Raw Material Information
Date issued:
Raw Material Name: _____________________________________________________
Code No.: ____________________________________________________________
Lab. Batch No.: ________________________________________________________
Manufacturers' Batch No.: _________________________________________________
Expiring on: ___________________________________________________________
Date Originally Received
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Original Amount Received
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Quantity Remaining
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GRS number
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Any previous extension of Shelf-Life?
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Yes/No
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If Yes, date last tested:
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Is this quantity worth
testing?
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Yes/No
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Warehouse Details
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Amount to be sampled: ____________________________
Storage bin: ____________________________________
Condition of packaging: ____________________________
Warehouse sign:
Laboratory Details
Date:
Raw Material Specification Number:
Tests
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Results
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Calculations:
PASS/REJECT:
If PASS, new Expiry Date:
Sign Date:
Laboratory Manager
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