Title Page
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Client / Site
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Conducted on (Date and Time)
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Inspected by
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Location
GENERAL INFORMATION
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Critical Control Point
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Equipment
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Specified Range
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Actual Reading
HACCP DEVIATION REPORT
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Past History
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Corrective Action
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Future Corrective Action Needed
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Product Disposition
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Attach photo(s) if necessary
COMPLETION
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Full Name and Signature of the Inspector