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QUESTIONNAIRE FOOD CERTIFICATION

Section 1: Company/Organisation Details


Name of Company or Organization

( please enter the wording of your Company name


EXACTLY as you wish it to appear on the certificate)

Address

Postcode

ADDRESS FOR INVOICE: if above, enter same


If company is part of a group, please specify
group

Management Representative (Contact)

Position

Food safety Manager

E-mail address
Tel No:

Fax No:

Section 2: Certification (s) Required (please tick)


ISO
22000:2005
ISO
9001:2008

BRC Global Food

HACCP

FSSC 22000

SQF 1000 level I

SQF 2000 level I

Others

SQF 1000 level II

SQF 2000 level


II

SQF 1000 level


III

(please
indicate)

SQF 2000 level


III

Type of request
Certification

Certification
audit integrated
with existing
std.

Renewal of
Extension ,
existing
modificatio
certification
n
For integrated please identify your
existing certified standard you wish to
combine with the above certification.

> Does your company already have third party certification ?.. if yes, please indicate below.
Standard (s) :
ISO 9001:2008
ISO 14001:2004
OHSAS 18001:2007
ISO 22000
HACCP/GMP
SQF 1000/2000
BRC
IFS
GAP / Global GAP
Others

CB (Certification Body)
CB

CB

CB

CB

CB

CB

CB

CB

Please indicate

Section 3: Scope/Processes
Please define the scope of registration e.g. product produced
or attach/send supporting information)

Q FOOD GP 4100 Issue 5

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(please complete this question in detail

Exclusions:

Are there any local activities that are not included within the scope of the
certification?. If so, please describe the exclusions (if any)

Give details if any specialist operations or services carried out by a sub contractor?

Product/Process Information
Please list below each product family(ies) and product types
(A product family shown common process or technology)

Product Type

Exp. of product family: production of canned fruit juices and frozen fruit juices (2 product families)
Exp. of product types: canned mango juice, canned pineapple juice, canned guava juice and canned strawberry juice. (4
product types)

Product Family

> Total number of production lines: ______________________ *


> Number and type of HACCP study(ies) * :
________________________________________________
* A HACCP study corresponds to a hazard analysis for a family of products/services with similar hazards and similar
production technology and, where relevant, similar storage technology. E.g. Production of ice-cream and cheese = 2
HACCP studies

> Please check off any of the following that apply to your business:
Labor intensive environment.
automation

Repetitive Tasks

Simple process &/or Process

Any other relevant info on production lines:

________________________________________________________________________
Please indicate if you have a timescale(s) for the following
Implementation date of

Audit language
the system
Pre-audit(if applicable)

Certification audit

Section 4: > Number of employees = __________

Total # of shifts, along w/ employees per shift


Total number of employees that are non shift (i.e. management
,Admin, etc) Include temporary.
Total number of employees in shift (i.e. production workers)
Include temporary.

In case of seasonal product(s), please indicate the period(s) of production for each category of product including number
of employees (permanent & temporary ) included in the scope.

Production floor area (ft2)


OR

(m

2)

< 107,000 ft2


< 10,000 m2

108,000 - 323K ft2


10,001- 30,000m2

324,000 - 538K ft2


30,001- 50,000 m2

Gross annual turnover (Revenue) of your business (Required for SQF applicants only):
Q FOOD GP 4100 Issue 5

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> 538,000 ft2


>50,000 m2

If additional sites, provide details;site/company


name and address.

Products or activities

# of staf

Documentation at
this site same as
the main office?
.same system ?

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Section 5 Background Information
Has previous contact been made with SGS Personnel i.e. via telephone etc.?
YES/NO
If you have used or intend to use consultancy services for the activities to be certified please
give the name of the consultancy organisation and/or the name of the individual consultant(s)
Where did you hear about SGS?
Main reason for certification

competitive advantage

Customer request _________________________________________

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improve food safety system

Corporate

others______________________________

Appendix 1
ISO/FSSC 22000/HACCP/GMP BUSINESS CATEGORIES AND FOOD SECTORS
Please indicate with tick products produced (Internal use only_if indicate in proposal worksheet no need to submit this part )
For FSSC 22000 category C,D,E only
Food
Category
Codes
A

Food Product Categories


Farming 1 (Animals)

Farming 2 (Plants)

Processing 1 (Animal
perishable product) including
all activities after farming e.g.
slaughtering

Q FOOD GP 4100 Issue 5

Sector
A1
A2
A3
A4
A5
B1

Food Product Sector List


Animal
Fish
Raw Milk Production
Egg production
Beekeeping

Fruits

Vegetables

Grain

Spices

Nuts

Horticulture products
Red and white meat/Poultry /Meat product and
preparation

Red meat slaughtering plants

Raw poultry/raw prepared poultry products

Lamb

Venison

Offal

Other meat

Reconstituted raw meat/poultry product e.g.


nuggets, fresh cut meat, bacon, ham, meat
pie, steak, sausage, delicatessen , frozen
meat, meat pate, dried meat etc.

C1

C2

Fish and fish product

Wet fish (Raw/ready to eat)

Molluscs (Raw / Ready to eat)

Crustracean (Raw /Ready to eat)

Communited fish products - raw (chilled /


frozen)

Smoked fish raw (chilled / frozen)

Fish pate (chilled)

Kitchen ready fish products (chilled / raw


ingredients)

C3

Egg

Shell egg

C4

Dairy

Liquid milks

Liquid milk fractions

Liquid cream (chilled)

Liquid milk drinks

Liquid tea and coffee creamers

Yogurt and fermented milk-based product


(chilled)

Fromage frais / crme fraich

Dried milk / milk formulation

Dried tea and coffee creamers (dried)

Cream (frozen)

Yogurt and fermented milk (frozen)

Dairy-based desserts (chilled)

Dairy-based desserts (frozen)


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Tick

Processing 2 (Vegetable
perishable product)

Processing 3 (Stable product)

Q FOOD GP 4100 Issue 5

Hard cheese
Semi hard cheese
Soft cheese
Mould ripened cheese
Processed cheese / cheese food
Raw milk products

C5

Ready to eat , chilled and frozen

Fresh and frozen pies and pizzas

Fresh and frozen cooked dishes

Frozen desserts(pie..)

Sandwiches

Hot pie

Soup

Sauces (chilled / frozen)

Pasta (chilled)

Quiches / flans (chilled / frozen)

Ethnic foods (chilled / frozen)

Pizza (chilled / frozen)

Baby food

D1

Produce

Fruit (fresh / chilled)

Juice( fresh/chilled)

Vegetables (fresh / chilled)

Preserved fruits/vegetable

Herbs (fresh / chilled/ frozen)

Nuts (in shell)

Fruit / fruit mixed (frozen)

Vegetables / vegetables mixed (frozen)

Tobacco products

D2

Ready to eat, chilled and frozen

Fresh pastries

Fresh convenient salads

Fresh pastas

Vegetable pate / spreads (chilled / frozen)

Salad dressings (chilled)

Myco protein / tofu

E1

Ambient stable hermetically sealed packs

Low acid foods (canned)

High acid foods (canned)

Low acid foods (in glass)

High acid foods (in glass)

Low acid foods (aseptic / UHT)

High acid foods (aseptic / UHT)

Low acid foods (pouch / tray)

High acid foods (pouch / tray)

E2

Beverages

Alcoholic drinks (distilled)

Alcoholic drinks (fermented)

Alcoholic drinks (fortified wine)

Alcoholic drinks (brewed)

Alcopops

Soft drinks including flavoured water /


Isotonics

Concentrates / squashes / cordials

Minerals / table waters / ice

Coffee

Tea

Herbal drinks

Cereal beverages (food drinks)

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E3

Grain products/cereals/biscuit/flour/
Confectionary/snack

Rice / rice-based food

Pasta / noodles

Nut preparations

Sugar (all variations)

Chocolate

Cereals/Processed cereals

Oats

Muesli / mixtures

Crisps

Wheat snacks

Corn snacks

Nuts (Processed)

Poppadoms

Bread (fresh / mod.At / frozen)

Pastries (fresh / frozen)

