PRODUCT COMPLAINT FORM

Form No. GUC-COM-001 Date 06.08.2016 Complaint No. 001/2016

1 Complaint by Anas Horani
2 Location/Branch/ Place Plant-4
3 Nature of Complaint about Product Quality ✘ about Packaging Pro

4 Complaint communicated through/by ✘ e-mail Phone sample sub

Sample description
5 Brand Name Original Product Red Grape Product type Drink Packg&Size 250m

Batch Code 21G16 D.O.P 16.07.2016 D.O.E. 15.04.2017 TIME 00:52H

Equipment & Process details (during the production of complaint product)
Which Pasteurizer ? Which Filler? Time of Production Started
Line-1 (KF1818) Tetrapack Line-1 07:26H (20.07.2016)
6 Total Syrup Prepared Total no.of Cases Produced Time of Production completion
137500 L 19882 cases 13:44H (21.07.2016)
Product Pasteurization set Temp.C Pasteurizer Flow rate(lit/hr) Filler Speed (pack/hr)
93C 7440 L/hr 24000 Packs/hr
Was there any problem in pasteurizer during
7 No
said Production date? Explain

Was there any abnormal deviations observed

8 No
during the said production date? Explain.

9 Was Product Quality & other integral tests No

results show any deviations? Explain.
Was the microbiological tests qualified the
10 No
release of the product for sales?. Explain

What are the findings for the root cause of the

11 old shrink film
complaint sample? Explain

12 What are the corrective measures taken to re-work by using new shrink film
prevent re-occurrence of the problem?

Prepared by (Chemist) Checked by (QA Supervisor) Verified by (Manager Q.C

Babekir
DUCT COMPLAINT FORM
001/2016
s Horani
t-4
about Packaging Problem

sample submitted

Sample description
250ml TP

00:52H
Process details (during the production of complaint product)

shrink film

work by using new shrink film

Verified by (Manager Q.C)