Report No. 3098759CHI-001
Ole Hickory Pits
Page 8 of 28
Issued: 29-Jun-2006
Revised: 20-Dec-2017
Photo #
Item
no.
1
Name and
location
2
Manufacturer/
trademark
3
Material type /
model
4
Technical data and Acceptance
5
Mark(s) of
conformity
6
4.0 Critical Components
1
15
Door Closer/
Latch, NFZ
Kason Industries
P/N 1092 Plated
steel
Polished zinc plated steel
NR
US Coatings
HeatGrip 4950
Impact , Abrasion and Heat
Resistance, NSF/ANSI 51-
Section 4.4.1, 9.2, 10.1, 11
NR
PPG Industrial
Coatings
Ebony
PCTT90119
Impact , Abrasion and Heat
Resistance, NSF/ANSI 51-
Section 4.4.1, 9.2, 10.1, 11 Verify
NSF Listing
NSF
6) Indicates specific marks to be verified, which assures the agreed level of surveillance for the component. "NR" - indicates Unlisted and
only visual examination is necessary. "See 5.0" indicates Unlisted components or assemblies to be evaluated periodically refer to section
5.0 for details.
5) Food Contact (FC) items indicate one of the following: the NSF standard (used to obtain the Mark of conformity indicated in next column);
MFCR number preceded by FD; or MAF number preceded by FS with a reference to the illustration. Food Zone, Non-Food Contact (FZ,
NFC) items indicate either the relevant 21 CFR number or the information as indicated for Food Contact (FC) items. Additionally Food Zone
metallic materials indicate both the NSF standard and the clause number.
NOTES:
1) Not all item numbers are indicated (called out) in the photos, as their location is obvious.
3) “Various“ means any type, from any manufacturer that complies with the "Technical Data and Acceptance" and meets the "Mark(s) of
conformity" can be used.
2) Identifies where on the equipment the part is used by Zone - Food Zone (FZ), Heated Food Zone (HFZ), Splash Zone (SZ), Non-Food
Zone (NFZ), Exterior Zone (EZ), Refuse Contact Zone (RCZ), or Power Zone (PZ). FZ items also indicate either Food Contact (FC) or Non-
Food Contact (NFC).
4) Model or part number of the component, or type of material such as: Stainless Steel, Galvanized (or Zinc-Coated) Steel, Aluminum,
Nylon, ABS, Silicone Rubber, etc.
1
16
Black Paint, HFZ,
NFC, SZ, NFZ
ED 16.3.14 (20-Apr-17) Mandatory
