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    Allergen Chart PDF

    Uploaded by

    MDAGHRI YOSRA
    The document is an allergen check list for food suppliers and manufacturers. It contains a table with 3 columns to indicate if various allergens are present in a product, other products made on the same line, or in the manufacturing plant. The supplier is asked to fill in each cell with yes or no and include ingredient names where applicable. They are also asked if they have procedures to avoid cross-contamination from allergens present in other products or the plant. The supplier must sign and date the form and notify of any product modifications.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Allergen Chart PDF

    Uploaded by

    MDAGHRI YOSRA
    185 views1 page
    The document is an allergen check list for food suppliers and manufacturers. It contains a table with 3 columns to indicate if various allergens are present in a product, other products made on the same line, or in the manufacturing plant. The supplier is asked to fill in each cell with yes or no and include ingredient names where applicable. They are also asked if they have procedures to avoid cross-contamination from allergens present in other products or the plant. The supplier must sign and date the form and notify of any product modifications.

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    Allergen Chart (2) (4).pdf

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    The document is an allergen check list for food suppliers and manufacturers. It contains a table with 3 columns to indicate if various allergens are present in a product, other products made on the same line, or in the manufacturing plant. The supplier is asked to fill in each cell with yes or no and include ingredient names where applicable. They are also asked if they have procedures to avoid cross-contamination from allergens present in other products or the plant. The supplier must sign and date the form and notify of any product modifications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    185 views1 page

    Allergen Chart PDF

    Uploaded by

    MDAGHRI YOSRA
    The document is an allergen check list for food suppliers and manufacturers. It contains a table with 3 columns to indicate if various allergens are present in a product, other products made on the same line, or in the manufacturing plant. The supplier is asked to fill in each cell with yes or no and include ingredient names where applicable. They are also asked if they have procedures to avoid cross-contamination from allergens present in other products or the plant. The supplier must sign and date the form and notify of any product modifications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    ALLERGEN CHECK LIST FOR FOOD SUPPLIERS AND MANUFACTURERS

    Brand Name
    Product Name
    UPC Code
    Internal Product Code

    Please fill the following table for each product. Column I indicate the allergens that may be found in the product, from addition or
    cross-contamination. Column II indicates the allergens present in others products that are run on the same equipment but at a
    different time. Column III indicates whether any allergens are present in your plant.

    Please fill in each cell of the table with a YES or a NO and, when applicable include the name of the ingredient.
    Column I Column II Column III
    Present in others Present in the
    Component. products same
    Present in the manufactured on the manufacturing
    product same line plant

    Peanut or its derivatives ex: Peanut – pieces, protein, oil, butter, flour, and
    mandelona nuts (an almond flavoured peanut product) etc. Peanut may also be
    known as ground nut

    Tree Nuts : almonds, Brazil nuts, cashews, hazelnuts (filberts), macadamia


    nuts, pecans, pine nuts (pinyon, pinon), pistachios and walnuts or their
    derivatives, e.g., nut butters and oils etc. or derivatives

    Sesame or its derivatives, e.g., paste and oil etc.

    Milk or its derivatives, e.g., milk caseinate, whey and yogurt powder etc.
    Eggs or its derivatives, e.g., frozen yolk, egg white powder and egg protein
    isolates etc.

    Fish or its derivatives, e.g., fish protein, oil and extracts etc.
    Crustaceans (including crab, crayfish, lobster, prawn and shrimp) and
    Shellfish (including snails, clams, mussels, oysters, cockle and scallops) or
    their derivatives, e.g., extracts etc.

    Soy or its derivatives, e.g., lecithin, oil, tofu and protein isolates etc.
    Wheat, triticale or their derivatives, e.g., flour, starches and brans etc.
    Includes other wheat varieties such as spelt, durum, kamut, emmer etc.
    Mustard or its derivatives, e.g., mustard seeds, mustard flour, ground
    mustard, prepared mustard etc
    New Regulations coming into force on August 4, 2012, will include mustard

    Sulphites, e.g., sulphur dioxide and sodium metabisulphites etc.

    Other

    Do you have procedures to avoid cross-contamination of the product with the allergens not included in the product but noticed in
    columns II and III? ___________(Yes/No)

    If for any reason, there are modifications in this product, you are responsible for updating your records and
    notifying us immediately.

    Signature
    Supplier contac :
    and Date :

    CONFIDENTIAL
    Page 1 of 1

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