Hazard Analysis & Critical Control Points (HACCP) >NCIMS HACCP Hazard Analysis Worksheet

http://www.fda.gov/Food/GuidanceRegulation/HACCP/ucm121113.htm[2/13/2014 3:51:12 PM]

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NCIMS HACCP Hazard Analysis Worksheet
Return to Dairy Grade A Voluntary HACCP

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 potential 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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Hazard Analysis & Critical Control Points (HACCP) >NCIMS HACCP Hazard Analysis Worksheet
http://www.fda.gov/Food/GuidanceRegulation/HACCP/ucm121113.htm[2/13/2014 3:51:12 PM]
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