Incoming Inspection

Inspection Information

• Inspection Date

  Date

• undefined

• Received Material Number

Belleview Product Information

• Item Number

• Product Name

• Material Type

  Select Active Pharmaceutical Ingredient (API) Excipient Component Label Rx Finished Good

  • Active Pharmaceutical Ingredient (API)
  • Excipient
  • Component
  • Label
  • Rx Finished Good

• What is the Manufacturers FEI

• Are they Licensed with Florida DBPR

  Yes

  No

  N/A

• Enter their Florida DBPR License Number

Manufacturer or Vendor Information

• Manufacturer or Vendor

• Manufacturer Lot Number

• Expiration Date

  Date

• Manufactured Date (If Applicable)

  Date

Purchase Order

• Purchase Order Number

• Quantity Ordered

• Quantity Received

• Units

  Kg

  L

  Each

  Bottles

Cleanliness

• Clean and Orderly

  Pass

  Fail

  N/A

Oder

• Absence of Objectionable Oder

  Pass

  Fail

  N/A

Roof, Floor, and Wall Integrity

• No openings or compromise to roof, floor, walls, or evidence of water damage

  Pass

  Fail

  N/A

Overall Trail Condition

• Trailer appears to be free of contaminants

  Pass

  Fail

  N/A

Trailer Seal

• Is Seal Required for Shippment

  Yes

  No

  N/A

• Seal Present

  Yes

  No

  N/A

Temperature (Refrigerated Materials Only)

• Is material supposed to be refrigerated

  Yes

  No

  N/A
Temperature Between 2-8C (36-46F)

Pest Monitoring

• Absence of Pest

  Pass

  Fail

  N/A

Signature

• Performed By Signature

  Sign

• Reviewed by Signature

  Sign