodi0e/mmr/Se

dl$ #4e l,"rr .#;

lowirerorl\danager #,,.,u1u", !1,, ., ,,,1" Inqpector:],i-t

Nmfio of case* ofegs o,!,h@dAtlne-of

nowa DspaRTMEhrr oB .{cnlctrx,T,rrR* e n anro Sz,pwam.osmrcEGG HANDLERS XNSPECTX@IV REPO]R6-

inspeAion

&r"u,* Ske:'r& K,/,

Nunbt ofcases ofeggs on h*td atttne of

-LId, es good rpair, "ffi.ffii;vatedtT.scatesad;@ffi;alll{iesr.atioa rmi6: aS"F orberow,

:T1 *" of objectionabte oaors, gooi

19. Ihermometers: provided and accurafe

o. Huqnringmaeeu'ag@'

z.*gs@ffim;mmx'm:,8. Storqge and use oftoxic if€urs

storaee of carroqsE'EGE6a zz.Neweggm6m23.,Labelin@lTt drr., qaoge, addres+ ptant or iicense

f.monnef il"o-

10.

ll. *

12, SheII washer dm and sanitary condition

tr Privafie

?:Ierneqerc * 90oF oiaboffiElOoF warmer t&an wash qat*

lpray

equipnt€nt cleaamd

qmerorlvfanaggr:Inqpector:

u (s

Iowe DnpLnrurNT oF Acrrcurrunr e LeNo s*wanosmpEGG EANDI,ERS NYSPTCTION NNPONi

i., :

Nronbq ofeas* ofeggs,on!@;gttneof,, , vtsptiillon

sewagsdiEiosal qys!@

conv€ni@qhdmd coldnm,

-

r t. SSQrage and usa of.todc ii€ms:$.fi @geof carlq"n.iand€ss: d=

ofpohlile!ry4er tr Public

-:12. Shell unadii€r.6t-q3q.{iiar'sitrini conilition

13.washienii{i eE90EEffi;ffiwater l0oF warm€r '' on washra. Sanitizer siryy rinssEffiE'

eqtipmoE clemmd

Comments:

&tsrrJ"

Pn{ r"L'e Cflns" q E^

& 6a urN

'* ^

&,,**;nT'"-r*. l,#&

lowa DnpaRTMENlr or Acruct*tue.E & n-axo stewanosmrpEGG HAN,,.,ERs m{s*EcrtCINr ffi pffi"*

Numbe ofcasas ofeggs on hod dthne of

inqulon

lf:{oin* s""d "ert dro,;ffiry'

vqted

],}j{ryryotr xnirs:4ioF o, udoil::3 oo ofobjectionabte odon gooA

3. Adqu* system/removal ofren se

19. Thsmomsters: provided and accu?teo:Ptumorng@.-*Iasin*@

ffi8. Stouge and use oftoxic itemse- storageoT@EG6i

egg cartons for sale to

&Hffi@dlrnginstructions

trmtm trpublic

12. SheII casher clear ard sanitary condition

t@psafired90S;;

sprayrinse a

0.

i:

13. nlvder14. si,

Egg equipmat cleaoud

Ii

Record I00

A

B

D&tiB

Cha

IsI"ca&ds

lomments:

.eer

1r,!

!.9j9.

Iowa DnpantnnsNT oF,tcm.lcul,r,rrRr & Laryo Sruwam,psr*mEGG HANDILER.S M{SP]ECT'XON REP@R.T

D& oflxspection: .,.

0- '1.1 -l "

InspectorNo. T I i

IA tlandlerc Lice,nse No..l A f.':;:c\,.,i I

Name of Firm

Addres'**41 .i -i r lr-,'t-ti AUeI60agtr ' -qzPtoomliEffi

USDAPlamNo.

