Notice of the Yantai Municipal Market Supervision Administration on the”Provisions on the Implementation of Main Responsibilities of Food Production and Business Units in Yantai (Draft for Solicitation of Comments)” to solicit public opinions
By: Date: 2021-04-13 Categories: authoritativerelease Tags: ,
   In order to urge food production and business units to effectively implement the main responsibility for food safety, based on the reality of our city, our bureau drafted the”Provisions on the Implementation of the Main Responsibility of Food Production and Business Units in Yantai (Draft for Solicitation of Comments)”, which is now open for public comments . The public can submit their opinions through the following channels and methods before April 13, 2021:
   1. Send comments to [email protected] via email, indicating the requirements for comments;
   2. Send your opinions by letter to:Food Production and Safety Supervision Division of the Municipal Bureau, No. 17, Xinyuan Road, Laishan District, Yantai City (Postal Code:264003), and indicate”Regulations for Soliciting Comments” on the envelope.
   Yantai Market Supervision Administration
   April 6, 2021
  Yantai City Food Production and Business Units Implement the Regulations on Subject Responsibility

   (draft for comments)
   Chapter One  总 则
   Article 1 In order to further promote the implementation of the main responsibility of food safety by food production and business units, and to ensure food safety, in accordance with the”Food Safety Law of the People’s Republic of China”,”The Implementation Regulations of the Food Safety Law of the People’s Republic of China” and other laws, regulations, rules and food Safety standards are formulated in accordance with the actual conditions of this city.
   Article 2 These regulations apply to enterprises and catering units (hereinafter referred to as food production and operation units) engaged in the production and operation of food (including food additives) and health food in the administrative area of ​​Yantai City, as well as small workshops, small restaurants, and small stalls (Hereinafter referred to as the”three small”) to perform the main responsibility of food safety and the supervision and inspection and comprehensive management of the implementation of the main responsibility of the food by the market supervision and management departments at all levels in accordance with the law.
  Article 3 The food production and operation unit shall ensure that the products and production and operation activities of its production and operation meet the requirements of laws, regulations and standards, and shall bear corresponding legal responsibilities.
   Article 4 As the first person responsible for ensuring food safety, food production and business units shall implement a self-inspection system for the main responsibility of food safety, conduct regular self-inspections on the legal obligations that should be performed in the process of food production and operation, and follow the requirements Submit a self-examination report to the market supervision and management department.
  Article 5 Market supervision and management departments at all levels clarify the implementation of food production and operation units by the three-level market supervision and management departments of the city, county, and institute in accordance with the”Guiding Opinions of the Shandong Provincial Market Supervision Administration on the Division of Powers for Food Production Supervision and Inspection” and other documents And the”three small” food safety subject responsibility supervision and inspection power division, supervise and guide food production and operation units and the”three small” to implement the main responsibility of food safety.
  The municipal market supervision and management department is responsible for supervising and inspecting the implementation of the main responsibility of food safety by the key supervision units of the city.
  The county-level market supervision and management department is responsible for formulating and organizing the implementation of the supervision and inspection plan for the main responsibility for food safety of the food production and operation units in the jurisdiction and the”three small”, and is responsible for the supervision and inspection of the main responsibility for the key supervision and implementation of the food safety of the enterprise.
  The grassroots supervision office is responsible for formulating and organizing the implementation of the supervision and inspection plan for the implementation of the main responsibility of food safety for the”three small” in the jurisdiction, and is responsible for the supervision and inspection of the main responsibility for food safety of the enterprises entrusted by the county bureau in the jurisdiction.
  Article 6 Encourage food production and business units to entrust third-party professional technical institutions to regularly inspect and evaluate the implementation of their main responsibilities for food safety.
  Article 7 Encourage relevant industry associations to organize food production and business units to carry out self-examination and reporting on the main responsibility of food safety in accordance with the requirements of these regulations.
  Article 8 Market supervision and management departments at all levels shall supervise and guide food production and business units to implement the self-inspection and reporting system for the main responsibility of food, take the self-inspection as an important basis for supervision and inspection, and apply the self-inspection and the results of supervision and inspection in accordance with the law. We will improve the methods and methods of supervision and inspection in a targeted manner, improve the effectiveness of supervision and inspection, and deal with violations of laws and regulations discovered in a timely manner in accordance with the law to eliminate hidden food safety hazards.
   Chapter Two   Organization and Personnel Management
  Article 10 The main person in charge of a food production and operation unit is the first person responsible for food safety, and is fully responsible for the implementation of the main responsibility for food safety of the unit. The main person in charge of a food production and operation unit shall be the legal representative and person in charge of the unit.
   Article 11 Food production and business units shall perform the following duties:
  (1) Responsible for organizing the formulation and implementation of the unit’s food safety management system;
  (2) Responsible for establishing and improving the unit’s food safety responsibility system, and implementing the various food safety responsibilities required by these regulations to people;
  (3) Responsible for setting up food safety management agencies and equipping food safety management personnel;
  (4) Responsible for organizing and implementing internal food safety self-inspection, and regularly inspecting and evaluating food safety status;
  (5) Responsible for organizing and carrying out food safety knowledge training;
  (6) Responsible for organizing the formulation and implementation of food safety incident handling plans;
  (7) Responsible for coordinating and cooperating with the supervision work of the market supervision and management department;
  (8) Responsible for providing resources and conditions guarantee for the implementation of the main responsibility of food safety;
  (9) Responsible for implementing other responsibilities stipulated by food safety laws, regulations, rules and food safety standards.
  Article 12 The main person in charge of the food production and operation unit and the food safety management personnel shall not be prohibited from practicing.
  Article 13 Food production units and food business enterprises shall be equipped with full-time or part-time food safety professional and technical personnel, and clarify their food safety responsibilities. Special food production and operation units such as formula foods for special medical purposes and formula foods for infants and young children shall also set up corresponding R&D institutions and R&D technical personnel in accordance with relevant requirements.
  Article 14 Persons engaged in the work of contacting directly imported foods shall undergo an annual health check and obtain a health certificate before they can work. Persons suffering from diseases that hinder food safety stipulated in the”Catalogue of Diseases Impairing Food Safety” issued by the health administrative department of the State Council shall not engage in work that comes into contact with directly imported food.
  Article 15 Food production and business units shall formulate and implement annual food safety training and assessment plans for different personnel. The training and assessment content should at least include food safety laws, regulations, rules, food safety standards, and the food safety management system formulated by the unit. When food safety-related laws, regulations, rules and standards are updated, training should be carried out in a timely manner.
  Article 16 Food production and business units shall arrange food safety management personnel and main practitioners to conduct no less than 40 hours of concentrated training and assessment on food safety laws and regulations, food safety knowledge, and industry ethics and ethics each year.
  Article 17 Food production and business units shall conduct food safety pre-job training for employees, and shall not be allowed to work if they fail the assessment.
  Article 18 Food production and business units shall establish training files, evaluate training effects, and keep training records. The training records are kept for at least 2 years.
   Chapter 3 Subject Liability
  Article 19 Food production units, special food production units, and small workshops shall bear the following main responsibilities for food safety in accordance with the law:
  (1) The entity’s main qualification responsibility;
  (2) Responsibility for control of production materials;
   (3) Production process control responsibility;
   (4) Food management responsibility;
  (5) Factory inspection responsibility;
  (6) Label identification responsibility;
  (7) Product traceability responsibility;
  (8) Training and assessment system;
   (9) Accident handling, reporting, and recall responsibility;
   (10) Other food safety responsibilities.
  Article 20 Food business units, catering units, special food business units, small restaurants and small vendors shall bear the following main responsibilities for food safety in accordance with the law:
  (1) The entity’s main qualification responsibility;
  (2) Responsibility for the legality of product procurement;
   (3) Responsibilities for the business process;
  (4) Product traceability responsibility;
  (5) Training and assessment system;
  (6) Accident handling, reporting, and recall responsibility;
   (7) Other food safety responsibilities.
   Chapter 4  Self-inspection and report
   Article 21 Food production and business units shall formulate a food safety self-inspection management system in accordance with the requirements of Chapter 2 of these regulations, conduct a comprehensive self-inspection at least once a year, and take the initiative to rectify problems when problems are found, and ensure that production and operation conditions and behaviors continue to meet Requirement to ensure that all main responsibilities are in place, truthfully fill in”XX Food Production Unit Self-inspection Report (Template)” (Annex 1),”Self-Inspection Form for Implementation of Main Responsibility” (Annex 2-6), and keep self-inspection records .
  Article 22 Food production and business units shall strictly abide by laws, regulations and food safety standards, conduct regular food safety self-inspections, investigate hidden risks, and submit their annual self-inspection to the local county-level market supervision and management department by the end of September each year. Check the report.
   Article 23 Units that produce health foods, formula foods for special medical purposes, formula foods for infants and young children, and other main and supplementary foods exclusively for specific groups of people, shall establish a system that is compatible with the food they produce in accordance with the requirements of good manufacturing practices. The production quality management system conducts self-inspection on the operation of the system every year to ensure its effective operation.
   Article 24 If the production and operation conditions change and do not meet the statutory requirements, the food production and operation unit shall immediately take corrective measures; if a potential risk of food safety accidents is found in the self-inspection or the supervision and inspection of the market supervision and management department, The food production and operation unit shall immediately stop its production and operation activities, and submit a self-inspection report to the market supervision and management department within a time limit. Only after verification that the rectification is completed can it resume production and operation.
  Article 25 In any of the following circumstances, it shall actively report to the local county-level market supervision and management department in writing within 2 working days, and report major risks immediately:
   (1) Continuous suspension of production or suspension of business for 3 months or more;
   (2) Continuous suspension of production or resumption of production for 3 months or more;
  (3) The unit that has submitted a suspension of production or suspension of business for less than three months resumes production and operation;
  (4) In the purchase inspection, it is found that there are major unsafe factors such as illegal addition, disease or death of meat, or unknown source with food safety hazards;
  (5) Handling consumer complaints and reports involving major food safety issues;
  (6) Potential risks of food safety accidents;
  (7) Circumstances required by other laws, regulations and rules.
  Article 26 The content of the self-examination report is:
   (1) Self-inspection of the implementation of the main responsibility of food safety;
   (2) The rectification of the problems found in the self-examination;
   (3) Handling of food safety incidents, etc.;
   (4) Other matters that should be reported in accordance with laws and regulations.
   Article 27 The self-inspection report of the food production and operation unit shall be filled in truthfully the”XX Food Production Unit Self-inspection Report (Template)” (Annex 1) and the”Self-inspection Form for the Implementation of Main Responsibilities by Food Production and Operation Units””(Annex 2-6),”Food Production and Business Unit’s Self-Inspection Report Authenticity Commitment” (Annex 7), and other materials that need to be reported, signed by the principal person in charge or quality and safety authorized person in paper, Submit the form of electronic document or online submission to the market supervision and management department.
  Chapter 5 Supervision and Inspection
  Article 28 Market supervision and management departments at all levels shall comprehensively apply written inspections, daily supervision inspections, unannounced inspections, special inspections, and system inspections to supervise and urge food production and business units to implement their main responsibilities.
  Article 29 Market supervision and management departments at all levels shall carry out daily supervision and inspection of licensed food production and operation units within their jurisdiction in accordance with risk classification and grid supervision mode.
   Article 30 The market supervision and management departments at all levels shall consult the self-examination records of food production and business units during supervision and inspection, and if they find that the contents of the self-examination report are incomplete and do not meet the requirements, they shall be required to provide explanations and provide supplementary materials within a time limit .
  Article 31 The municipal and county-level market supervision and administration departments shall, in accordance with the food safety risk situation and supervision resource conditions, issue an annual supervision and inspection plan in a timely manner, clarify the supervision and inspection unit, inspection methods, planned inspection time, etc.
   Article 32 The market supervision and management departments at all levels shall include the food production and business unit’s self-inspection report on the implementation of the main responsibility for food safety and the supervision and inspection of the implementation of the main responsibility for food safety into the unit’s food safety integrity file and serve as a quantitative level classification Important basis. The above information (paper and electronic documents) shall be kept for no less than two years, and may be announced to the public through appropriate channels.
  Article 33 Market supervision and management departments at all levels shall increase the frequency of supervision and inspection for enterprises that fail to fulfill their main responsibility for food safety or submit self-inspection reports as required. Those suspected of violations shall be promptly transferred to the inspection department for investigation and punishment.
  Chapter VI Legal Liability
  Article 34  Food and food additives that have false production date, shelf life or exceeded shelf life in the production and operation shall be dealt with in accordance with Article 124 of the Food Safety Law.
  Article 35  Food producers and operators purchasing or using food raw materials, food additives, or food-related products that do not meet food safety standards shall be dealt with in accordance with Article 125 of the Food Safety Law.
  Article 36 In any of the following circumstances, it shall be handled in accordance with Article 126 of the Food Safety Law:
  (1) Food and food additive producers fail to inspect purchased food raw materials and produced food and food additives in accordance with regulations;
  (2) The food production and operation enterprise fails to establish a food safety management system in accordance with the regulations, or fails to allocate, train, and assess food safety management personnel in accordance with the regulations;
  (3) Food and food additive manufacturers fail to inspect licenses and related certification documents when purchasing goods, or fail to establish and comply with purchase inspection records, factory inspection records and sales records systems;
  (4) The food production and operation enterprise has not formulated a food safety accident handling plan;
  (5) Food producers and operators arrange for persons who have not obtained a health certificate or suffer from diseases that hinder food safety as specified by the health administration department of the State Council to engage in work that comes into contact with directly imported food;
  (6) Food business operators fail to sell food according to regulations;
  (7) Food producers and operators fail to inspect and evaluate the food safety status regularly, or the production and business conditions have changed, and they have not been dealt with according to regulations;
   (8) Food production enterprises and catering service providers fail to formulate and implement production and operation process control requirements in accordance with regulations.
   Article 37   A food producer and business operator who has been ordered to suspend production and business operations or other than the revocation of a license for violation of the Food Safety Law three times in a year shall be ordered to suspend production and business until the license is revoked.
   Chapter 7  Attached to the rule
  Article 38 Encourage industry associations to play their role in industry self-discipline, carry out training and publicity, build platforms, and industry guidance, and promote food production and business units to implement the main responsibility of food safety.
   Article 39  These regulations shall be implemented from *month*day, 2021, and are valid until *month*day, 2026.
  Attachment:1.XX food production unit self-examination report (template)
  2. Self-inspection form for the implementation of main responsibilities of food production and processing units
  3. Self-inspection form for the implementation of main responsibilities of food business units
  4. Self-inspection form for the implementation of the main responsibility of the catering service unit
  5. Self-inspection form for the implementation of main responsibilities of health food production units
  6. Self-inspection form for the implementation of main responsibilities of health food sales units
  7. Self-inspection report authenticity commitment letter
  Attachment 1
   XX food production unit self-inspection report (template)
Self-inspection time:The first self-inspection of the year
   In accordance with the”Food Safety Law of the People’s Republic of China”,”Measures for the Daily Supervision and Inspection of Food Production and Operation” and other laws and regulations, our company has requirements for the qualifications of producers, production environment conditions, production equipment and facilities, sanitation management, and purchases. Self-inspection was carried out in aspects of inspection, production process control, product inspection, storage and delivery control, non-conforming product management and food recall, employee management, food safety accident handling, food additive use management, labeling and identification.
   After self-inspection, no problems were found.
   Self-inspector’s signature:
   Signature of legal representative (main person in charge):
  year month day
  ———————————————– —-
   After self-inspection, the following problems were found:
  1.XXXXXX.
  2.XXXXXX.
  ……
  Our company has rectified the problems found in the self-examination, and the rectification has been completed. The rectification situation is as follows:
  1.XXXXXX.
  2.XXXXXX.
  ……
   Self-inspector’s signature:
   Signature of legal representative (main person in charge):
  year month day

  Attachment 2
  Self-inspection form for the implementation of main responsibilities of food production and processing units
Name of unit:Certificate number:Address:Date of self-examination:
Item number
Check content
Self-check results
1. Production environment conditions
1.1
The factory area has no dust, no water, and the factory area and workshop are clean and tidy.
Conform ()
Inconsistent ()
1.2
Plant areas, workshops and toxic, harmful places and other pollution sources should be kept at a prescribed distance.
Conform ()
Inconsistent ()
1.3
Toilet rooms should be kept clean,Hand washing facilities should be set up,Not in contact with food production, packaging or storage areas Direct connection.
Conform ()
Inconsistent ()
1.4
There are changing clothes, non-manual hand washing, hand drying, disinfection equipment and facilities to meet normal use.
Conform ()
Inconsistent ()
1.5
Walls, ceilings,floors and other hardware facilities are complete,no damage. Ventilation,Dustproof,Lighting,Storage of garbage and waste and other equipment, The facility is operating normally.
Conform ()
Inconsistent ()
1.6
The detergent used in the workshop,chemicals such as disinfectant should be combined with raw materials,semi-finished products, finished products, Packaging materials, etc. are placed separately,and have corresponding requisition and use records.
Conform ()
Inconsistent ()
1.7
Regularly inspect the use of anti-rodent,anti-fly, anti-insect devices and have corresponding inspection records, No signs of pests in the production site
Conform ()
Inconsistent ()
2. Incoming inspection results
Note:①Inspect the raw and auxiliary materials warehouse;Randomly check the types of raw and auxiliary materials, and all inspections for less than 2 types.
2.1
There are purchase inspection and recording system documents, the regulations are detailed and complete, and there is operability.
Conform ()
Inconsistent ()
2.2
Inspect food raw materials,food additives,food-related product supplier licenses, product qualification Proof documents;The supplier is unable to provide food ingredients with valid conformity certification documents,have inspection records.
Conform ()
Inconsistent ()
2.3
Incoming inspection records and certification materials are authentic,complete,The retention period of records and vouchers shall not be less than six months after the expiration of the product warranty period. If the shelf life is not clearly guaranteed,The shelf life shall not be less than two years.
Conform ()
Inconsistent ()
2.4
Establish and preserve food raw materials,food additives,food-related product storage,keeping records and collecting Use outbound records.
Conform ()
Inconsistent ()
2.5
The water quality of food processing water should meet the requirements of GB5749-2006 (Sanitary Standards for Drinking Water),Foods with special requirements for processing water quality should meet the corresponding regulations; Self-provided water sources and water supply facilities should comply with relevant regulations.Products involving drinking water hygiene and safety used in water supply facilities should also comply with relevant national regulations.
Conform ()
Inconsistent ()
3. Production process control Note:extract at least 2 batches of products from the finished product warehouse, according to the production date or batch number, trace back the production process record and control all inspections, >There are at least one product for random inspection of products for specific groups of people.
3.1
There are production process control system and food safety self-inspection system documents,The regulations are detailed and complete,Operability,< ins>Regularly conduct self-inspection, record and dispose of food safety status
Conform ()
Inconsistent ()
3.2
The raw and auxiliary materials used,food additives,food-related product varieties and claims, purchase The contents of the inspection records are consistent.
Conform ()
Inconsistent ()
3.3
Create and save production feed records,including feed type,product name,production date or batch number, ins>Used quantity, etc.;Production input records and raw and auxiliary materials, finished products records to maintain material balance and output rate.
Conform ()
Inconsistent ()
3.4
No use of non-food raw materials,recycled food,chemical substances other than food additives,exceeding the shelf life Food raw materials and food additives produce food.
Conform ()
Inconsistent ()
3.5
No over-range or over-limit use of food additives has been found.
Conform ()
Inconsistent ()
3.6
New food raw materials produced or used, are limited to the new food raw materials announced by the health administration department of the State Council.
Conform ()
Inconsistent ()
3.7
No drugs were found to be used to produce food using raw materials that are only used for health food.
Conform ()
Inconsistent ()
3.8
The production process and parameters in the production record are consistent with the process provided by the enterprise when applying for a license.
Conform ()
Inconsistent ()
