Allergen Risk Assessment Template 1

Issue Date: XX/XX/XXXX
Allergen Risk Analysis Template Revised: New

Approved By: Replaces: New
Version: 001
Potential Allergen Cross-Contact
Potential Allergen Description Significant Hazards
Supplier Mitigation Steps

(W) Wheat
(Sh) Shellfish
Serious Allergen Cross-
Contact Hazard
In Same Facility
(E) Egg
Ingredient/Packaging/Workplace-related
On Same Line
Allergen (F) Fish
Rationale or Basis Control Mechanism
In Product
(P) Peanut
(S) Soy
(TN) Tree Nuts ( Yes or No )
(Se) Sesame
W N Y Y Y Wheat cross-contact in production facility No Manufacturer has controls to prevent cross-contact Cross-contact prevention
Sh N N N N/A N/A No Not present in product, on line, or in facility N/A
E N N N N/A N/A No Not present in product, on line, or in facility N/A
F N N N N/A N/A No Not present in product, on line, or in facility N/A
Cultures
P N N N N/A N/A No Not present in product, on line, or in facility N/A
S N N N N/A N/A No Not present in product, on line, or in facility N/A
TN N N N N/A N/A No Not present in product, on line, or in facility N/A
Se N N N N/A N/A No Not present in product, on line, or in facility N/A
W N N N N/A N/A No Not present in product, on line, or in facility N/A

Version: 001
No
Sh N N N N/A N/A Not present in product, on line, or in facility N/A
No
E N N N N/A N/A Not present in product, on line, or in facility N/A
Salt No
P N N N N/A N/A Not present in product, on line, or in facility N/A
No
S N N N N/A N/A Not present in product, on line, or in facility N/A
No
TN N N N N/A N/A Not present in product, on line, or in facility N/A
No
Se N N N N/A N/A Not present in product, on line, or in facility N/A
No

Version: 001
No
No
Rennet
No
No
No
No
No
Calcium Chloride
Version: 001
Calcium Chloride No
No
No
No
No
No
Annatto
Version: 001
Annatto No
No
No
No
No
No
Peppers No

Peppers Issue Date: XX/XX/XXXX
Version: 001
No
Supplier has highly refined soy oil in same facility. This is
not considered an allergen, but our customer would like
S N N Y Y Highly refined soy oil cross-contact
to treat the refined soy as an allergen. They do have
Cross-contact prevention
cross-contact mitigation steps in place
No
No
No
Sh N N N N/A Shellfish cross-contact Not present in product, on line, or in facility Cross-contact prevention
No
Supplier has mitigation steps in place to prevent cross-

F N N N N/A Fish cross-contact No
contact
Spices No
P N N N N/A Peanuts cross-contact
contact
No
S N Y Y Y Soy cross-contact
contact
Version: 001
No
TN N N Y Y Tree nut cross-contact
contact
No
Se N N Y Y Tree nut cross-contact
contact
No
No
Food Contact Packaging No
No
No

Version: 001
No
No
No
Corrugated Packaging No
No
No
No

Version: 001
No
No
Food Grade Lubricants No
No
No
No

Version: 001
GMP's, employee allergen

W N N Y Y Wheat cross-contact in production facility No GMP's, employee allergen training
training
No
Sh N N Y Y Shellfish cross-contact GMP's, employee allergen training
training
No
E N N Y Y Egg cross-contact GMP's, employee allergen training
training

F N N Y Y Fish cross-contact No GMP's, employee allergen training
training
Factory Employee Breakroom No

P N N Y Y Peanuts cross-contact GMP's, employee allergen training
training
No
S N N Y Y Soy cross-contact GMP's, employee allergen training
training
No
TN N N Y Y Tree nut cross-contact GMP's, employee allergen training
training
No
Se N N Y Y Tree nut cross-contact GMP's, employee allergen training
training
Version: 001

W N N Y N Wheat cross-contact in production facility No GMP's, employee allergen training
training
No
Sh N N Y N Shellfish cross-contact GMP's, employee allergen training
training
No
E N N Y N Egg cross-contact GMP's, employee allergen training
training

F N N Y N Fish cross-contact No GMP's, employee allergen training
training
Employee Uniforms No
P N N Y N Peanuts cross-contact GMP's, employee allergen training
training
No
S N N Y N Soy cross-contact GMP's, employee allergen training
training
No
TN N N Y N Tree nut cross-contact GMP's, employee allergen training
training
No
Se N N Y N Tree nut cross-contact GMP's, employee allergen training
training
Version: 001
W N N N N Wheat cross-contact in production facility No Not present in product, on line, or in facility N/A
No
Sh N N N N Shellfish cross-contact Not present in product, on line, or in facility N/A
No
E N N N N Egg cross-contact Not present in product, on line, or in facility N/A
Processing Aids F N N N N Fish cross-contact No Not present in product, on line, or in facility N/A
No
P N N N N Peanuts cross-contact Not present in product, on line, or in facility N/A
No
S N N N N Soy cross-contact Not present in product, on line, or in facility N/A
No
TN N N N N Tree nut cross-contact Not present in product, on line, or in facility N/A

Allergen Risk Assessment Template 1

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Allergen Risk Assessment Template 1

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Issue Date: XX/XX/XXXX

Allergen Risk Analysis Template Revised: New

Supplier Mitigation Steps

Sh N N N N/A N/A No Not present in product, on line, or in facility N/A

E N N N N/A N/A No Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

P N N N N/A N/A No Not present in product, on line, or in facility N/A

S N N N N/A N/A No Not present in product, on line, or in facility N/A

TN N N N N/A N/A No Not present in product, on line, or in facility N/A

Se N N N N/A N/A No Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

P N N N N/A N/A Not present in product, on line, or in facility N/A

S N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

S N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

P N N N N/A N/A Not present in product, on line, or in facility N/A

S N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

P N N N N/A N/A Not present in product, on line, or in facility N/A

S N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

P N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

Supplier has mitigation steps in place to prevent cross-

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A

Food Contact Packaging No

P N N N N/A N/A Not present in product, on line, or in facility N/A

S N N N N/A N/A Not present in product, on line, or in facility N/A

TN N N N N/A N/A Not present in product, on line, or in facility N/A

Se N N N N/A N/A Not present in product, on line, or in facility N/A

W N N N N/A N/A No Not present in product, on line, or in facility N/A

Sh N N N N/A N/A Not present in product, on line, or in facility N/A

E N N N N/A N/A Not present in product, on line, or in facility N/A

F N N N N/A N/A No Not present in product, on line, or in facility N/A