CU^.I rl I g-1r 1a ,1- 1-

zipC{d(.Srt t -74 **

e [c,.r K*-coutyNo.

ac)Nt*nb* $casa of

eggs onhandotdmeoftnspeaton

17. ScaIE adequate to deteraitre tret

18. Re,ftigeration unrlts: 45"F or below,clean, free ofobjectionable odorq goodrepaii3. Adequare sysrem/removal of refirsE

19. ThermomeEn: providd and accurate

21. Loose-packed eggdcases properlylabeled: firE nerne and USDA plart orlicens:e number

New eggcartons forsats to

23. Labeling of eg carrffi@pack dafc, nameo address, plant or ticeirsenumber, salFs ftandling instrucdons

26. Pssonnel in conh.,twi6@;

matcr.hls, floor

6. Plumbing od soryage disposal syst€m

.I{md sink convenierrt hot and cola later,

8. Storqge and use ofbxic items

9. Storage ofertons andcases: andclea[

water: ElPublic E Prirate

12. Shell srasher cleaa urd saitary conditioa

t€mpsmtrc d90oF orabovgl06Fwmer $rater

14.ofr

spray rinse d to200p/m

15. F.gg equipne cbauand

Record I00

A

B

Ditdq

Chs

Lorg

r rl.q

)omments:

wnerorMan4ger: Inqrcctor:

Iowe Dupanrunrrrr or Acnrctrr.ruRE & Laryo Strwanosrup ,r{EGG EANDI,ERS INSPECUON NTTONT

ZS{p 0 0*r1

Nunbq dwes ofegt onhmdatthne of

ittspeztton

l;#*"*''Pato Ftz. Scates ar@dGmine aet

ll_ltryrySon rmir: 4iT or ueroil:31 tio of objecrionabte odon, good

g, Adequqp Exsfieu/rcooval oflsnrse

19. Ihemometerc: provided and accuzte

9;Plryhrag@zrj.gasrnr@

i-l_lg'*"*u"ecvoroffiraDded: fim name anO USOj. pfhtLlicasenumber

& Storagq aod use of toxic itas

23.Iah,E;Gffinslffii:ksafe handling ii"t"urtion"

ZZ.O..oo"nt@Eading qreigtiry washing and snimlnn

sbrBge qtonsatrd cases: d{ydclean

t4"ofr

r0.iT

slrayriasddsh/n6

uaten tr public ) trPrivafiet

12. SheU urasla cteq anO wlary condhi,on

temeea:mne at$Fq ve. rln-iltrash

equipmenf clwmd

A

B

Dffi6

Aq

Iosg

fl'PpQ

Record I00

olnmenh:5L+

vner orll[anager:Inqpector:{ BMfre

_._".::rare.:n_

IoWA Dpperrurxr or AcnrcrrlTrrRE * La,vo SrBwaios * /

'rNmtbelofcasatof

@ on(94 @ttne cf:

Attach Restricted Labels on ReveroeSide of this tr'om

inspeaion

0.Hrr-Afugmaset*"ge@.u,rEqure

8. Storage and use of toxic iterns

-ttoryeqotgryEEa@EEa

I,2. $heli.rcShi:r chin and qi6y coriAtion

mptraturc at 90T or abover rinse

SdirslrjlrayiGA

ryqtd

Record

)qnrer orInspector:

Iowl' DnpenrurNT oB Acxrcur,ruRE & Larvo SrBwenpsrrrpEGG EAI{DIJRS INSPECTION REPORT

Nmbuofcases ofegs onfuinddlrmeof

.insp@ion

.ll

AtfCch Refficted:Labels ori Reversegr SidC of thisf,,ou .,, r, '

of clexmable matuialg floor drains

md se$ag9 disposl system

convoiof, bot and cold water,

E. Storage and usp of toxic itens9;...iofage ofpgrtqnsqd ca$s: &yud

10,

iI eda oifilerfotryEien

12: Shell W$er olem and miqry conditiol

t€mixtrdure d 90tF. or 6D0ve rinlcl(P]F qmmerrhann ash vBter

14. spray rinse at 50ptn to 2@prtn

15.Egg

A

Bi

Ditdg'

Cn€6

Im

l.GahrE

Inqpecton

.

lowa DspantmpNT oFAcm.tcunrTlnE & X,aml Sq,ewanpsmtpEGG HANDI,ERS TNSPECTT@}V REPffi,

-

Ntanbe ofcases ofeggs on hand dfime of

tnryedton

t4.ofr

spray

15, Fgg qulpmqf

A

B

Dirdlg

Chq

L$

L^Gt&cr!

louments:

Record

].:B:{aiosgooate@ffivented

tz. scatesao@6TffiiG3:In: fi,om eresenA;fEiffi;l,l.j{iu*fon unirs: a5T orbelow,rr111 ii,o ofobjectiouable odors, gooi3. Adquarc gnste,m/removal ofon *

19. Theraromsters: provided aud accurane

erfhmfing@

i#i#,ffiffi""#ffitrjffi1,_E. Storage md use oftoxic items9-Stongeo@clem egg cartoas for salesE

zs.rabetins@Paq daie, qrye, address, ptaot o, tic.oL

safe handling iri"t oaio",ofpotable warerj trhbtic (I)

12. Shell nasher cleaa and saniary condition13.wasigm@

i4

d.&:w

Iower)rpenrurNr or Aonrcrrrrunr ei L-aro srBwanosrrrpEGG EAIYDLERS INSPECTION REPORT

I[sp€stor

IAIImdI(6&.$

w3IlmseNo

"o''u.pc

Ntonbo ofcases ofegs on$andotrtue of

Weqrbn.'1..-...

| 6,Pluubi,rig.1Cl@@

zTaEdshkcon@E, Storage and use oftoxic iteras

Cflton-s and qses: dry aud

udq: trPublicfl

"!t2.i[e]t trotaana'sdiaycmaUouWashtempqCIqear9qop;56*

l0$reaiB€rtha; washta.ffiof

9. Sfrclsao

Attach Rstrrct€d Labels on Reveme

Record

TPq;"l4aaag* rnspecror:. .

-----

#,efl= #zys

Iowa Drpanrury:1{"*culTuRt & Lam Smvenosnrp* Egg- nrCiudrronREpoRT

i

Ntonbq ofcases ofegs on hmd a mi o7. msp"aton

I'aq*r.e- ffi3:fjotc@

rruuqPag@3H.*5t storageatrd*oioffi

;Hxrceof ironsanaqses-@a

1?,++:g creraaoryiary,;m13. Wash at90Torabove,ffi

l09F14;

),: El-.tivaefZj*

ofqpay rinsoat

/WIS.rEgg

A

B

DtdB

C[es

Lirs

tiailc

vherorit{qn4ger: "t Iqqpector:

r-lowa DppaRTMENT, or .Acrucurn[rRg & ]Lamo Stpwanosmm

EGG HAX{D]LERS M{SPtrCMOW MME6T;'*

Nwtbu ofcas* ofegs onlwtdatttme of

ittspectton

t. Building eoodr. r:uuomg: good repair, cleaa adequatelyYented

tz. scatesaaqu6iffi;;l,8j*ryon units: aiT or betow,

:3 *" ofobjectiouable odorq gooi]: ryequale sJrutemkeoroval of refirse+.Ploorsora@19. Therrnomdtrs: provided and accurde

6.Phrnbin@:311siut@

ffi'ffi""Hffitrf,ffiY;licensemmber

::.-ff. rur9 o, egg cartom: grade, size,

Ig.lut", Eme, ad&trs, pt nt or li""rs"nmrber, safe handt ing iistrucdons

E. Storage and use oftoxic itemscartors and cases: dry asd

I1. * Ctrreot I'atgt: tr Public(r

12, Shell vasher clean and snihry coudition

fmpgaarrearmF;nffiffi;snash

14.ofr

qprayrinse C

15. clemandnainhined

I00

)wnerorlMan4ger:Inspector:

now* DppaRTMENT or AonrcurrrrnE & L*wo StewanpsmmEGG ffiANIDN,ERS SNSPECT]I@N REP@R.T

Nwtbe of cases ofeggs onhmdatttrueof

insputtonAttach Retricted Labels on Reveree

Side of this Fom

17. Scales adequde to detennine net2 Free ftom premce of birdg ,nsectC

18. Reftigeratiou units:45oF or below,clem, free of objectionable odore goodrepair3. Adquae rystelo/removal ofrefirse

19. Ihsmometers: pmvided and accurafie

6. Plumbing aod sewage disposal q/sten

7. I{and sink convenient, hot and cola water,J!. Ioose-packed eggycase.s properlylabeled: firm narne aud USDA plant orIicense number8. Storags md use oftoxic iters

Stopge of emons and casc: dry md Neweggcartors for sale to

23; Iabsling of eqg carto$: grade@psk dalq nme, address" plant or licensen-nmber, safe handling instructions10. Adeuate supply ofpotabte warer tr pubtic (t) Edirryre (2i *

12. She[ rrashs dm md mimy condition

14. Sauitizer spray rinse d 5Qffi to 26. Personsel in conactwio sh@

t€rtrpffired orabovg rinsel0$ufirmq

equipment cleaumd

Comments:

