CORRECTIVE AND PREVENTATIVE ACTION REPORT

DOCUMENT: FORM DOCUMENT NO: QMF93

REASON FOR CHANGE: Update the document to new numbering system REVISION NO: 11
DEPARTMENT: All REVISION DATE: 07/06/2023
REVIEWED: QA Coordinator APPROVED: QA Manager NEXT REVISION DATE 07/06/2025

Select the correct classification FOOD SAFETY ISSUE: GENERAL ISSUE:

CAR NO:
with an "X": x

Hellmanns Honey & Mustard rejected due to raw material with high count of micro..
SECTION A: FILLED IN BY INITIATOR

SUPLLIER / CUSTOMER : STOCK/ PRODUCT 1000027UL BATCH NO: 2JA0114203

Unilever CODE:
PO NO/ LOT NO: MANUF DATE: 2022.11.23 EXPIRY DATE: 2024.05.22
23R000482 (If applicable)
QUANTITY:
800 kg
DATE RECEIVED: 2023.07.05 DATE RAISED: 2024.01.27

RAISED AGAINST: Supplier RAISED BY: Ncumisa TIME LOSS: N/A

(If applicable)

IMMEDIATE CORRECTIVE ACTION TAKEN (where applicable):

To be safely disposed off.

ROOT CAUSE OF NON-CONFORMANCE (Use 5-why method):
Why Questions Answer(s) Evidence Solution
SECTION B: FILLED IN BY PERSON CAR IS RAISED AGAINST

CORRECTIVE ACTION TO BE TAKEN: DATE:

PREVENTATIVE ACTION: DATE:

SECTION C: VERIFICATION BY ASSISTANT QA MANAGER:

SIGNATURE: DATE CLOSED: