Food Donation Tracking Form for Food Facility Operators Use this form to help you keep track of your facility’s food donations. Name of Facility or Event Address Name of Receiving Agency Delivered and/or Received By (Print Name) Date of Pick-Up DONOR Time temp RECEIVER Time temp Weight Date Type of Food Temperature at holding was taken (if Temperature at was taken (if Accepted (lbs) (if perishable) perishable) receipt (if perishable) perishable) YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO DONOR Time temp RECEIVER Time temp Weight Date Type of Food Temperature at holding was taken (if Temperature at was taken (if Accepted (lbs) (if perishable) perishable) receipt (if perishable) perishable)
Food Donation Tracking Form for Food Facility Operators Use this form to help you keep track of your facility’s food donations. Name of Facility or Event Address Name of Receiving Agency Delivered and/or Received By (Print Name) Date of Pick-Up Date Type of Food Weight (lbs) DONOR Temperature at holding (if perishable) Time temp was taken (if perishable) RECEIVER Temperature at receipt (if perishable) Time temp was taken (if perishable) Accepted YES or NO YES or NO YES or NO YES or NO YES or NO YES or NO Date Type of Food Weight (lbs) DONOR Temperature at holding (if perishable) Time temp was taken (if perishable) RECEIVER Temperature at receipt (if perishable) Time temp was taken (if perishable) Accepted
FDTrackingForm.docx