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IE HSE Cold Chain/Fridge Breakdown/Power Failure Form 2021 free printable template

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HSEColdChain×FridgeBreakdown×PowerfailureForm Intheeventofacoldchainexcursion, fridgebreakdownorpowerfailure, pleasecompleteandreturnthis formimmediatelytotheNIO:Anchal. Gupta×HSE.ieormariangela.
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How to fill out IE HSE Cold Chain/Fridge Breakdown/Power Failure Form

01
Begin by entering the date and time of the incident at the top of the form.
02
Provide details of the specific location of the fridge or cold chain equipment that experienced the breakdown.
03
Describe the type of equipment affected (e.g., refrigerator, freezer, etc.).
04
Indicate the duration of the power failure or breakdown, including start and end times.
05
Note the temperature readings before and after the incident.
06
List any products that were stored in the affected equipment and their respective quantities.
07
Detail the actions taken to address the issue, including any corrective measures implemented.
08
Include names and contact information of individuals responsible for managing the incident.
09
Sign and date the form as the person filling it out.

Who needs IE HSE Cold Chain/Fridge Breakdown/Power Failure Form?

01
Healthcare facilities that store temperature-sensitive medications and vaccines.
02
Food service establishments that must maintain proper refrigeration for perishable goods.
03
Laboratories that rely on cold chain equipment for samples and reagents.
04
Regulatory bodies requiring documentation of compliance with cold chain standards.
05
Staff responsible for quality assurance and incident management in related organizations.
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The IE HSE Cold Chain/Fridge Breakdown/Power Failure Form is a document used to report incidents of breakdowns or power failures affecting cold chain storage conditions, ensuring that temperature-sensitive products are monitored and managed properly.
Individuals responsible for managing cold chain storage, including facility managers, pharmacists, and healthcare professionals, are required to file the form when a breakdown or power failure occurs.
To fill out the form, provide details such as the date and time of the incident, description of the problem, duration of the breakdown, corrective actions taken, and any impact on the stored products.
The purpose of the form is to document and address cold chain disruptions, ensure compliance with health and safety regulations, and provide a record for audit and quality assurance.
Required information includes the date and time of the incident, precise location of the cold storage unit, duration of the power failure or breakdown, temperature readings during the event, actions taken to mitigate the issue, and any affected products.
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