3.9
Establish and save control records of key control points in the production and processing process.
Conform ()
Inconsistent ()
3.10
No cross-contamination of people and logistics was found at the production site.
Conform ()
Inconsistent ()
3.11
No cross-contamination of raw materials, semi-finished products and directly imported food was found.
Conform ()
Inconsistent ()
3.12
If there are production environment monitoring requirements such as temperature, humidity, etc., monitor and record regularly.
Conform ()
Inconsistent ()
3.13
Regular maintenance and records of production equipment and facilities.
Conform ()
Inconsistent ()
3.14
No false production date or batch number has been found.
Conform ()
Inconsistent ()
3.15
Workers wear work clothes and hats,No individuals unrelated to production or other items unrelated to production are found in the production workshop,Employees wash their hands Enter the production workshop after disinfection.
Conform ()
Inconsistent ()
3.16
The control of landing products, the measures taken and the disposal situation, and the disposal records are complete.
Conform ()
Inconsistent ()
3.17
If waste grease and other substances are produced during the production process, a record of the disposal of the waste is required.
Conform ()
Inconsistent ()
4. Product inspection result note:take spot check method
4.1
There are inspection management system documents,For raw materials,semi-finished products,finished products inspection regulations are detailed and complete, > is operable.
Conform ()
Inconsistent ()
4.2
For self-inspection by the enterprise, shall have an inspection room and inspection capabilities suitable for the items to be inspected, have inspection-related equipment and chemical reagents, The inspection equipment shall be inspected on schedule. Chemical reagents and their configuration reagents are within the validity period,purchased,use,configuration records, ins> keep material balance with production and sales records.
Conform ()
Inconsistent ()
4.3
If self-inspection is not possible, should entrust a qualified inspection agency to conduct inspection. And sign a valid batch inspection factory inspection agreement,and keep the batch inspection report,correspond to the production record. If there is a type inspection requirement,Perform the type inspection according to the regulations,and keep the inspection report.
Conform ()
Inconsistent ()
4.4
There are food safety standards texts that are compatible with the products produced,Inspections are carried out in accordance with the provisions of the food safety standards. Inspectors of the enterprise are on duty, responsibility performance,Inspectors are skilled in the operation of self-inspection items.
Conform ()
Inconsistent ()
4.5
Create and save batch original inspection data and inspection report records,Inspection records are true,complete, and Production, sales records maintain material balance.
Conform ()
不符合()
4.6
按规定时限保存检验留存样品并记录留样情况。留存的样品及记录保存期限不得少于产品保质期满后六个月;没有明确保质期的,保存期限不得少于二年。
符合()
不符合()
5.贮存及交付控制
注:采取抽查方式,有冷链要求的产品必须检查冷链情况。
5.1
原辅料的贮存有专人管理,贮存条件符合要求。
符合()
不符合()
5.2
食品添加剂应当专门贮存,明显标示,专人管理。食品添加剂购进、领用、使用记录完备,与生产、销售记录保持物料平衡。
符合()
不符合()
5.3
不合格品应在划定区域存放。
符合()
不符合()
5.4
根据产品特点建立和执行相适应的贮存、运输及交付控制制度和记录。
符合()
不符合()
5.5
仓库温湿度应符合要求。
符合()
不符合()
5.6
生产的产品在许可范围内。
符合()
不符合()
5.7
有销售台账,台账记录真实、完整。
符合()
不符合()
5.8
销售台账如实记录食品的名称、规格、数量、生产日期或者生产批号、检验合格证明、销售日期以及购货者名称、地址、联系方式等内容。
符合()
不符合()
6.不合格品管理和食品召回
注:采取抽查方式
6.1
建立和保存不合格品的处置记录,不合格品的批次、数量应与记录一致。
符合()
不符合()
6.2
实施不安全食品的召回,有召回计划、公告等相应记录。
符合()
不符合()
6.3
召回食品有处置记录。
符合()
不符合()
6.4
未发现使用召回食品重新加工食品情况(对因标签存在瑕疵实施召回的除外)。
符合()
不符合()
7.从业人员管理
7.1
有食品安全管理人员、检验人员、负责人。
符合()
不符合()
7.2
有食品安全管理人员、检验人员、负责人培训和考核记录。食品安全管理人员履责记录。
符合()
不符合()
7.3
未发现聘用禁止从事食品安全管理的人员。
符合()
不符合()
7.4
企业负责人在企业内部制度制定、过程控制、安全培训、安全检查以及食品安全事件或事故调查等环节履行了岗位职责并有记录。
符合()
不符合()
7.5
建立从业人员健康管理制度,直接接触食品人员有健康证明,符合相关规定。
符合()
不符合()
7.6
有从业人员食品安全知识培训制度,并有相关培训记录。
符合()
不符合()
8.食品安全事故处置
8.1
有定期排查食品安全风险隐患的记录。
符合()
不符合()
8.2
有按照食品安全应急预案定期演练,落实食品安全防范措施的记录。
符合()
不符合()
8.3
发生食品安全事故的,有处置食品安全事故记录。
符合()
不符合()
9.食品添加剂生产者管理
9.1
原料和生产工艺符合产品标准规定。
符合()
不符合()
9.2
复配食品添加剂配方中的原料品种发生变化的,按规定变更、报告。
符合()
不符合()
9.3
食品添加剂产品标签载明“食品添加剂”,并标明贮存条件、生产者名称和地址、食品添加剂的使用范围、用量和使用方法。提供给消费者直接使用的食品添加剂,注明“零售”字样,标明各单一食品添加剂品种及含量。
符合()
不符合()
10.企业资质情况
10.1
营业执照、生产许可证在有效期内;实际生产场所、生产的产品范围与生产许可证载明内容一致。
符合()
不符合()
10.2
在生产许可有效期内,生产条件、检验手段、生产技术或者工艺等生产许可事项发生变化的,按规定变更或报告。
符合()
不符合()
10.3
不存在伪造、涂改、倒卖、出租、出借、转让食品生产许可证的情况。
符合()
不符合()
10.4
生产所依据标准符合规定。企标在备案有效期内。
符合()
不符合()
11、标识标注符合情况
注:可直接检查第3项中抽取的样品
11.1
名称、规格、净含量。
符合()
不符合()
11.2
生产日期、保质期。
符合()
不符合()
11.3
成份或者配料表。
符合()
不符合()
11.4
产品执行标准代号。
符合()
不符合()
11.5
贮存条件及产地。
符合()
不符合()
11.6
所使用的食品添加剂在国家标准中的通用名称。
符合()
不符合()
11.7
营养标签标注。
符合()
不符合()
11.8
专供其他特定人群的主辅食品标签应标明主要营养成分及其含量(仅适用特定的产品)。
符合()
不符合()
11.9
法律、法规或者食品安全标准规定必须标明的其他事项。
符合()
不符合()
12.食品安全追溯体系情况
12.1
建立食品安全追溯体系,保证食品可追溯。鼓励采用信息化手段采集、留存生产经营信息,建立食品安全追溯体系。
符合()
不符合()
注:1.第9项仅适用于食品添加剂生产企业。
  2. 1.7、3.4、3.5、3.6、11.7、11.8项等项目不适用于食品添加剂生产企业。
  附件3
  食品销售单位落实主体责任情况自查表
  单位名称:                        证号:                 地址:                        自查时间:
 
食品通用自查项目
检查项目
序号
检  查  内  容
评价
备注
1.经营资质
1.1
食品经营许可证是否合法有效,是否在经营场所显著位置悬挂或张贴。
□是 □否
 
1.2
食品经营许可证载明的有关内容与实际经营是否相符。
□是 □否
 
2.经营条件
2.1
是否具有与经营的食品品种、数量相适应的场所。
□是 □否
 
2.2
经营场所环境是否整洁,是否与污染源保持规定的距离。
□是 □否
 
2.3
是否具有与经营的食品品种、数量相适应的生产经营设备或者设施。
□是 □否
 
2.4
是否在经营场所显著位置张贴最近一次监管部门的监督检查表
□是 □否
 
3.食品标签等外观质量状况
3.1
经营的食品是否在保质期内。
□是 □否
 
3.2
经营的食品感官性状是否正常。
□是 □否
 
3.3
经营的肉及肉制品是否具有检验检疫证明。
□是 □否
 
检查项目
序号
检  查  内  容
评价
备注
 
3.4
检查的食品是否符合国家为防病等特殊需要的要求。
□是 □否
 
3.5
经营的预包装食品、食品添加剂的包装上是否有标签,标签标明的内容是否符合食品安全法等法律法规的规定。
□是 □否
 
3.6
经营的食品的标签、说明书是否清楚、明显,生产日期、保质期等事项是否显著标注,容易辨识。
□是 □否
 
3.7
销售散装食品,是否在散装食品的容器、外包装上标明食品的名称、生产日期或者生产批号、保质期以及生产经营者名称、地址、联系方式等内容。
□是 □否
 
3.8
经营食品标签、说明书是否涉及疾病预防、治疗功能。
□是 □否
 
3.9
经营场所设置或摆放的食品广告的内容是否涉及疾病预防、治疗功能。
□是 □否
 
3.10
经营的进口预包装食品是否有中文标签,并载明食品的原产地以及境内代理商的名称、地址、联系方式。
□是 □否
 
3.11
经营的进口预包装食品是否有国家出入境检验检疫部门出具的入境货物检验检疫证明。
□是 □否
 
4.食品安全管理机构和人员
4.1
是否有专职或者兼职的食品安全专业技术人员、食品安全管理人员和保证食品安全的规章制度。
□是 □否
 
4.2
是否有食品安全管理人员。
□是 □否
 
4.3
是否存在经市场监管部门抽查考核不合格的食品安全管理人员在岗从事食品安全管理工作的情况。
□是 □否
 
5.从业人员管理
5.1
是否建立从业人员健康管理制度。
□是 □否
 
5.2
在岗从事接触直接入口食品工作的食品经营人员是否取得健康证明。
□是 □否
 
检查项目
序号
检  查  内  容
评价
备注
 
5.3
在岗从事接触直接入口食品工作的食品经营人员是否存在患有国务院卫生行政部门规定的有碍食品安全疾病的情况。
□是 □否
 
5.4
是否对职工进行食品安全知识培训和考核。
□是 □否
 
6.经营过程控制情况
6.1
是否按要求贮存食品。
□是 □否
 
6.2
是否定期检查库存食品,及时清理变质或者超过保质期的食品。
□是 □否
 
6.3
是否按照食品标签标示的警示标志、警示说明或者注意事项的要求贮存和销售食品。对经营过程有温度、湿度要求的食品的,是否有保证食品安全所需的温度、湿度等特殊要求的设备,并按要求贮存。
□是 □否
 
6.4
是否建立食品安全自查制度,定期对食品安全状况进行检查评价。
□是 □否
 
6.5
是否建立和保存处置食品安全事故记录,是否按规定上报所在地市场监管部门。
□是 □否
 
6.6
采购食品(食品添加剂),是否查验供货者的许可证和食品出厂检验合格证或者其他合格证明(以下称合格证明文件)。
□是 □否

6.7
是否建立食用农产品进货查验记录制度,如实记录食用农产品的名称、数量、进货日期以及供货者名称、地址、联系方式等内容,并保存相关凭证。记录和凭证保存期限不得少于六个月。
□是 □否

6.8
是否建立并严格执行食品进货查验记录制度。
□是 □否

6.9
是否建立并执行不安全食品处置制度。
□是 □否

6.10
从事食品批发业务的经营企业是否建立并严格执行食品销售记录制度。
□是 □否


6.11
是否张贴并保持上次监督检查结果记录。
□是 □否

特殊场所和特殊食品自查项目
检查项目
序号
检  查  内  容
评价
备注
7.市场开办者、柜台出租者和展销会举办者
7.1
集中交易市场的开办者、柜台出租者和展销会举办者,是否依法审查入场食品经营者的许可证,明确其食品安全管理责任。 
□是 □否

7.2
是否定期对入场食品经营者经营环境和条件进行检查。
□是 □否

8.网络食品交易第三方平台提供者
8.1
是否建立入网食品生产经营者审查登记、食品安全自查、食品安全违法行为制止及报告、严重违法行为平台服务停止、食品安全投诉举报处理等制度,并在网络平台上公开。
□是 □否

8.2
是否对入网食品生产经营者食品生产经营许可证、入网食品添加剂生产企业生产许可证等材料进行审查,如实记录并及时更新。
□是 □否

8.3
是否建立入网食品生产经营者档案,记录入网食品生产经营者的基本情况、食品安全管理人员等信息。
□是 □否

8.4
是否设置专门的网络食品安全管理机构或者指定专职食品安全管理人员,对平台上的食品经营行为及信息进行检查。
□是 □否

9.食品贮存和运输经营者
9.1
贮存、运输和装卸食品的容器、工具和设备是否安全、无害,保持清洁。
□是 □否

9.2
容器、工具和设备是否符合保证食品安全所需的温度、湿度等特殊要求。
□是 □否

9.3
食品是否与有毒、有害物品一同贮存、运输。
□是 □否

10.特殊食品
10.1
是否经营未按规定注册或备案的特殊医学用途配方食品、婴幼儿配方乳粉。
□是 □否

10.2
特殊医学用途配方食品广告是否符合《中华人民共和国广告法》和其他法律、行政法规关于药品广告管理的规定。
□是 □否

检查项目
序号
检  查  内  容
评价
备注

10.3
特殊医学用途配方食品是否经国务院药品监督管理部门注册。
□是 □否

10.4
特殊医学用途配方食品广告是否符合《中华人民共和国广告法》和其他法律、行政法规关于药品广告管理的规定。
□是 □否

10.5
专供婴幼儿和其他特定人群的主辅食品,其标签是否标明主要营养成分及其含量。
□是 □否

自查结论(可另附页)
整改措施(可另附页)
自查人签名:
                             日
单位主要负责人/质量安全授权人签名:

                                  年        日(章)

 

  附件4
  餐饮服务单位落实主体责任情况自查表
  单位名称:                    证号:                地址:                        自查时间:


检查项目
序号
检查内容
检查结果
备注
1.许可管理
1
食品经营许可证合法有效,经营场所、主体业态、经营项目等事项与食品经营许可证一致。
□是 □否

2.信息公示
2
是否在经营场所醒目位置公示食品经营许可证。
□是 □否

3
监督检查结果记录表公示的时间、位置等是否符合要求。
□是 □否

4
是否在经营场所醒目位置公示量化等级标识。
□是 □否

3.制度管理
5
是否建立从业人员健康管理、食品安全自查、进货查验记录、食品召回等食品安全管理制度。
□是 □否

6
是否制定食品安全事故处置方案。
□是 □否

4.人员管理
7
主要负责人是否知晓食品安全责任,是否设有符合要求的食品安全管理人员。
□是 □否

8
从事接触直接入口食品工作的从业人员是否持有有效的健康证明。
□是 □否

9
是否开展从业人员食品安全培训并做好记录。
□是 □否

10
从业人员是否穿戴清洁的工作衣帽,双手是否清洁,是否保持个人卫生。
□是 □否

5.环境卫生
11
食品经营场所是否保持清洁、卫生。
□是 □否

12
烹饪场所是否配置排风设备,定期清洁。
□是 □否

13
用水是否符合生活饮用水卫生标准。
□是 □否

14
卫生间是否保持清洁、卫生,定期清理。
□是 □否

6.原料控制(含食品添加剂)
15
是否查验供货者的许可证和食品出厂检验合格证或其他合格证明,是否如实记录有关信息并保存相关凭证。
□是 □否

16
原料外包装标识是否符合要求,是否按照外包装标识的条件和要求规范贮存,并定期检查,是否及时清理变质或者超过保质期的食品。
□是 □否

17
食品添加剂是否由专人负责保管、领用、登记,并有相关记录。
□是 □否

18
是否遵循不用或少用食品添加剂的原则,是否按照要求不使用防腐剂、稳定剂、乳化剂等食品添加剂。
□是 □否

7.加工制作过程
19
食品原料、半成品与成品在盛放、贮存时是否相互分开。
□是 □否

20
制作食品的设施设备及加工工具、容器等是否具有显著标识,按标识区分使用。
□是 □否

21
专间内是否由明确的专人进行操作,使用专用的加工工具。
□是 □否

22
食品留样是否符合规范。
□是 □否


23
中央厨房、集体用餐配送单位配送食品的标识、储存、运输等是否符合要求。
□是 □否

24
有毒有害物质不得与食品一同贮存、运输。
□是 □否

8.设施设备及维护
25
专间内是否配备专用的消毒(含空气消毒)、冷藏、冷冻、空调等设施,设施运转正常。
□是 □否

26
食品处理区配备是否运转正常的洗手消毒设施。
□是 □否

27
食品处理区是否配备带盖的餐厨废弃物存放容器。
□是 □否

28
食品加工、贮存、陈列等设施设备是否运转正常,并保持清洁。
□是 □否

9.餐饮具清洗消毒
29
集中消毒餐具、饮具的采购是否符合要求。
□是 □否

30
是否具有餐具、饮具的清洗、消毒、保洁设备设施,并运转正常。
□是 □否

31
餐具、饮具和盛放直接入口食品的容器用后是否洗净、消毒,炊具、用具用后洗净,保持清洁。
□是 □否

自查结论(可另附页)
整改措施(可另附页)
自查人签名:
      
单位主要负责人/质量安全授权人签名:
      日(章)
附件5
  保健食品生产单位落实主体责任情况自查表
  单位名称:                    证号:                地址:                              自检时间:


检查项目
序号
检查内容
评价
备注
1.生产者资质情况
1.1
生产许可证在有效期内。
□是 □否
 
1.2
实际生产的保健食品在生产许可范围内。
□是 □否
 
1.3
注册或备案的保健食品相关内容发生变更的,已按规定履行变更手续。
□是 □否
 
1.4
工艺设备布局和工艺流程、主要生产设备设施符合原许可条件。
□是 □否
 
1.5
需要变更食品生产许可证载明事项的,已按规定履行变更手续。
□是 □否
 
2.进货查验情况
2.1
建立并执行原辅料和包装材料的采购、验收、贮存、发放和使用等管理制度。
□是 □否
 
2.2
查验原辅料和包装材料供货者的许可证和产品合格证明;对无法提供合格证明的食品原辅料,应当按照食品安全标准进行检验。
□是 □否
 
2.3
建立并执行原辅料和包装材料进货查验记录制度,如实记录原辅料和包装材料名称、规格、数量、生产日期或生产批号、保质期、进货日期以及供货商名称、地址、联系方式等内容,并保存进货凭证。
□是 □否
 
2.4
进货查验记录和凭证保存期限符合规定。
□是 □否
 
2.5
出入库记录如实、完整,包括出入库原辅料和包装材料名称、规格、生产日期或者生产批号、出入库数量和时间、库存量、责任人等内容。
□是 □否
 
 
2.6
原料库内保健食品原辅料与其他物品分区存放,避免交叉污染。
□是 □否
 
2.7
原料库通风、温湿度以及防虫、防尘、防鼠设施等符合要求。
□是 □否
 
2.8
对温湿度或其他条件有特殊要求的按规定条件贮存。
□是 □否
 
2.9
原辅料按待检、合格和不合格严格区分管理,存放处有明显标识区分,离墙离地存放,合格备用的原辅料按不同批次分开存放。
□是 □否
 
2.10
设置原辅料标识卡,标示内容应包括物料名称、规格、生产日期或生产批号、有效期、供货商和生产商名称、质量状态、出入库记录等内容。
□是 □否
 
2.11
标识卡相关内容与原辅料库台账一致,应做到账、物、卡相符。
□是 □否
 
3.生产过程控制情况
3.1
按照经注册或备案的产品配方、生产工艺等技术要求组织生产。
□是 □否
 
3.2
生产时空气净化系统正常运行并符合要求。
□是 □否
 
3.3
空气净化系统定期进行检测和维护保养并记录,建立和保存空气洁净度监测原始记录和报告。
□是 □否
 
3.4
有相对负压要求的相邻车间之间有指示压差的装置,静压差符合要求。
□是 □否
 
3.5
生产固体保健食品的洁净区、粉尘较大的车间保持相对负压,除尘设施有效。
□是 □否
 
3.6
有温湿度控制措施和相应记录,洁净区温湿度符合生产工艺的要求并有监测记录。
□是 □否
 
3.7
洁净区与非洁净区之间设置缓冲设施。
□是 □否
 
 
3.8
生产车间设置与洁净级别相适应的人流、物流通道,避免交叉污染。
□是 □否
 
3.9
原料的前处理(如提取、浓缩等)在与其生产规模和工艺要求相适应的场所进行。
□是 □否

3.10
原料的前处理(如提取、浓缩等)车间配备必要的通风、除尘、除烟、降温等安全设施并运行良好。
□是 □否

3.11
原料的前处理(如提取、浓缩等)未与成品生产使用同一生产车间。
□是 □否

3.12
保健食品生产工艺有原料提取、纯化等前处理工序的应自行完成,具备与生产的品种、数量相适应的原料前处理设备或者设施。
□是 □否

3.13
工艺文件齐全,包括产品配方、工艺流程、加工过程的主要技术条件及关键控制点、物料平衡的计算方法和标准等内容。接受委托加工的,应当建立与所生产的委托产品相适应的质量管理文件。
□是 □否

3.14
应有批生产记录,真实、可追溯。
□是 □否

3.15
批生产记录完整、规范。
□是 □否

3.16
批生产记录中的生产工艺和参数与工艺规程一致。
□是 □否

3.17
投料记录完整,包括原辅料品名、生产日期或批号、使用数量等,并经第二人复核签字。
□是 □否

3.18
与原辅料、中间产品、成品直接接触的容器、包材、输送管道等符合卫生要求。
□是 □否

3.19
工艺用水有水质报告,达到工艺规程要求。
□是 □否

3.20
水处理系统正常运行,有动态监测及维护记录。
□是 □否


3.21
投料前生产车间及设备按工艺规程要求进行清场或清洁并保存相关记录。
□是 □否

3.22
生产过程中物料应有清晰的状态标识,如产品名称、批号、储存期限等。
□是 □否

3.23
设备、容器应有清洁等状态标识。
□是 □否

3.24
更衣、洗手、消毒等卫生设施齐全有效,生产操作人员按相关要求做好个人卫生。
□是 □否

3.25
定期对生产设备、设施维护保养,并保存记录。
□是 □否

3.26
建立和保存停产、复产记录及复产时生产设备、设施等安全控制记录。
□是 □否

3.27
记录和保存生产加工过程关键控制点的控制情况,对超出控制限的情况有纠偏措施及纠偏记录。
□是 □否

3.28
现场未发现使用非食品原料、超过保质期的原辅料、回收保健食品生产保健食品的现象。
□是 □否

4.质量管理情况
4.1
设立独立的质量管理部门并有效运行。
□是 □否

4.2
明确品质管理人员的岗位职责并按要求履职。
□是 □否

4.3
落实原辅料、中间产品、成品的不合格品管理制度,保存完整的不合格品处理记录。
□是 □否

4.4
落实原辅料、中间产品、成品的检验管理制度、质量标准、检验规程。
□是 □否

4.5
检测仪器和计量器具定期检定或校准。
□是 □否


4.6
有仪器设备使用记录。
□是 □否

4.7
有能力检测产品技术要求规定的出厂检验指标。
□是 □否

4.8
按照产品技术文件或标准规定的检验项目进行检验,保存检验原始数据记录和检验报告。
□是 □否

4.9
设置留样室,按规定留存检验样品,并有留样记录。
□是 □否

5.产品标签、说明书情况
5.1
标签、说明书符合保健食品相关法律、法规的要求,与注册或备案的内容一致。
□是 □否

6.贮运及交付控制情况
6.1
建立和执行与产品相适应的仓储、运输及交付控制制度和记录。
□是 □否

6.2
根据保健食品的特点和质量要求选择适宜的贮存和运输条件。
□是 □否

6.3
非常温下保存的保健食品,建立和执行贮运时的成品温度控制制度并有记录。
□是 □否

6.4
贮存、运输和装卸保健食品的容器、工器具和设备安全、无害,保持清洁。
□是 □否

6.5
每批产品均有销售记录,记录内容真实、完整、可追溯。
□是 □否

7.不合格品管理和召回情况
7.1
执行产品退货、召回管理制度。
□是 □否

7.2
保存产品退货记录和召回记录。
□是 □否

7.3
对退货、召回的保健食品采取补救、无害化处理或销毁等措施,并保存记录。
□是 □否


7.4
向当地市场监管部门及时报告召回及处理情况。
□是 □否

8.从业人员管理情况
8.1
生产和品质管理部门的负责人为专职人员,符合有关法律法规对学历和专业经历要求。
□是 □否

8.2
专职技术人员占职工总人数的比例不少于5%。
□是 □否

8.3
质检人员为专职人员,符合有关要求。
□是 □否

8.4
采购管理负责人有相关工作经验。
□是 □否

8.5
建立从业人员培训记录及考核档案。
□是 □否

8.6
从业人员上岗前经过食品安全法律法规教育及相应岗位的技能培训。
□是 □否

8.7
建立从业人员健康检查制度和健康档案,直接接触保健食品人员有健康证明,符合相关规定。
□是 □否

9.食品安全事故处置情况
9.1
落实保健食品安全事故处置预案。
□是 □否

9.2
每年不少于一次检查与生产的保健食品相适应的质量安全防范措施,并保存相关记录。
□是 □否

9.3
发生保健食品安全事故的,建立和保存事故处置记录。
□是 □否

10.生产质量管理体系运行自查情况
10.1
每年不少于一次对生产质量管理体系的运行情况进行自查,保证其有效运行。
□是 □否

10.2
每年一次向市场监管部门提交生产质量管理体系自查报告。
□是 □否

自查结论(可另附页)
整改措施(可另附页)
自查人员签名:
年       
单位主要负责人/质量安全授权人签名:

      日(章)

附件6
保健食品销售单位落实主体责任情况自查表
单位名称:                        证号:               地址:                           自查时间:
检查项目
序号
检  查  内  容
评价
备注
1.经营资质
1.1
经营者持有的食品经营许可证是否合法有效。
□是 □否

1.2
食品经营许可证载明的经营项目是否含“保健食品销售”。
□是 □否

2.经营条件
2.1
是否具有与经营的品种、数量相适应的场所。
□是 □否

2.2
经营场所环境是否整洁,是否与污染源保持规定的距离。
□是 □否

2.3
是否具有与经营的品种、数量相适应的生产经营设备或者设施。
□是 □否

2.4
是否设保健食品专柜(专区)销售,并在专柜(专区)显著位置设立提示牌,用绿底白字注明“保健食品销售专区(专柜)”字样。
□是 □否

3.经营的保健食品的合法性
  3.1
是否经营未按规定注册或备案的保健食品。
□是 □否

3.2
检查的保健食品是否在保质期内。
□是 □否

3.3
经营的保健食品的标签、说明书的内容是否符合法律法规的规定,是否涉及疾病预防、治疗功能,内容是否真实,是否载明适宜人群、不适宜人群、功效成分或者标志性成分及其含量等,并声明“本品不能代替药物”,与注册或者备案的内容相一致。
□是 □否


3.4
经营的保健食品的标签、说明书是否清楚、明显,生产日期、保质期、注意事项等是否显著标注,容易辨识。
□是 □否

  3.5
经营的进口保健食品是否有中文标签,并载明食品的原产地以及境内代理商的名称、地址、联系方式。
□是 □否

3.6
经营的进口保健食品是否有国家出入境检验检疫部门出具的入境货物检验检疫证明。
□是 □否

4.食品安全管理制度和人员
4.1
保健食品经营企业是否有保证食品安全的规章制度。
□是 □否

4.2
保健食品经营企业是否有食品安全管理人员,现场考核其是否具备相应的食品安全管理能力。
□是 □否

4.3
保健食品经营企业是否存在经市场监管部门抽查考核不合格的食品安全管理人员在岗从事食品安全管理工作的情况。
□是 □否

4.4
保健食品经营企业是否对职工进行食品安全知识培训和考核。
□是 □否

5.经营过程控制情况
5.1
是否按要求贮存保健食品。对经营过程有温度、湿度要求的保健食品,是否有保证食品安全所需的温度、湿度等特殊要求的设备,并按要求存放。
□是 □否

5.2
是否定期检查库存保健食品,及时清理变质或者超过保质期的保健食品。
□是 □否

5.3
经营者采购保健食品,是否查验供货者的许可证和食品出厂检验合格证以及产品批准证明文件,是否索取、留存有供货方盖章(或签字)的进货凭证。
□是 □否

 5.4
保健食品经营企业是否建立并严格执行食品进货查验记录制度,并保存相关凭证。记录和凭证保存期限不得少于产品保质期满后六个月。
□是 □否

5.5
保健食品经营者是否建立食品安全自查制度,定期对食品安全状况进行检查评价。
□是 □否

5.6
发生食品安全事故的,是否建立和保存处置食品安全事故记录,是否按规定上报所在地市场监管部门。
□是 □否


5.7
是否建立并执行不安全食品处置制度。
□是 □否

5.8
从事保健食品批发业务的经营企业是否建立并严格执行保健食品销售记录制度。
□是 □否

5.9
经营者是否张贴并保持上次监督检查结果记录。
□是 □否

5.10
经营场所设置或摆放的保健食品广告(包括宣传资料)内容是否真实合法,是否含有虚假内容,是否涉及疾病预防、治疗功能,是否声明“本品不能代替药物”;广告内容是否经生产企业所在地省、自治区、直辖市人民政府市场监管部门审查批准,取得保健食品广告批准文件。
□是 □否

自查结论(可另附页)
整改措施(可另附页)
自查人员签名:
      
单位主要负责人/质量安全授权人签名:
      日(章)

  附件7
  自查报告真实性承诺书
  郑重承诺如下:由本单位按照《烟台市食品生产经营单位落实主体责任规定》等有关要求,向市场监督管理部门提交的《落实食品安全主体责任情况自查表》和其他相关报告材料均真实、准确、有效。如有不实,本单位愿意承担由此产生的一切法律责任。
  单位主要负责人/质量安全授权人签名:
  单位名称(盖章)
  年     月     日