Document, Container, Handling, Packing,

RAW MATERIAL INSPECTION REPORT Temperature, Sensory, Physic, Chemical

and Microbiological Parameters

RAW MATERIAL INSPECTION REPORT

Date Inspection : PO Number :

Vendor Name : Packing Type : QA

FORMS
Reference : WI21.04-006-xxx
Type of Raw Material WI21.04-001-xxx

Entry a Inspection List Please entry the code √ for a real inspection condition

Disposition
Description of Activities Inspection Date (Initials)
Accept Reject Hold

Check Quantity Control Certificate of Vendor

Check Document for Raw Material

Check Container Condition Parameters

1. Clean Condition
2. Acceptable Odor
3. Clean for Pest Activity
4. Good Equipment
5. Floor and Walls Condition
6. Temperature Container

Download Data Logger

Heck Primary & Secondary Packing Raw Material Condition

Taken Sample for a Temperature, Sensory, Physical,
Chemical and Microbiological Test (Military STD)
Check samples taken as per pcs for a temperature check
Check samples taken as per pcs for visual, weight and
sensory test
Check samples taken as per pcs for chemical Test

Check samples taken as per pcs for Microbiological Test

Check the Handling Process unloading

Remarks : Description of Raw Material (Please entry a description of raw material check parameters not found in listed)

Checked By: Inspected By: Approved By

Name : Name : Name :

QC Incoming : QC Checking : QC Supervisor:

Distribution Report PPIC Dir & Marketing Production PBB

F-S-21-04-179-00