Regulation 10(2)
SCHEDULE 3E+W+SCertificate of Analysis or Examination
This
Atodlen has no associated
Memorandwm Esboniadol
| Certificate of Analysis or Examination carried out under the Food Safety (Sampling and Qualifications) (England) Regulations 2013 |
|---|
| TO: (name and address of person who originally submitted the sample) |
| ……………………………………………………………………………………………………….. |
| ……………………………………………………………………………………………………….. |
| I, the undersigned |
| ………………………………………………………………………………………………………. |
| public analyst*/food analyst*/food examiner* for………………………………………………… |
| ………………………………………………………………………………………………………. |
| certify that at…………………………………(time) on……………………………………..(date) |
| the sample marked as follows: |
| Date sample taken:…………………………………………………………………………………... |
| Reference number, description etc:………………………………………………………………….. |
| ……………………………………………………………………………………………………….. |
| Weight or measure: (may be omitted if the sample could not be conveniently weighed or measured or if the weight or measurement is not material to the result) |
| ……………………………………………………………………………………………………….. |
| was received by me from — |
| the person named above* |
| OR |
| (insert the name and address of the analyst/examiner to whom the sample was first submitted) |
| ……………………………………………………………………………………………………….. |
| ……………………………………………………………………………………………………….. |
| I certify that the sample was analysed*/examined* by me or under my direction and the results are as follows: |
| ……………………………………………………………………………………………………….. |
| ……………………………………………………………………………………………………….. |
| (if necessary continue overleaf) |
| My opinion and observations are (if deemed appropriate by analyst/examiner): |
| ……………………………………………………………………………………………………….. |
| ……………………………………………………………………………………………………….. |
| (if necessary continue overleaf) |
| I further certify that the sample had undergone no change that would affect my results, opinion or observations. (This statement is required if the sample has been analysed. It should be adapted if the certificate relates to food examination) |
| Certified by me this day ……………………(insert date) at………………………… (insert place) |
| Signature:………………………………………… Status………………………………………. |
| Name in BLOCK LETTERS |
| Official address:……………………………………………………………………………………... |
| ………………………………………………………………………………………………………. |
| Telephone No:……………………….. E.mail:…………………………………………….. |
| (*delete as appropriate) |