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NCIMS HACCP Hazard Analys is Worksheet

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To aid in reading a printed copy it is recommended that it be printed in "landscape" mode.

SUBJECT

Hazard Analysis Worksheet

ISSUE DATE PRODUCT

PLANT NAME SUPERSEDES PAGE

ADDRESS

(1)

Ingredient/Processing

Step

(2)

Identify potenti al food safety hazards

introduced, controlled or enhanced

at this step.

(3)

Are any

potential

food-safety

hazards

reasonably

likely to

occur?

(4)

Justify your decision

for column 3

(5)

What control measure(s) can be applied

to prevent, reduce, or eliminate the food

safety hazards?

(6)

Is this

step a

critical

Control

point?

(Yes/No)

Biological

Physical

Chemical

YES NO

YES NO

YES NO

YES

NO

Biological

Physical

Chemical

YES NO

YES NO

YES NO

YES

NO

Instructions and

Example

Raw Milk Receiving

Biological Vegetative Pathogens Yes Likely to occur based on

historical data

Pasteurization No

Physical None (Leave Blank) (Leave Blank) (Leave Blank)

Chemical Animal drug residues No Appendix N Testing in

PP #5 Protection from

Adulteration

(Leave Blank)

Approved By: _____________________________________________________ Date:_____________________________

(Signature)

Do not carry the hazard through subsequent steps.

If a firm identifies a potential hazard in column 2 and yes is noted in column 3, justification is required in column 4 (This justification normally includes the scientific, regulatory,

or historical reasons for the decision) and a control measure is required in column 5.

If a firm does not identify a potential hazard in column 2, then columns 3, 4 and 5 will be blank.

If a firm identifies a potential hazard in column 2 and No is noted in column 3, justification is required in column 4. This justification normally includes Prerequisite Programs or

procedures that manage the hazard to ensure that control at this step is not necessary. Column 5 will be left blank.

Column 6 will be answered yes only if the step in column 1 is a critical control point. The control measure is applied at that step.-

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