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Shellfish Purchase Record - Oregon€¦ · Web viewFood Safety Program - Oregon.gov/ODA/FSD 05/2014...

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Shipping Date & Time* Shippe rCert # Origin al Harves t Area Receivi ngPurch ase Date & Time Receive d Iced or ≤ 45° ambient * Proper ly tagged Y/N Quantity, Product And/or Lot # Documentation ≤ 50° internal prior to shipping Y/N* Correcti ve Actions Taken Receivin g employee initials Food Safety Program - Oregon.gov/ODA/FSD 05/2014 SHELLFISH PURCHASE RECORD : COMPANY NAME: Dealer Certification Number: OR SP or SS COMPANY ADDRESS: Page 1 of 2

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Page 1: Shellfish Purchase Record - Oregon€¦ · Web viewFood Safety Program - Oregon.gov/ODA/FSD 05/2014 SHELLFISH PURCHASE RECORD: COMPANY NAME:Dealer Certification Number: OR SP or SS

Shipping Date & Time*

ShipperCert #

Original Harvest Area

ReceivingPurchase Date &

Time

Received Iced or≤ 45°

ambient*

Properly tagged

Y/N

Quantity, ProductAnd/or

Lot #

Documentation ≤ 50° internal prior

to shippingY/N*

Corrective Actions Taken

Receiving employee

initials

Signature of person performing weekly records review: _____________________________ Date___________________Signature of person performing weekly records review: _____________________________ Date___________________

* Indicates new record keeping requirement

Food Safety Program - Oregon.gov/ODA/FSD 05/2014

SHELLFISH PURCHASE RECORD:

COMPANY NAME: Dealer Certification Number: OR SP or SSCOMPANY ADDRESS:

Page 1 of 1

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