This government document is issued by Department of Agriculture for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:qqxrx9mf39e&q=https://www.agriculture.pa.gov/consumer_protection/FoodSafety/manufacturing-packing-holding-distribution/Documents/NSSP%2520Inspection%2520Form%2520Page%25201%2520and%25202-2007.pdf&sa=U&ved=2ahUKEwjOqeHc_9L8AhU2SPEDHcGqCUs4WhAWegQIBBAB&usg=AOvVaw0bGEZIPH4e1MSnwzZ3FAGe