]wner orlvfarager

Io.rre.DspARtMENT or AcBrcur,ruxg & Laro SrBw4npsrrrp

EGG HANDI..ERS INSPECTION REPOBT-- ,'l -; €

[\r*'J.. T*or Peo"/l,t

.ffi s kt* u*

* k{***RsiledNtqnbuofctia of

eggq on !tqt4,: d' tlne of Attach Resficted Labets iin Rwcrsegi6s sf fhisX'bm ',''. :

i l1- t CuirentryuerBt on fils for

lrz. snar rdrt*+lean -o "*i, my conairion

Il3,:Wai[t d{lForabilve"drswaicr IOfF waimfr +hrn ietsh waitr14. Sanidzer qlrqy das6 d 50p/m b 2@p/mof15. Fgg drying Elurpnertt clem aidmtrbind

Iowe DBpenrMeNT oF Acnrcur,rrrRE & fegro Srrwenosrrrp

EGG EAn{DLERS INSpECTTON' BE"OBT

Nmtbu $case^s olegr' onli@d@of

:.::.;Attach Rstricted Labels riaiRevdrse.

Side of ihis f6i1ii::::: '- ,

:NO

--r

6. Plumbing and seuagq disposal.sysm

|t.Hmdsilla hst trnd coldqrater,

s,,Storage and useof.bxio it€-sg. Stofagre ofc4rbns and 9Pq: drf

t0...Adeqrlatq

11 Sh'ell waCher oltm ard Snimy oonalition

ItWafi at90lFoiabove,rinsemsr f OpF tranns. ftan -vmsh urater.--

sprayriused

uren trhblic Elftivab

Comnents;

{

$

Mnrto of cases ofeggon$q$,a .neof

tnspealon

Attach Rgfictd Labels on BeveneSide of this Fonit6

6. Ptullbind rind iir;wtge ilisp.lsat sjrstgry

hdt-and cold wder,

: 8.:storags md usq oftoldcirmsanri cases: dryand

$@. [lhrUic

:

li-SheU, umstdn d.m and iiqitary conditisn

IIWFteryfh&iF d 90s, orshve, ri4so

iffiff.lge1t c €tr,than water

equipn@tclromd

Commbnts:

, .,-

Oqher orNdanager: lnqpec,tor;

Xowa DnpeRT&[ENIr oB.{orucul-ttrms & ]L*ryp StewaspsulpEGG HIAND]LER,S TNSPECTNONI REPOR.T

f,xrlg olJnspefloftL-;'(b* 1\: '? tr ,'a

InspectorNo.--f, .- :

NaneqFFim 1,1 +., Y-r-a.oo<;---c,'i.a

oryner IA llandlers ticeose No.'€u-:"-.Qr-1*? (Mmass l*'*{flf USDAPlantNo.

City Tipffie€?_r'? u"

L;omtv .'\\cr -:,.-., \

yNo. ,*t SResricted

Junbo XL L M s

Nwrrber of cases ofew onlwldddftze of

tnspectlon

Attach R.estricted l,abels tl!! RevenreSide of this Fom

l. Building: good repair, clear, adequaielyverted 17. Scates adequate to det€nnine net2" Free &om preseuce ofbirds, irsectq 18. Refrigaation units: 45T or below,

clem, free of objectionable odon, goodrepair

19. Ihermometem: provided and accurarc4. Floors of clemable materials. floor drains

5. Plumbiag and ssr+zge disposal syste,m

21. loose-packed eggdcases properlylabele& firm name and USDA Plmt orlicense number

7. I{and sink convenient" hot ad cold waier,

23. Labelingofeg cartons: grade, size,par,k dafE osmg address, plant or license

26. Persornel in comct with sheil esgs:

8. Storage and uso oftoxic items

9. Storage ofcartons and cases: dry aodclan :

water: tr Public

12, She[ qmSer cleao and sanihry condition

13. lVash tmpature at 901F orabovg rinsewater l0cF ummer than wash water14. Saitizer spray rinss d ro200ptoof

Comments:

R.ecord 100

JwnerorMaqag€r:

.+;*:

Iowa DrpARTMENT oF AcRrcrrLTuRE & LanrD Sirweno9ure

EGG LENS INSPECTIONNBPONT- JUN 2:5 2CI13

5sffi,T1q

ticpue:-i+;;,.No..

:tlw*Efficasa olrys onhutdattmeof

iwpectlon

Ataci Rerricted Lalels on ReverseSide of this Fom

P.lunbihg aiit sEw$ dithgsat sy@

7. IImd sink oonvenie'rl, hbtand ooldwder,

s. t&&uduseoftoxici@cartons mdtcases: dry and

uatr:r: tr'Public

|i.'$te! sasb€rcleo md qn-iary condition

iliter l0oFxiiimerthanurash.waCer,,t4, Sqfiry Eqry rinsg d sqPre-to ? @P,hofchlorine '

.ii; Egg drying equipnpqq cfqn md

Iown DrpenttusNT or Acnrcur,tuRE & Lerqp Srrwlnosrrrp

EGG HANDLERS INSPECTION REPORT

Ntmbo of cases ofegs onhndottbuof

trcpeton

Attach Retricted Labels on ReverseSide of this Fom

l. Buildins'good Fpah, clm, adequaely17. Scales adeouatoto dst€rmine net

lE. Refriguuion tmie 451F or below,clem, &ee of obJecdouable odorq goodr€eair3. Adequate slrcter/remwal of refire

19. Ihernomerers: provided and acctrrde

21. Loospacked eggYcas€s prry€rlylabele& firm nme and USDA Plant orlicenserumber

New eg cartons ftr sales CI

23. Iabeling of eg ctrtons: gradg size,pgck dd& ame, addrcss, plam u license

safe handllne instructions

26. Persomol fu cmtlc* with shell egs:

6. Plrrmbing md eeil'age disposal s]6ten

7. IIod sink convenienq hot and cold wder,tourcls

& Sf4r4ge md,use oftoxia itmscarbnsandqses: dry

tetonflefor

l2;'Shell vashs clem md mniary condition

13, Wash teryeruno at 9(FF orrhan mih

14, Saqitizer spray rinss d fo2fr}p,ltr

lll &g drying equipm€rrt clean and

l) tr Plirmfe (2) *

nowa Dppanu'nanNT oF,{omlcur.r'r.rxn & X.*xp St'swanpsrupEGG EIANDLER.S TNSPEC]TTON REPORT

Dats ofltrspec'tio[ 7, lrt ' ". r ,'u"11a1;*: r2 InspectorNo./l\

Nameotr'mA q €.,o&.ft ilr*&*r*

u\nnerTre,, l"tll,-i sa- 'fa."lr,o IAllandlers LimseNo.{A5{,,*1.&

Addr€slteti r. Vz- Lw/a.e.-c Sf

trvleager; l.'PhoneNumbsrv-? .*,lt9 E4 cl ?

USDAPlamllo.

fft,i=, -.tlrj

;LDt;de51 5*Fq" e*.*s

y No.IL,0J

Nwtber ofcases ofegs onhndaltfineof

iwpeatan

.Attach Retrictd Labels on Rever:rseSide of this Fom

IN OUT NA NO1. Building: gpod repab, clem, adequately 15. Cmdling dervice, adequaoevemeo 17. Scals adequate to determine not rilei!&t2. Free fiom prcsence ofbirds, insects"rodqts

18. Refrig€rdion rmits: 45T or below,clem, Aee ofobjecdonable odory goodrepair3. Adequate system/removal of refuse

4. Floors of cleaable matalals, floor drainsprovided fifneeded) 19. thelmometers: provided and accurate

5. Floom walls- and ceilinEclsn J 20. Transportation vchicles: retigeEteqI claandgoodrepair6. Plumbing od seuage diposal system

adequa@

7. Ilaud sink convaieat hot and cold water,sanitaff tourcls orovided

2l. I"oose-packed egg cases propedylabele* firm ranre andUSDAPlant orIicenseruBbEr8. Storage and use oftoxic items

9. Storage ofcartoos aod cases: dry audclem

22. New egg cuious for sales to retail foodstorEs

rilitE tr 4EalffiErmiEf,lmrmwfir r rEn w,,fflg4dJqrrde supply ofpooable u,aten tr hblic (l) tr Privde (2) *

23. Iabeling of eg ctrtoffil grade, size,pac,k dde, natrq address, plant or licensenumber, safe handling instructions

I l. i C\rrat waE td on file for privde wstem- 65s t"sreri: 24. Ade{uate lecods rmirtained

