3.5.1.6 - Q003.5.1.8b Supplier Traceabilty Test R2

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Evolution Foods

Supplier Traceability Test – Manufacturer


Complete text in red, change to black and delete this instruction, prior to sending to the supplier.

Supplier Dulsan Organica S.A


Raw materials supplied Chia seeds
Date test requested 19/01/2022
Due date for test submission 25/01/2022
As part of BRC as a non-GFSI approved supplier we are required to test your traceability system. An extract of the
requirement for is:

The site shall have a documented traceability procedure designed to maintain traceability throughout the site’s
processes. At a minimum this shall include:
 how the traceability system works
 the labelling and records required.
A summary of the documents that should be referenced during the test, and clearly show the links between them.

Can you please complete the questions below and returned with appropriate evidence requested

Trace Test Details


Please carry out test on Chia seeds
Delivery date 22/10/2021
Trace code TCH 62/21
Country of Origin Paraguay

Country of Manufacture
(if different from above)
(1) Quantity produced on this lot number 111.000 kg

(2) Quantity delivered to Evolution 111.000 kg, the dates are detailed in the attached
(if more than 1 delivery please note delivery report.
dates and quantities)
(3) Quantity delivered to other customers None

Mass Balance (1-(2+3)) Attached

Comments lot TCH 62-21 was processed for client Evolucion


Foods LTD
Documents required to be supplied as a minimum to demonstrate traceability.
Highlight traceability coding which links sheets
Document Attached (Yes/No)
Intake Delivery Records- raw material & packaging No
Line Start Up Records yes
Production Control Sheet yes
(including WIP/ batch preparation – if applicable)
Weight Control Records no
Quality Check Records yes
CCP Records no
Scales/ Checkweigher/ Metal Detection yes
(external calibration certificate)
Glass/ Hard Plastic Audit No
Pest Control yes
Document No. Revision No. Revision Date Authorised By: Page No
Q003.5.1.8b 2 18.02.2021 Helen Wilson 1 of 2
Evolution Foods
Supplier Traceability Test – Manufacturer
Hygiene Records/ Swabbing Results Yes
(Product & Environment)
Despatch Documentation Yes
Microbiological/ Chemical Test Results
Process Flow Yes
Vulnerability Risk Assessment – complete attached
document Q003.5.1.7 Supply Chain Questionnaire
Copy of Traceability Procedure Yes
Product Specification
Sustainability Status – Palm, Soy, Organic, UTZ, yes
Fairtrade, IP – if applicable

Supplier
Completed by Silvia Gonzalez
Date 25/01/2022

Evolution Review
Checked by
Date Received
Date Approved
Comments

Further Actions to be taken


Approval Approved/ Not Approved

Document No. Revision No. Revision Date Authorised By: Page No


Q003.5.1.8b 2 18.02.2021 Helen Wilson 2 of 2

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