Product Safety Audit Program
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Date of Audit
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Vendor Name
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Factory Name
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Address
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Telephone / Fax
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E-mail
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Contact Person
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Type for Audit
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Initial Audit
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Surveillance Audit
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Product Category
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* TCP order in production during audit?
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Yes No
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Audit Rating ( )
** Corrective Action Plan will be submitted by __________
** Next audit to be done by ______________
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Signature of Factory Representative
Name:
Title:
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Signature of Auditor
Name:
Title:
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