Recall Report
Mock Recall Date:
Please Specify: Actual Recall Completed by:
*Please attach all documentation to this report as evidence of investigation.
Recall Start Time: Customer Name:
Product Name: Quantity:
Product Code: Supplier:
Production Date: Packaging Code:
Reason for Recall/Description of Problem:
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Product Distributed: Date: Qty: Trace Code: Product Returned: Date:
% Mock Recall Effectiveness: Product Regained X 100 = % Effectiveness
Product Produced
= _____________%
Completion Time: __________________
*** Note: Mock Recall must be completed within four hours of start time.
If Mock Recall is less than 95%, outline cause and indicate corrective action required:
Notes:
Documents/Records to be Attached: Attached
Receiving and Shipping Logs
Labels of Products That Are Recalled
\\ Production Logs
Customer Complaint
Microbiological Results
Other:
Verified by: ______________________________ Date: _________________________