Dish machine service report
Aug 20, 2026
Record
| Company | Sample company (fictional) |
|---|---|
| Trade | Dish Machine Service Log |
| Service visit | Aug 20, 2026 |
Machine
| Machine ID | Machine ID 2 |
|---|---|
| Machine type | Stationary rack, dual temperature |
| How it sanitizes | Chlorine |
| Manufacturer | Tollin Industrial |
| Model | MO-4137 |
| Serial number | SE-4137 |
| Rinse pressure range on the data plate | Rinse pressure range on the data plate 2 psi |
| Service visit interval | 1 month |
Service visit
| Scheduled | Aug 20, 2026 |
|---|---|
| Completed | Aug 20, 2026 |
| Status | Completed |
Service
| A thermometer reads each wash and rinse tank and the final rinse or sanitizer tank | Pass |
| The kitchen has a sanitizer test kit on hand | Fail |
| Wash and rinse arms clear, nozzles open, end caps on | Pass |
| Curtains, doors and seals in place, no leaks | Pass |
| Detergent, rinse aid and sanitizer lines primed, containers labelled | Pass |
| Scrap screens and baskets clean and seated | Pass |
| Data plate readable | Pass |
Readings
| Reading | Value | Result |
|---|---|---|
| Wash tank, stationary rack single-temperature hot-water machine FDA Food Code 2022, 4-501.110 wash solution temperature (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 232 °F | Pass |
| Wash tank, stationary rack dual-temperature hot-water machine FDA Food Code 2022, 4-501.110 wash solution temperature (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 211 °F | Pass |
| Wash tank, single tank conveyor dual-temperature hot-water machine FDA Food Code 2022, 4-501.110 wash solution temperature (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 225 °F | Pass |
| Wash tank, multitank conveyor multitemperature hot-water machine FDA Food Code 2022, 4-501.110 wash solution temperature (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 211 °F | Pass |
| Wash tank, chemical-sanitizing machine FDA Food Code 2022, 4-501.110 wash solution temperature (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 169 °F | Pass |
| Final rinse at the manifold, stationary rack single-temperature machine FDA Food Code 2022, 4-501.112 hot water sanitizing rinse (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 232 °F | Pass |
| Final rinse at the manifold, every other hot-water machine FDA Food Code 2022, 4-501.112 hot water sanitizing rinse (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 253 °F | Pass |
| Final rinse flow pressure FDA Food Code 2022, 4-501.113 sanitization pressure (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 8 psi | Pass |
| Iodine strength FDA Food Code 2022, 4-501.114(B) iodine (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 18.5 mg/L | Pass |
| Quaternary ammonium solution temperature FDA Food Code 2022, 4-501.114(C) quaternary ammonium (https://www.fda.gov/media/164194/download), checked 2026-10-29 | 106 °F | Pass |
| Chlorine strength | Not taken | Recorded |
Photos
Photos taken on the phone at the job print here, each captioned with what it shows.
Findings
| Severity | Finding | Status |
|---|---|---|
| Stop using the machine | The kitchen has a sanitizer test kit on hand. Failed at this service visit. | Open |
Signature
The signature drawn on the phone at the job prints here.
Next due
| Service visit | Sep 20, 2026 | Set by your contract |