Authorised By: Susan Sunny Hotel Manager

Document Date: Next Review Date:

1st

March 2013 1

st March 2014

Document Number HACCPPROGRAM Revision 0 Page No 1 of 1

Form owner: Site Manager Frequency: Annual

Form 10: Product Recall Form (by an External Supplier to Sunnyside)

Date: Time: Recall No:

Information received from: Name: Company:

Complaint No: Tel No:

The following Product is subject to a recall:

Brand Name: Pack weight / size:

Manufacturer: Country of origin:

Supplier:: Code / other reference mark:

Reason for product recall:

Is item used as an ingredient in site produced foods:

YES NO

If yes, what products is it contained in:

What are the production dates of all affected product:

NO FURTHER DELIVERIES OF THIS PRODUCT ARE TO BE ACCEPTED UNTIL THIS NOTICE IS CANCELLED

Action to be taken in respect of any stocks of the above product already on the premises:

Signed:

Date: