FAILURE TO COMPLETE THE FOOD SAFETY REPORT IN FULL WILL CONSTITUTE AN OPPORTUNITY FOR REVIEW BY THE BOARD OF DIRECTORS. 1. The food safety report is requested because a food safety incident had taken place at a processing facility in your district prior to the food safety report being approved. 2. Please state whether you would be making the report or not. If you are not sure whether you need the food safety report, please use the following text to complete the Food Safety Report Request: No I Need a Food Safety Report; 3. The food safety incident(s) that occurred should be disclosed in detail, and, if applicable, a link to the video or the website of the facility where the incident(s) took place should be provided, including: Location of the facility, Date and Time with Description of the incident or incidents, Date and Time of notification by the food service director to the consumer, and, A description of the food incident(s). 4. Please complete a food safety incident(s) incident list, as detailed in the document “Food incident list” attached to the FOOD SAFETY REPORT REQUEST. The report and incident list cannot be more than 3 pages as set forth in the FOOD SAFETY REPORT REQUEST document. Please list each information on a separate line. If you complete the food safety incident(s) incident list as well as the FOOD SAFETY REPORT REQUEST document, they will be reviewed in the FOOD SAFETY REPORT request, therefore it is highly recommended that if you have already included the incident list in the FOOD SAFETY REQUEST document, you include it again in the FOOD SAFETY REPORT request. If you request a new food safety report the report and incident list would be reviewed in the FOOD SAFETY REPORT REQUEST document, therefore it is highly recommended that if you did not include the incident list in the FOOD SAFETY REQUEST document, you include it again in the FOOD SAFETY REQUEST document. 5.
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APPLICATION FOR GAP/GAP AUDIT FARM NAME: LOCATION: CITY/STATE: TELEPHONE #: E-MAIL: CONTACT PERSON: Please define the Audit Scopes that you would like to include in the Audit: PART 1 FARM REVIEW PART
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