ALLERGEN CHECK LIST FOR FOOD SUPPLIERS AND …
ALLERGEN CHECK LIST FOR FOOD SUPPLIERS AND MANUFACTURERS
SUPPLIER’S/MANUFACTURER’S NAME: ________________________________
PLANT LOCATION: __________________________________________________
PRODUCT NAME:_____________________________UPC#___________________________
Please fill the following table for each product. Column I indicates the allergens that may be found in the product, from addition or cross-contamination. Column II indicates the allergens present in other products that are run on the same equipment but at a different time. Column III indicates whether any allergens are present in your plant.Please fill in each cell of the table with a YES or a NO and, when applicable, include the name of the ingredient. Do not leave empty cells.
Column I
Column II
Column III
Component
Present in the product
Present in other products manufactured on the same line
Present in the same manufacturing plant
Peanuts (including peanut proteins, peanut oil, and mandelona nuts (an almond flavoured peanut product) etc.
Tree Nuts (almonds, Brazil nuts, cashews, hazelnuts(filberts), macadamia nuts, pecans, pine nuts, pistachios and walnuts)
Sesame Seeds
Milk and derivatives, specify e.g. milk, lactose, caseinate, whey, etc.
Eggs or egg products
Fish, crustaceans (e.g. crab, crayfish, lobster, shrimp)
Shellfish (e.g. clams, mussels, oysters, scallops)
Soy Products
Wheat
Sulphites (e.g., sulphur dioxide and sodium metabisulphites etc.)
Others (as considered necessary)
Do you have procedures to avoid cross-contamination of the product with the allergens not present in the product but noted in columns II and III? Yes No.
If, for any reason, there are any modifications in this product, you are responsible for updating your records including labels and specifications, and notifying us immediately.
Supplier Signature:____________________________ Date: ______________________
Supplier Contact ___________________ Signature: ____________________ | |
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