Title Page

  • Client / Site

  • Conducted on (Date and Time)

  • Inspected by

  • Location

GENERAL INFORMATION

  • Critical Control Point

  • Equipment

  • Specified Range

  • Actual Reading

HACCP DEVIATION REPORT

  • Past History

  • Corrective Action

  • Future Corrective Action Needed

  • Product Disposition

  • Attach photo(s) if necessary

COMPLETION

  • Full Name and Signature of the Inspector

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