12. Shell washer cleaa and miary condition 25. Remisrcd/Inedible eggs pmpcrlyhandled

13. Wash temperature at 90:F or abovg rinsewater l09F warmer than srgsh urafff14. Sanitizer qpray rins at sh/n to 2@p/mof chlorine

26. Pmonnel in contactwith shell oggs:Eood hyeienic practice& clean clothes

15. Pgg drying equipment cleao andmaintahed

27. Demonsmtio! of hwledge: candlinggrading; weighing washine atrd sniffiiotr

Owner orl\daoagen Inspector:

-- nowl'Dgpanu'napNToF'Acx'lctn't[rR'E&n'awostrwan'psr*lp--'ncc HANDLER's m{sPECTr@N REFoRT

ilofirspectionlf5..-'.- -r" . ae_r<"__tnspectorNo. .- ^-tti \,

Ocmsrtr/\ r: I l- \ar- rr\s-_ei_S_-

EllandlqsDcmeNo-

\. \! r'{Lt I PhoneNumbcrMeager l*1 ,.'7 -"?.frz--qzt-zmAffit.to'

Zir Code't tcr?-e

CorE'tyC -\n rr < i,\r.s.+--

CormtyNo.

Natnbs ofcases ofeggs onhetd dtune of

inryectton

t- A*hi"g godrepair, clean' adquately

ff nefieerdiou rmits: {5o[ or below,

ctear, te€ of objectionable dorq good

3. A@uate sJNstsmlre,Eoval ofrcfi$e

@fnermomctere: provided and accurafe

eFtunbinc md sewage disposal system

21. Ioose-packed egg$cases properly

labele* finn nams andUSDAPlantorlicense number

8. Stotage and nse oftoxic items22" New egg cartons for sales to

I t aboting ofegg cartons: grade, size"

pack dde, aary e,, addreq plant or.liceirse

safe handling instructionsr.o. AdeflBre supp8 of poabr" @

,6. PersoffiE coutart with shell eggs:

12. Shell vrasher clea and sanitary condition

@rc dgooF orabovgwder

spray rinse d

flAficlanmd

nowa Dspanrmsnrr or,{cnrcur-rump & X,.mro Srpwnsosmlp

EGG HAI{DI,ERS XhISPtrCTI@N REPORT

Nmfiw of coses ofegs onhmd at ttme of

lnspedion

Attach Restrdeted Labels on RevereeSide of this F'orm

l. Building good repair, clean, adequatetyvented /

16. Candline devic€" adequate

17. Scales adequafe to de&rmine net weio&t

2. Free iom preence ofbirdC insecf,qrodents

f8. Re,&igeraion uits: 459F or below,clea, free ofobjectionable odo6 goodrqpair3: Adequate sysen/reoroval of refirse

4. Floors of clmable material$ floor drainsnmvided fif needed)

19. Thermometem: provided and accurae

5. Floors. walls. and ceiline clean 20. Transpormion vehicles: ref igerateqclean and sood re{rair d6. Plumbine and serr,ase disDosal svst€m

adequato

7. Iland sink convenient, hot and cold water,snihnr tourets nrovlded

21. Loose-packed eggJcases pro,perlylabele& firm name and USDAPlantorlicensenrmber8. Stomge and uss oftoxic itemg i./

9. Storage ofcartons and cases: dry andclean

22. New egg cartors for sales to retoil foodstorts

,d10. Adequarc srpply ofpoable rryats: tr Public (l) Ei.prirate (4 *

23. Iabsling of eg carto$: gradg size,packdare, ume, ad&eq plarrt orlicenseuumbs. salFs handlinq instrustions

I l- * Curtentnder test on file for orivate svste,m. dare tste& tD -AJ *14 24. Adequate rccords maintained

12. Shell wa$er clea and wnitary condition25. Restristedllnedible eggs pmpedyhddld

14. smitizrr spray rinsg at 50plm t0 200plmof chlorine

26. Penonnel in conrast with shell eggs:eood hvsie.nie orastices. clea clothes bl

15. Eeg drying equipme,nt clean mdmaintained

27. DemonsMion of knowledga: candlinglradlne. weistritrEr washine and sanifation tl

Comrirents:

Oramer or lrdanager: Inspector: