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Food Safety and Standards Authority of India Ministry of Health ...

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FORM I<br />

[See rule ……]<br />

[Report <strong>of</strong> the <strong>Food</strong> Analyst]<br />

Report No............<br />

Certified that I .....................(name <strong>of</strong> the <strong>Food</strong> Analyst)......................... duly<br />

appointed as <strong>Food</strong> Analyst under the provision <strong>of</strong> the <strong>Food</strong> <strong>Safety</strong> <strong>and</strong> St<strong>and</strong>ards Act, 2006,<br />

for...........................................................(name <strong>of</strong> the local<br />

area)…..................................................received from**……..................................a sample<br />

<strong>of</strong>.......................................................bearing Code No. <strong>and</strong> Serial<br />

No.......................................<strong>of</strong> Designated Officer / Authorized Officer on<br />

................................................(Date <strong>of</strong> receipt <strong>of</strong> sample).................... for analysis.<br />

The condition <strong>of</strong> seals on the container <strong>and</strong> the outer covering on receipt was as<br />

follows:-<br />

....................................................................................................................................<br />

......................................................................................................................................................<br />

..................................................................................................................<br />

I found the sample to be ............(category <strong>of</strong> the food sample)............ falling under<br />

item No. ........................<strong>of</strong> <strong>Food</strong> <strong>Safety</strong> <strong>and</strong> St<strong>and</strong>ards Rules, 2008 / * proprietary food. The<br />

sample *was in a condition fit for analysis <strong>and</strong> has been analysed on…………………(Give<br />

Date <strong>of</strong> starting <strong>and</strong> completion <strong>of</strong> analysis).................................................<strong>and</strong> the result <strong>of</strong> its<br />

analysis are given below<br />

/ *was not in a condition fit for analysis for the reason given below:-<br />

Reasons:-<br />

....................................................................................................................................<br />

....................................................................................................................................<br />

Analysis Report:-<br />

(i) Sample Description:-<br />

....................................................................................................................................<br />

....................................................................................................................................<br />

62

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