Attachement_D_Inventory_Checklist.pdf
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- AG-3198-S-15-0027
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Store Visit PWS Attachment D
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ATTACHMENT D OF
TASK ORDER PERFORMANCE WORK
STATEMENT (PWS)
INVENTORY CHECKLIST
SNAP STORE VISIT CONTRACT
Store Name: FNS Number:
Reviewer (Print Name): Signature (Original in ink):
Site Visit or 1st attempt: Date:_ /_ / Arrival Time:_ am / pm (circle one)
(If applicable) Re-Visit or 2nd attempt: Date:_ / /_ Arrival Time:_ am / pm (circle one)
Checklist for FNS or Authorized Agent Use Only U.S. Department of Agriculture - Food and Nutrition Service December 2010 - BRD/SNAP
Dairy Products 1-5 Units
6-20 Units
> 20 Units F/F/R
Butter/ Margarine Cheese (hard/ soft)/ Cottage Ice Cream/ Ice Milk Milk/ Cream Sour Cream/ Yogurt/ Dips Infant Formula (Animal-milk based)
F / V 1-5
Units 6-20 Units
> 20 Units F/F/R
100% Juice (Fruit or Vegetable)
FRUITS
Apples Pears Apricots/ Peaches/ Nectarines Mangoes/ Plums/ Prunes/ Mixed Fruit
Bananas/ Plantains/ Pineapples Papaya/ Guava/ Dates/ Figs Coconut/ Coconut Milk
Berries (Blue/ Black/ Rasp/ Cran/ Straw, etc.)
Cherries/ Grapes/ Kiwi
Melons (Watermelon, Honey Dew, Cantaloupe, etc.)
Citrus (Oranges, Tangerines, Limes, Grapefruit, Lemons, etc.)
VEGETABLES
A sparagus/ Artichokes/ Broccoli Cauliflower/ Brussels Sprouts Cabbage/ Sauerkraut
Beans/ Bean Sprouts/ Tofu/ Peas/ Nuts/ Nut Butters/ Lentils/ Soy Products
Carrots/ Parsnips/ Turnips/ Beets/ Radishes/ Mixed Vegetables
Celery/ Onion/ Leeks/ Mushrooms Corn Greens/ Lettuce (Boston, Collards, Iceberg, Kale, Green/ Red Leaf, Mustard, Romaine, Spinach, Swiss Chard, etc.)
Peppers/ Bell Peppers/ Avocados Potatoes (White/ Sweet/ Yams) Squash (Acorn, Butternut, Eggplant, Spaghetti, Yellow, Zucchini, etc.)/ Okra/ Cucumbers/ Pumpkins
Tomatoes/ Tomato Sauce Soup/ Stew (all types) Infant F& V/ Juices / Soy-based Formula
Breads and Cereals 1-5 Units
6-20 Units
> 20 Units F/F/R
Loaf Bread (sliced, unsliced)/ Rolls/ Buns/ Bagels/ English Muffins/ Biscuits/ Pizza/ Pot Pies/ Tortillas/ Pitas
Cakes/ Muffins/ Pastry/ Pie Crusts/ Pancakes/ Waffles
Breakfast Cereals (hot, cold) Pasta Rice/ Barley/ Millet/ Rye Corn Meal/ Grits Flour/ Cracked Wheat/ Baking Mixes Snacks: Cookies/ Crackers/ Chips/ Pretzels/ Popcorn/ Stuffing Mix/ Croutons/ Bread Crumbs/ Granola Bars/ Rice Cakes
Infant Cereal
Meats, Poultry, Fish 1-5 Units
6-20 Units
> 20 Units F/F/R
Beef/ Veal Lamb/ Mutton/ Goat Pork (Ham, Bacon, Sausage, etc.)
Chicken/ Turkey/ Duck/ Goose Game Birds
Deli/ Lunch Meat/ Hot Dogs
Canned/ Potted Meat (beef/ pork/ poultry)
Eggs Fish, Finned (Catfish, Cod, Flounder, Haddock, Halibut, Herring, Mackerel, Perch, Salmon, Sardines, Scrod, Snapper, Sole, Swordfish, Trout, Tuna, Turbot, Whiting, etc.)
Fish, Shell/ Misc. (Clams, Crabs, Mussels, Oysters, Scallops, Shrimp, Squid, etc.)
Infant Meats Meat Jerky (e.g. beef jerky, pork jerky, etc.)
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