FA 02 Corrective Action Request

							                                                                                      Form A-02
Company XYZ                              Corrective Action Request
                                                                                      Page 1 of 1
Issued on:                          Version No: 1                                 Revised:
Issued by:                          Supersedes:

                                                       Reference CAR#
Corrective Action Request                                                                    CAR
Return Completed Form to HACCP Coordinator                                Date: _________________


                                                         Time To
Requested By:                                            Complete:

Responsible person:


1. Problem / Deviation




Root Cause:




WORK PLAN: (Filled by the responsible person)




Preventive Action Plan




Follow up and Completed BY



Completed:                            Not Completed:


Verified Completed/Initial: _________________            Date: _______________



                      Acceptable:                        Unacceptable:
Notes: