Title Page
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Conducted on
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Prepared by
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Location
Product / Equipment Information
- Product / Equipment Information
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Date:
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Tag Number:
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Item Description:
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Production / Receiving Date:
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Lot Number / UPC Code:
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Quantity (Pounds, Units, Cases):
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Type of Product
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Reason for Hold:
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Product Location:
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Comments:
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Held By:
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SQF Practitioner Notified of this Hold:
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Production Supervisor Can Release Product:
Product Release Information
- Product Release information
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Action Taken:
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Released By:
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Release Date:
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SQF Practitioner Signature:
Product Disposition Information
- Product Disposition Information
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Action Taken:
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Disposed of by:
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Date of Disposal:
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SQF Practitioner Signature:
Verification
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Verified By:
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Verification Date:
