Title Page
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Conducted on
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Prepared by
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Location
- Breakdown Repair Log
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Date
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Equipment/Area
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Description of Breakdown
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Was food safety compromised? (if yes complete a CAR)
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Corrective Actions:
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Description of Repair
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Maintenance Initials
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Post Maintenance Sanitation Completed
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If not, why?
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SQFP/QA Initials
Verification
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Verified By:
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Date & Time of Verification:
