厂商问卷中英文对照外部

1、FACILITY QUESTIONNAIRE FOOD SAFETY食品安全-工厂调查问卷1.0 COMPANY PROFILE 厂商资料Company Name:公司名称:Site Address:公司地址City城市:Prov./State省份:Country 国家 :Postal code,ZIP邮政编码 :Website公司网址:Mailing Address:通讯地址(if different)(如与上述不同)Billing Address:发票寄送地址(if different)(如与上述不同)Please indicate if you are as

2、sociated with/or a division of another organization: 请说明是否隶属于另一个机构或与其他机构有关系2.0 CONTACT INFORMATION 联系人Contact Name:姓名Phone:电话Position:联系地址Fax:传真Please feel free to attach your business card 请尽量提供您的名片E-Mail:电子邮件Corporate Contact (if different): Name/Number:总公司联系人（如不同）姓名/电话Billing Contact (if differen

3、t): Name/Number:发票接收人（如果不同）姓名/电话3.0 SITE INFORMATION场所描述Is there more than one facility to be registered?是否多于一个场所需要认证? No Yes (Please complete Multi-site Details PART III)否 是 （请完成本问卷第三部分-多重场所详述）Size of your site (sq. ft / sq. m.):现场的面积（平方米）Please indicate the primary industry sector serviced by your

4、 company:请说明贵公司主要工业/服务领域If known, please indicate the 4-digit SIC code applicable to your activities:如果知晓，请给出贵公司业务活动的4位数标准工业 SIC 分类参数4.0 REGISTRATION SERVICE OPTIONS认证服务选项Service Element:服务单元Options:选项Target Dates:预计完成时间When would you like the Documentation Review (DR) to be conducted? 您希望何时进行资料评审？P

5、rior to Reg. Audit, at our site 现场审核之前在贵公司Prior to Reg. Audit, at QMI 现场审核之前在QMIPre-Assessment现场预评估Combine with DR 与文件评审同时进行Registration Audit认证现场审核Surveillance Audit Frequency:年度跟踪审核频率 Semi-annual 半年度 Annual 年度QMIs practice is to provide all documents electronically. Does this meet your needs or wo

6、uld you prefer: Faxed QMI的宗旨是希望提供所有的文件为电子版本。请问这符合您的要求吗？抑或会选择： 传真形式Do you have any special audit requirements? Please List:请问你方还有没有别的一些特殊要求？如有请列表说明:i.e. Language?比如说审核语言？i.e. Health & Safety Risks?比如说健康与安全风险？5.0 REFERRAL INFORMATION 参考信息How did you hear about QMI? Training Advertising SCC RAB IQN

7、et QMI Customer 您是如何获知QMI的？培训 广告 加拿大认可委 美国认可委 国际IQNET QMI客户 Referred by our Consultant: 被我们的咨询师推荐的：Name 他的名字：Company所属公司： Other (Please indicate): 其他 （请详述）FACILITY QUESTIONNAIRE PART II工厂调查问卷 第二部分6.0 MANAGEMENT SYSTEM INFORMATION FOOD SAFETY食品安全管理体系相关信息To which standard are you seeking registration?

8、您正在寻求的认证标准是什么 ISO 22 000 : 2005 ISO 22 000 : 2005 + ISO 9001:2000 QMI HACCP based FSMS QMI HACCP based FSMS + ISO 9001:2000 Others (Please describes) : _Scope of Activities: Please describe the scope of your activities, products and services as it relates to your Food Safety Management System (FSMS)

9、:请描述贵公司与食品安全管理体系相关联的活动，产品和服务的情况Total number of employees affected by the scope? 受当前体系范围约束的员工数目是多少？How many shiftsday? Start/Finish times: / 每天有多少班制 班制起始时间Does your organization currently hold registration for another standard? No 否贵公司目前是否持有其它标准的认证证书?Yes: Which Standard/Registrar:是：是何种标准Are you seeki

10、ng integrated audit services? Yes 是No 否您是否寻求多标准一体化认证服务?Are you seeking a transfer of registration? No, skip to the next section. Yes, please complete the following:您是否寻求转换认证机构否，直接跳到下一节 是，请接着完成下面的内容Standard (including version):目前认证的标准(包括版本)Current Registrar:目前的认证机构Expiry Date of Current Certificate:

11、Please attach copy) 证书有效期(请附拷贝件):Last Audit Date/Next Audit Date:上次审核时间/下次审核时间 / 7.0 FOOD SAFETY MANAGEMENT SYSTEM (FSMS) INFORMATION食品安全管理体系信息Does your facility have a system for auditing/monitoring the applicable Industry sector requirements & specifications, the applicable Food Laws & Reg

12、ulations and the Prerequisite programs for your facilities (Good Food Safety Practices such as : GMP ; Good Manufacturing Practices GAP ; Good Agricultural Practices, GHP ;Good Hygienic Practices, GVP : Good Veterinarian Practices, GPP : Good Production Practices, GTP ; Good Trading Practices, Infra

13、structure & Maintenance Programs, etc.) 您的设备有适用的行业必备的条件及技术要求审核和检测的体系，适用的食品法律法规和必备的程序（良好食品安全规范，例如GMP/良好生产规范：GAP/良好农业规范，GHP/良好卫生规范，GVP/良好兽医规范，GPP/良好产品规范，GTP/良好贸易规范，基本设施和维护程序等）吗？YesNo 是 否Please list all applicable food safety codes, specifications, regulations and other industry sector requirements

14、 relevant to the scope of your system: (Please attach a list as necessary)请列出所有您的体系范围内相关食品安全规范，技术要求，规则和其他行业必备条件Operational Statistics: 操作统计Total Person hours worked per year: 员工每年工作的总小时数Level of process automation 自动化过程水平 High Medium LowFood processing required by your clients (High, Medium, Low) 您的

15、顾客必须的食品过程 High Medium LowBasic repetitive tasks (BRT) by percentage of workforce:基础循环作业（BRT）的职工总数的百分比Highly specialized tasks (HST) by percentage of workforce:高度熟练作业（HST）的职工总数的百分比Seasonal workers? NoYes, % of total workforce:有季节工吗？ 没有 有 百分比为：HACCP Plan: HACCP计划Please complete the table below or prov

16、ide copy of your HACCP plan. (Attach a list if necessary)请完成以下表格或者提供贵公司HACCP计划的复印件（必要时请附清单）How many operational processes on site?现场有多少操作流程？Activity/Product/Service/Facilities(i.e. process step: raw material receiving)活动/产品/服务/设备（例如：流程步骤：原材料加工）Identification of Hazards Category(i.e. physical, chemic

17、al, biological)危险类别的辨别（例如：物理，化学，生物）Critical Control Pts & Program or Procedures to Control ?有哪些危害控制关键点及相关的控制流程?Food Hazards & Associated Risks of Products, Activities and Facilities:食品危害及与产品，行为和设备有关的危险源In the table below, please mark N/A if not applicable. If applicable, choose the associate

18、d risk level: Low, Medium or High.在下表中，如果不相关请标注N/A，如果合适请选择风险级别：高，中，低Note : Consider routine & non-routine activities at all facilities in the workplace, whether provided by the organization or external parties. Products means from the suppliers food chains : raw materials, additives, components,

19、 packaging up to t he finished products & delivery/distribution to the customer.N/ALow低Med中High高Biological hazards & associated risks (i.e. contamination of products by bacteria spore & non-spore forming, viruses, protozoa and parasites, etc.)生物危害源（例如细菌孢子产生的污染物和非孢子生物，微生物，原生物和寄生物等）Physica

20、l hazards & associated risks (i.e. contamination of products by glass, wood, stones, metal, bone, plastic, personal effects, building material, etc.)物理危害源（比如由玻璃、木材、石头、金属、骨头、塑料、人为影响、建筑材料等污染的产品）Chemical hazards & associated risks (i.e. contamination of products by naturally occurring chemicals

21、 such as mycotoxins, allergens etc. and/or added chemicals such as antibiotics, lead, arsenic, food additives, etc.)化学危害源（比如由自然界的化学品：过敏源等或者添加的化学剂：抗生素、铅、砷、食物添加剂等污染的产品Packaging materials hazards & associated risks (i.e. prinking inks, adhesives)包装材料危害源（比如印刷业油墨、胶合剂等）Food-borne illness or disease re

22、lated to the products (i.e. based upon review or epidemiological data) 由该食品产品导致疾病的情况（比如基于之前的审核或者流行病学数据）Please list other food hazards & associated risks(or annex document and data):请列出其他食品危害源和有关联的风险（或附加文件和数据）Which measurements do you periodically monitor to evaluate your Food Safety Management S

23、ystem ( FSMS ) Performance? Please attach a list if necessary贵公司将使用哪一种测量方法定期监测评价您的食品安全管理体系的执行情况？如果可能请附清单Please list any other Food Safety Management System (FSMS) concerns that have not been addressed. Please attach a list as necessary (i.e. Any notice(s) from the Food authority about a violation of

24、 the Food regulations & corrective actions taken, etc.) 请您列出其他任何有关于食品安全管理系统而在这里未有列出的项目。如果可能请附清单（例如：任何食品相关的政府部门颁发的有关食品守则的违反及相应纠正措施的执行方面的通知等）Does your organization have a product recall system in place, supported by relevant procedures and associated records?请问贵公司在适当的地方有否产品召回制，并且有相关流程和记录支持的？Yes No

25、Please note: if there is more than one facility/site to be registered, please complete Part II of the facility questionnaire for each site. 请您说明：如有多于一个的工厂或者现场要认证，每一个现场请完成第二部分工厂问卷8.0 COMPETENCY ANALYSIS 能力分析 INTERNAL USE ONLY 此栏仅限QMI内部使用FACILITY QUESTIONNAIRE PART III工厂调查问卷-第三部分Please complete ONLY if your management system encompasses more than one site.如果在贵公司的管理体系与一个以上场地有关联时，请完成本部分内容：9.0 ADDITIONAL SITE DETAILS其他场地情