Cake (fresh / frozen)

Fruit pies / tarts (fresh / frozen)

Cake mixes

Ice cream accessories

Sliced bread

E4

Oil and fats

Cooking oils

Speciality oils

Vinaigrettes

Margarine

Butter

Low fat spreads

Analogues / ghee

Suet

E5

Dried goods

Soups

Sauces / gravies

Spices

Stock cubes

Herbs

Seasonings

Stuffings
Food ingredients

Liquid egg

Dried egg

Dried whey powder

Vitamins, dietary supplement, flavours

Salt

Gelatin

Vinegar

Candies fruits

Flour improvers

Home baking ingredients

Sugar/icing

Mill product

Cake decorations

Syrups (flavoured / unflavoured)

Pectin

E6

F
G
H
I

Feed production
Catering
Distribution
Services

Q FOOD GP 4100 Issue 5

F1
G1
H1
I1

Animal feed, fish feed


Hotels, restaurants, catering
Retails/ wholesales/shop/ trading
Water supply

I2

I3

Waste disposal

I4

Technical services
Testing
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Cleaning /disinfection
Pest control
Industrial laundry

J
K

Transport and storage


Equipment and facilities

(Bio)Chemical manufacturer

Packaging material
manufacturer

Analysis
Product development

J1
K1
K2
L1

Transport and storage


Equipment manufacture
Facility construction and maintenances
Additives/ vitamins

Biocultures

Pesticides /fertilizer

Drugs

Cleaning /processed reagents

M1

Packaging material

Appendix 3
Primary Sector

In case of primary sector, please indicate the following information:


Cattle Breeding:
Type of cattle

N of producers

Activity

Number of animals

Poultry:
No of house

Activity

Vegetables producers:
Type of vegetable

Q FOOD GP 4100 Issue 5

N of
producers

Activity

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Surface

Appendix 3
BRC Food
(Part 1)
Section 1
Disclosure Agreements (please tick the retailers with whom you have signed agreements to pass on
reports and/or certificates)
Asda

KwikSave

Somerfield

Boots

Littlewoods

Spar

Bookers Cash & Carry

Marks & Spencer

Tesco

Burger King

Morrisons

Wal Mart

CoOp Wholesale (CWS)

Netto

Other

Iceland

Sainsburys

Section 2
WAREHOUSING AND DISTRIBUTION
Please give a brief outline of your own warehousing and distribution activities.

Do you subcontract any warehousing and distribution? If YES, please tick and give details.

Q FOOD GP 4100 Issue 5

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BRC Food Addendum


(Part 2)
Section 3

Q FOOD GP 4100 Issue 5

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PRODUCT RANGE FOOD


Please indicate with tick products produced
Egg

Packs Ambient Stable

Shell Egg

Heat preserved
Raw Meat & Fish

Hermetically sealed

Red Meat Slaughter & cutting

Other

Raw Meat products & preparations


Beverages
Chill / Frozen

Alcoholic

Beef / Veal

Soft drinks

Pork / Lamb

Fruit juices

Venison

Coffee / Tea / Herbal

Offal / Other meat


Poultry Meat, Slaughter & cutting

Bakery products ambient

Chicken / Turkey

Bread / Pastries

Duck / Goose

Biscuits / Cake

Farmed & Wild Game


Fish Wet / Chilled

Dried Goods

Fish Frozen

Soup/Sauce/Gravy/Stock

Molluscs/ Crustacean Raw

Herbs / Seasoning / Stuffing

Molluscs / Crustacean Cooked

Nut preparations

Raw Fish products and preparations

Pet food

Fruit

Oils & Fats

Vegetables
Salads
Prepared/ Semi Processed
To eat or heat

Food Ingredients

Chilled

Egg Liquid / dried

Frozen

Dried Whey powder

Cooked meat

Vitamins

Cooked fish

Salt / Vinegar

Ready meals

Home Baking ingredients

Sandwiches

Cake decorations

Soups / Sauces

Pectin

Pasta

Confectionery

Quiches / Flans

Snacks

Veg. Pates/ Spreads

Breakfast cereals
Dairy

Other

Chilled

Frozen

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