A sample built from fictional records: every company, unit and date below is made up. Your reports carry your own records. Back to Ice Machine Cleaning
Sample company (fictional) · Ice Machine CleaningDraft generated Oct 30, 2026
Ice machine cleaning record
Full clean and sanitize
Record
Company
Sample company (fictional)
Trade
Ice Machine Cleaning
Cleaning
Full clean and sanitize
Machine
Machine ID
Machine ID 1
Where it is
North bay
Machine type
Cuber on a bin
Manufacturer
Brackwater Equipment
Model
MO-4100
Serial number
SE-4100
Cleaning interval
2 months
Water filter interval
2 months
Last filter change
Oct 10, 2026
Cleaning
Cleaning type
Full clean and sanitize
Date
Sep 30, 2026
Technician
Avery Lund
Cleaner or descaler used
Cleaner or descaler used 1
Sanitizer used
Sanitizer used 1
Water filter changed
Yes
Cleaning
Evaporator and water trough free of scale and slime after cleaning
Pass
Bin walls, door and gasket free of mold and slime
Pass
Ice chute and dispenser nozzle cleaned
Pass
Sanitizing cycle run to the maker's procedure
Pass
Condenser coil or air filter clean, airflow clear
Pass
Water filter inside its change date
Pass
Drain has an air gap and no drain line runs through the bin
Pass
Ice scoop kept outside the ice in a clean holder
Pass
Machine back in production, ice clear and odorless
Pass
Photos
Photos taken on the phone at the job print here, each captioned with what it shows.
Signature
The signature drawn on the phone at the job prints here.
Next due
Next full cleaning Virginia Food Regulations, 12VAC5-421-1780 equipment food-contact surfaces and utensils (https://law.lis.virginia.gov/admincode/title12/agency5/chapter421/section1780/), checked 2026-10-29