Inspection Data:

*1.Name of Agency:(Required.)

Allegan CountyBarry/Eaton CountyBay CountyBenzie/Leelanau CountyBerrien CountyBranch/Hillsdale CountyCalhoun CountyCentral MichiganChippewa CountyDelta/Menominee CountyDetroit CityDickinson/Iron CountyDistrict Health Department #02District Health Department #04District Health Department #10Genesee CountyGrand Traverse CountyHuron CountyIngham CountyIonia CountyJackson CountyKalamazoo CountyKent CountyLapeer CountyLenawee CountyLivingston CountyLMAS District HealthMacomb CountyMarquette CountyMidland CountyMid-Michigan Local HealthMonroe CountyMuskegon CountyNorthwest Local HealthOakland CountyOttawa CountySaginaw CountySanilac CountyShiawassee CountySt. Clair CountyTuscola CountyVanBuren/Cass CountyWashtenaw CountyWayne CountyWestern UP Local Health

*2.Total Number of Inspections Conducted for Fixed Food Establishments (ENTER NUMBERS ONLY):(Required.)

*3.Total Number of Inspections Conducted for Mobile, Vending & STFU's (ENTER NUMBERS ONLY):(Required.)

*4.Total Number of Inspections Conducted for Temporary Food Establishments (ENTER NUMBERS ONLY):(Required.)

*5.Total Number of Follow-Up Inspections Conducted (ENTER NUMBERS ONLY):(Required.)

Plans & Plan Review Data:

*6.Number of Plans Received for Review (ENTER NUMBERS ONLY):(Required.)

*7.Number of Plans Approved (ENTER NUMBERS ONLY):(Required.)

General Information Data:

*8.Number of Consumer Complaints Investigated (ENTER NUMBERS ONLY):(Required.)

*9.Total Number of FTEs Assigned to the Food Program in the Following Area(s): Plan Review, Supervision, Coordination, Clerical, and other Food Related NON-Inspection Time (ENTER NUMBERS ONLY):(Required.)

*10.Total Number of FTEs Assigned to Conduct Food Establishment Inspections (All Types) (ENTER NUMBERS ONLY):(Required.)

*11.What is your Current Evaluation Frequency Schedule in Risk Category Order "X/Y/Z" (I.E. 6/6/12 or 6/12/12 or 6/6/6).  Indicate 6/6/6 if the Standard 6-Month Schedule is Used.(Required.)

6/6/66/6/126/12/1212/12/126/12/612/6/612/12/6Other (Please Specify using the x/x/x Format)