Corrective Action Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Date of Event

  Date

• Issued by

• Reference number

• Details of Non Conformance

• System reference

• Source

  Jacket

  DPC

  CBS

  WHB

  HWB

• Laboratory certificate reference

• TVC control limit (cfu/ml)

  <500

  <1000

• TVC 22 C

• TVC 37 C

• Coliforms

Investigation / Explanation / Cause

• Salmonella sample required?

  Yes

  No

  N/A

• Salmonella results

Action Required

• Details

• Person(s) Responsible for Taking Corrective Action

• Due Date

  Date

Action Taken

• Details

• Completion Date

  Date

• Verifcation of Effectiveness of Corrective Action Taken

  PASS

  FURTHER ACTION REQUIRED

  FAIL

• QA Manager Name and Signature

  Sign

• Digital Images

  Media