U.S. Food & Drug Administration
Center for Food Safety & Applied Nutrition
FISH AND FISHERIES PRODUCTS
HAZARDS AND CONTROLS GUIDANCE:

Third Edition June 2001

APPENDIX 1

Forms

(Return to table of contents.)

This appendix contains a blank model HACCP Plan Form and a blank model Hazard Analysis Worksheet.

HACCP PLAN FORM


Firm Name:

Firm Address:










Product Description:

Method of Distribution and Storage:




Intended Use and Consumer:




(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
Critical Control Point (CCP) Significant Hazard(s) Critical Limits for each Preventive Measure Monitoring Corrective Action(s) Records Verification
What How Frequency Who
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


Signature of Company Official: ___________________________________________ Date: ________

          Page 1 of _________ 




(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
Critical Control Point (CCP) Significant Hazard(s) Critical Limits for each Preventive Measure Monitoring Corrective Action(s) Records Verification
What How Frequency Who
                   
                   

          Page _____ of _____




HAZARD ANALYSIS WORK SHEET


Firm Name:

Firm Address:










Product Description:

Method of Distribution and Storage:




Intended Use and Consumer:




(1) (2) (3) (4) (5) (6)
Ingredient/Processing Step Identify Potential Hazards Introduced, Controlled, or Enhanced at this Step(1) Are any Potential Food Safety Hazards Significant?

(Yes/No)

Justify your decision for Column 3 What Preventive Measure(s) can be Applied for the Significant Hazards? Is this Step a Critical Control Point?

(Yes/No)

    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       

          Page 1 of _____




(1) (2) (3) (4) (5) (6)
Ingredient/Processing Step Identify Potential Hazards Introduced, Controlled, or Enhanced at this Step(1) Are any Potential Food Safety Hazards Significant?

(Yes/No)

Justify your decision for Column 3 What Preventive Measure(s) can be Applied for the Significant Hazards? Is this Step a Critical Control Point?

(Yes/No)

    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       
    Biological
       
  Chemical
       
  Physical
       

          Page _____ of _____

See also:

FDA Seafood List

Foodborne Pathogenic Microorganisms and Natural Toxins Handbook (Bad Bug Book)

Seafood Information and Resources


Seafood HACCP   |   Fish & Fisheries Products Hazards & Controls Guidance: 3rd Edition (2001)


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