G.1 Allergen Checklist For Food Suppliers or Manufacturers
G.1 Allergen Checklist For Food Suppliers or Manufacturers
G.1 Allergen Checklist For Food Suppliers or Manufacturers
Please fill in each square with a YES or NO and when applicable (e.g. tree nuts), the name of the
ingredient being referred to. Please do not leave any empty spaces.
Allergen of Interest Present in the Present in other Present in the same
product products manufacturing
manufactured facility
on the same
line.
Peanuts (including peanut oil, and
mandelonas)
Tree Nuts (Please indicate what type)
Sesame Seeds
Milk and its derivatives (please specify
what form, e.g. milk, caseinate, whey, etc.)
Eggs
Fish
Shellfish
Soy
Wheat
Sulphites
Mustard
Please attach a finished product label to this form, for each Is there a policy or procedure to prevent allergen contamination?
product. _______ YES _________ NO
If for any reason, there are modifications to this Describe the policy or procedure:
product, you are responsible for updating your
records and notifying us immediately.