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Appendix C. Model Inspection Report Forms Random Package Report 119 Random Package Report – Example 120 Standard Package Report 121
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Document Date: 2014-11-06 15:44:50

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City

Alcoa Highway Knoxville / Nashville / /

Company

Group Cookies (Thin Mints) Manufacturer ABC Cookies Inc. / /

Currency

USD / /

Facility

Highway Knoxville / /

IndustryTerm

metal pull top / /

Organization

Unit of Measure / /

Person

Tare Weights / Lot Size / Lot Codes / /

/

Position

Rt / Official / Approved Rejected Comments Official / Rc/Rt / Passes Official / /

ProgrammingLanguage

FL / /

ProvinceOrState

Tennessee / West Virginia / /

SocialTag