Title Page
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Site conducted
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Premises Name
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Premises Address
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Conducted on
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Audit prepared by
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Location
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Section 38 of the Food Act 2003
Food Premise Information
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Business Name:
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Trading Name:
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ACN / ABN
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Premises Address:
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Owner / Manager Full Name:
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Position in company
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Business Email Address
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Authorised Officer:
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Date of Seizure:
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Seizure Reference:
Reason for Seizure
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Contaminated Food
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Mouldy Food
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Damaged Food
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Delivered Food left unattended on the street
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Food that is not labeled / incorrectly labeled
Seizure Checklist
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Image of the Food to be Seized
Temperature of food to be seized - Cold
Temperature of food to be seized - Hot
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Environmental Services Manager's consent given to conduct seizure?
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Second Authorised officer contacted to bring seizure kit?
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Seized items appropriately bagged, tagged and sealed?
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Seized items secured?
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Samples collected and stored appropriately?
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Explain to Owner / Manager that the food is being seized - the food must be left undisturbed. If the business decides to dispose of the food they must do so with the EHO as a witness. The business has up to 10 days to lodge an application with the District or Local Court for an order disallowing the seizure ( S45(c) Food Act 2003. Removing or Tampering with the seized items is an offence under section 41 of the Food Act 2003.
Seized Items
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Full description of items / equipment seized and units eg: kg, units, litres
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The seized items will be held at
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This Notification of Food Seizure document has been emailed to the owner of the business - before leaving the premises
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Owner / Manager
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Authorised Officer
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Authorised Officer
