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MANUAL OF NAVAL PREVENTIVE MEDICINE
FOOD ESTABLISHMENT INSPECTION REPORT
Violations cited in this report shall be corrected within the time frames specified below, but within a period not to exceed 10 calendar days for critical items
or 90 days for noncritical items.
FOOD ESTABLISHEMENT RISK CATEGORY TYPES (Check one)
WITH MAXIMUM NUMBER OF CRITICAL VIOLATIONS
o Type 1
o Type 2
o Type 3
o Type 4
Max. Critical: 2
Max. Critical: 4
Max. Critical:
7
Max. Critical:
7
TOTAL VIOLATIONS: CRITICAL _____
NONCRITICAL_____
ESTABLISHMENT:
DATE:
TIME:
ADDRESS:
CITY:
STATE:
ZIP:
PERSON IN CHARGE / TITLE:
TELEPHONE:
INSPECTOR / TITLE:
o ROUTINE
o FOLLOW-UP
o COMPLAINT
o OTHER:
INSPECTION TYPE:
Critical
Repeat
Code
Violation Description / Remarks / Corrections
Reference
(X)
(X)
NAVMED 6240/1 (Rev. 12/97)
Food Establishment Inspection Report Page __ of ___
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