Online Recall Risk Assessment Form V4

This tool is designed for one product at a time and can handle up to three affected batches of that product.

You will receive a fully editable Word-based recall pack by email, so you can update and refine the documents as your assessment develops.

What Went Wrong?

Undeclared AllergenForeign MatterMicrobiologicalChemicalIncorrect LabellingPackaging FaultOther

Not sure how to decide on a mock recall scenario? Check out our article on what to consider.

What is/are the allergen/s?
Crustaceans (e.g., prawns, lobster, crab)EggFishLupin (a legume often found in flour)Milk (dairy)Molluscs (e.g., mussels, oysters, squid)PeanutsSesame seedsSoybeansTree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, walnut)Wheat (and other cereals containing gluten)Sulphites (if in concentrations of 10 mg/kg or more)

What is/are the foreign matter/s?
Animal hairBone fragmentsBroken machine parts (nuts, bolts, washers, screws, springs)Ceramic or porcelain (chips from equipment or tools)Charred material (e.g. from over-fried or scorched product)Crystallised sugar or salt clumps (when large and sharp)Egg shell fragmentsFeathersFingernailsFragments from worn conveyor belts or O-ringsFruit pitsFruit pits fragmentsGlass (broken jars, light bulbs)Hair (human)Hard PlasticHard plastic (e.g. from scoops, containers)Insects (dead or alive)Jewelry (rings, earrings, watch parts)Matchsticks or toothpicks (from handling or serving)Metal shavings or fragments (from blades, machinery)Paper or cardboard fragmentsPersonal items (pens, buttons)Plasters/bandagesPlastic fragments (hard)Plastic fragments (soft)Rodent or pest body partsRubber fragments (e.g. from seals, gaskets, belts)Seed husks or hard hullsShell fragments (nut)Shell fragments (crustacean)Shell fragments (egg, nut, crustacean shells)Shot pellets (in game meat)Soft plastic films or packaging wrapSoil contaminationSoil or sand (clinging to produce or root vegetables)Staples or pins (e.g. from boxes or bags)StonesStones or pebbles (from vegetables, grains, legumes)Welding slag or wireWire bristles (e.g. from wire brushes)Wood splinters (e.g. from pallets or crates)

What is/are the microbiological hazard/s?
Bacillus cereusSalmonella sppCampylobacter sppSTEC (E coli O157 and others)Listeria monocytogenesClostridium botulinumClostridium perfringensStaphylococcus aureusPseudomonas sppAspergillus flavus(aflatoxins)Penicillium sppNorovirusHepatitis A virusCryptosporidium parvumGiardia lambliaTrichinella spiralisFusarium spp(e.g. fumonisins)Thermophilic anaerobesLactic acid bacteriaEnterobacteriaceaeTotal coliformsEscherichia coli (generic)Prions (BSE, vCJD)Yersinia enterocoliticaToxoplasma gondiiEnterobacter sakazakii (Cronobacter)Mycobacterium bovisPrions (BSE, vCJD)Taenia saginata

What is/are the chemical hazard/s?
Detergent residuesDisinfectant residues (e.g. quaternary ammonium compounds, chlorine)Sanitiser carryover (e.g. peracetic acid, hydrogen peroxide)Inadequate rinsing post-CIP (Clean-In-Place)Mycotoxins (e.g. aflatoxins in grains, nuts, spices)Alkaloids (e.g. solanine in green potatoes)Cyanogenic glycosides (e.g. in cassava, apricot kernels)Lectins (e.g. in undercooked red kidney beans)Histamine (e.g. in scombroid fish like tuna, mackerel)Shellfish toxins (e.g. paralytic shellfish poison, domoic acid)Ciguatoxins (reef fish)Pesticide residues (organophosphates, pyrethroids, etc.)Herbicide residues (e.g. glyphosate)Fungicide residuesHeavy metals (lead, mercury, cadmium, arsenic)Dioxins and PCBs (persistent organic pollutants)Nitrate/nitrite accumulation (e.g. in leafy greens)Migration of plasticisers (e.g. phthalates, BPA)Ink or adhesive migration from packagingLubricants (non-food grade or over-applied food-grade)Machine oilPaint flakes or coatings from equipmentResidues from fumigation (e.g. ethylene oxide)Incorrect dosing of food additives (e.g. nitrites in meats)Contaminated processing aidsNon-approved or undeclared additives (e.g. sulphites in fresh meat)Improperly formulated preservatives (e.g. benzoate/sorbate above legal limits)Vitamin or mineral overdose (e.g. in fortified foods)Illegal dyes (e.g. Sudan Red in chilli powder)Melamine (e.g. in dairy fraud)Ethanol or methanol (in beverages)Unauthorized preservatives or colourantsAllergen residues due to poor line cleaningResidues from previous product batches (cross-contamination)Reaction byproducts (e.g. acrylamide from high-heat processing)PhosphateSulphiteSodium NitritePolycyclic Aromatic Hydrocarbons (PAHs)Herbicide ResiduesFumigant ResiduesPatulinAnthelminticsTutinMarine biotoxinsPhomopsins

Describe what went wrong:

Upload a photo or supporting image of the issue, if relevant (optional, max 2 MB)

How was the issue identified?

Customer complaint / consumer feedbackTrade customer complaintInternal quality check / routine testingLaboratory testingSupplier notificationVerification agency / auditorMPI / New Zealand Food Safety notificationStaff observation / production issue identifiedOther

If Other, please describe:

Product Information

Tell us about the product that this recall risk assessment relates to.
Brand Name

Product Name

Barcode/Global Trade Item Number (Retail Unit)

Barcode / Global Trade Item Number (Shipper)

Individual product weight/volume

Select Unit

Food Storage Category

What is the date mark format?

If Other, describe

Intended Shelf-life

Select Unit

Serving Size

Select Unit

Is it sold as ready-to-eat? (E.g. no cooking or further processing required before eating.)
YesNo

Did you import the product?
YesNo
If Yes, from which country?

How Much Product is Affected

How do you Know How Much Product is Involved?
What documentation do you have that shows how much product is affected e.g. production records, and where can this information be found. In a recall situation it is crucial that this information is complete and secured as early as possible.

Units Used in Recall

How many affected batches are involved?
123

Detail	Batch 1	Batch 2	Batch 3
Product name (optional — leave blank to use the main product name from section 6)
Batch Code
Date Code
Amount Produced
Amount in Stock
Amount with Distributors / Transporters / Wholesalers
Amount with Retailers
Amount sold Online
Amount with Consumers / Unaccounted For Calculated as Produced − (Stock + Distributors/Transporters/Wholesalers + Retailers + Online)

Describe the reconciliation in plain English (optional)

Other Batches and Products

Are batches before and after affected / suspected?
YesNoDon't know
Describe full details (codes/dates) if Yes

Are any other products affected / suspected?
YesNoDon't know
Details (product names / codes / dates) if Yes

Distribution

Has the product reached consumers?
YesNoDon't know
If product is potentially hazardous and has reached consumers then there is a high likelihood that the product will need to be recalled.

You need to collate all the information you have on where this product has ended up. The best approach is to create a folder on your computer, or a physical folder, and add all the information you have. Include online sales, trade invoices, till receipts and any other records you may have.

Where will you keep this information and how will you share it with your verifier and New Zealand Food Safety if required?

Distribution Documentation?

Exporting

Has product been exported? This includes all product sold outside of NZ including exports to Australia and the Pacific Islands
YesNoDon't know
If Yes, please provide Export details:
Country(s):
Exporter Name:
Vessel/Flight:
Departure Date
Certificate Number(s):

Consumer/Medical Reporting

Are you aware of any consumer complaints about the product?
YesNo
If Yes, provide details

Are you aware of any reports of illness or injury?
YesNo
If Yes, provide details

Testing

Has any testing about this problem been completed on affected product(s)?
YesNoTesting underway
If yes, where are the results held?

Recall Decision

Date first notified to New Zealand Food Safety (if applicable)

Are there any other relevant factors? Use this section to record anything else that influences the recall decision. E.g. Experts consulted, and results of consultation.

Does this Recall Risk Assessment indicates a recall is required?
If you decide on a consumer-level recall for some products and trade-level for others, please indicate the products associated with each.
NoConsumer-level recall requiredTrade-level recall requiredPrecautionary trade recallMaybe – seek advice from NZFS (0800 00 83 33)

Details on reason for decision:

Business Details

New Zealand Business Number (if known) You can find your NZBN at companies-register.companiesoffice.govt.nz if you have one.

MPI Food Registration Type (if known)
National Programme 1National Programme 2National Programme 3Template Food Control PlanMy Food PlanCustom Food Control PlanTemplate Risk Management ProgrammeCustom Risk Management ProgrammeRegistered Food ImporterOther

MPI Food Registration Number (if known)

You can search your registration number here:

Business Name

Business Trading Name (if different)

Business Address

Address of manufacturing site (if different)

Email Address

Phone Number

Contact Person

Contact Name

Contact Position

Contact Email Address

Contact Number (Business)

Contact Number (After Business)

Brand Owner Details

Is your business the brand owner?
YesNo
If yes, please skip to ‘Section 4: Verifier Details’ below.

Have you discussed the recall with the brand owner?
YesNoN/A
Brand owner Name

Brand owner Address

Brand owner Phone Number

If you are not the brand owner, are you taking primary responsibility for the recall?
YesNoN/A

Are you subscribed to GS1 Product Recall?
UnsureYesNo

Verifier Details

What is the name of your verification agency, and the name of your last verifier?
Verification Agency

Verifier Name

If Other, please provide the Verifier Name

Verifier Email Address

Verifier Phone Number

LIVE [MOCK] RECALL

This section is only needed if a decision has been made to recall.

What's going to happen to the product?

What are you planning to do with affected product?
Destruction (retailer managed)Destruction (supplier managed)Re-labellingRe-processingRe-purposingDon't know yetOther
If Other (please describe)

Product in distribution or transit:
Destruction (retailer managed)Destruction (supplier managed)Re-labellingRe-processingRe-purposingDon't know yetOther
If Other (please describe)

What do your Customers and Consumers Need to Know?

What methods are you planning to use to inform consumers?
Point-of-sale noticeMedia releaseCustomer database - Email/DigitalCustomer database - PhoneNewspaper advertisementRadio advertisementSocial mediaCompany websiteTelevisionAllergyNZDon’t know yetOther
If Other(please describe)

What should consumers do with the product?
Do not consumeHandle with careConsume only if cooked thoroughlyConsume only if heated to 72°C for 1 minReturn to retailer for refundReturn to manufacturer for refundDo not consume if you are allergic to the undeclared allergenOther
If Other(please describe)

Upload an image of your product. Must be square and less than 1mb in size

This image will be added to a mock recall poster for you.

When you select submit, you will be emailed a recall pack that includes the recall risk assessment along with additional information that may include the completed poster and communication templates.

The system is designed so that the form does not reset when you submit, this means you can fill in some information, submit, then fill in more information without having to start again.

Documents to generate

Tick which Word documents you want in your pack. If more than one is selected, you will get a ZIP containing them.

Recall risk assessment (DOCX)

Mock recall poster (DOCX)

Batch reconciliation (DOCX)

Email to business customers (DOCX)

Email to online customers (DOCX)

Media release (DOCX)

Social media notification (DOCX)

Quarantine instructions (DOCX)

Email to business — trade recall (DOCX)

Privacy

Mock Recall team
Send the Mock Recall team a copy of this submission and generated files for review and support.

Server retention
Delete generated Word file(s) from the server after I download them (optional).

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