Expired Raw Material Form

Expired Raw Material Form

Raw Material Information                                                         Date issued:                              

Raw Material Name: _____________________________________________________

Code No.: ____________________________________________________________

    Lab. Batch No.:  ________________________________________________________

Manufacturers' Batch No.: _________________________________________________

Expiring on: ___________________________________________________________ 

Date Originally Received	Original Amount Received	Quantity Remaining	GRS number

Any previous extension of Shelf-Life?	Yes/No	If Yes, date last tested:
Is this quantity worth testing?	Yes/No
Warehouse Details

Amount to be sampled:  ____________________________

Storage bin: ____________________________________

Condition of packaging: ____________________________

Warehouse sign:                                                       

Laboratory Details

    Date:                               

Raw Material Specification Number:                                                      

Tests	Results

Calculations:

PASS/REJECT:                                        

    If PASS, new Expiry Date:                          

Sign                                                                                                   Date:                       

Laboratory Manager