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    Allergen Statement

    Uploaded by

    Wury Antoro
    This document confirms that tapioca starch produced by PT.Sinar Pematang Mulia is free of allergens listed in Annex IIIa of the EU directive. The tapioca starch is manufactured in Bandar Mataram, Lampung, Indonesia. Based on an internal evaluation, control procedures exist to prevent cross-contamination, so the tapioca starch does not contain cereals, crustaceans, eggs, fish, peanuts, soy, milk, nuts, celery, mustard, sesame, sulphur dioxide, lupin, or molluscs.

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    Allergen Statement

    Uploaded by

    Wury Antoro
    52 views3 pages
    This document confirms that tapioca starch produced by PT.Sinar Pematang Mulia is free of allergens listed in Annex IIIa of the EU directive. The tapioca starch is manufactured in Bandar Mataram, Lampung, Indonesia. Based on an internal evaluation, control procedures exist to prevent cross-contamination, so the tapioca starch does not contain cereals, crustaceans, eggs, fish, peanuts, soy, milk, nuts, celery, mustard, sesame, sulphur dioxide, lupin, or molluscs.

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    This document confirms that tapioca starch produced by PT.Sinar Pematang Mulia is free of allergens listed in Annex IIIa of the EU directive. The tapioca starch is manufactured in Bandar Mataram, Lampung, Indonesia. Based on an internal evaluation, control procedures exist to prevent cross-contamination, so the tapioca starch does not contain cereals, crustaceans, eggs, fish, peanuts, soy, milk, nuts, celery, mustard, sesame, sulphur dioxide, lupin, or molluscs.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    52 views3 pages

    Allergen Statement

    Uploaded by

    Wury Antoro
    This document confirms that tapioca starch produced by PT.Sinar Pematang Mulia is free of allergens listed in Annex IIIa of the EU directive. The tapioca starch is manufactured in Bandar Mataram, Lampung, Indonesia. Based on an internal evaluation, control procedures exist to prevent cross-contamination, so the tapioca starch does not contain cereals, crustaceans, eggs, fish, peanuts, soy, milk, nuts, celery, mustard, sesame, sulphur dioxide, lupin, or molluscs.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Date : March 2, 2021

    To : PT. MAYORA

    Here with we confirm that our product below:

    (TAPIOCA STARCH)

    Is product manufactured by PT.Sinar Pematang Mulia in location Jl.Lintas Pantai Timur Km 60 Mataram
    Udik,Bandar Mataram ,Lampung Tengah ,Lampung 34169

    Based on our internal evaluation to the allergen risk of cross contamination, we confirm that a control
    procedure is exist and the material mentioned above is free from / containing of (*) any allergen material
    might cause allergic symptom to the consumer, as listed on Annex IIIa of Commission Directive
    2007/68/EC on following page.

    This statement is made in good faith and should be used as intended.

    Best Regards,

    Name
    Designation (must be QA or other equivalent assurance system function)

    Annex IIIa of Commission Directive 2007/68/EC for materials risk to allergen symptom:
    Page 1 of 3
    No. Materials Comment
    (not added-not used
    /added-used)
    1 Cereals containing gluten (i.e. wheat, rye, barley, oats, spelt, kamut or their
    hybridized strains) and products thereof, except:
    (a) wheat-based glucose syrup including dextrose
    (b) wheat-based maltodextrin
    (c) glucose syrup based on barley
    (d) cereals used for making distillates or ethyl alcohol of agricultural origin for
    spirit drinks and other alcoholic beverages
    2 Crustaceans and products thereof
    3 Eggs and products thereof
    4 Fish and products thereof, except:
    (a) fish gelatine used as carrier for vitamin or carotenoid preparations
    (b) fish gelatine or Isinglass used as fining agent in beer and wine
    5 Peanuts and products thereof
    6 Soybeans and products thereof, except:
    (a) fully refined soybean oil and fat
    (b) natural mixed tocopherols (E306), natural D-alpha tocopherol, natural D-
    alpha tocopherol acetate, natural D-alpha tocopherol succinate from
    soybean sources
    (c) vegetable oils derived phytosterols and phytosterol esters from soybean
    sources
    (d) plant stanol ester produced from vegetable oil sterols from soybean
    sources

    7 Milk and products thereof (including lactose), except;


    (a) whey used for making distillates or ethyl alcohol of agricultural origin for
    spirit drinks and other alcoholic beverages
    (b) lactitol

    8 Nuts, i.e. almonds, hazelnuts, walnuts, cashews, pecan nuts, Brazil nuts,
    pistachio nuts, macadamia nuts and Queensland nuts, and products thereof,
    except;
    nuts used for making distillates or ethyl alcohol of agricultural origin for spirit
    drinks and other alcoholic beverages
    9 Celery and products thereof
    10 Mustard and products thereof
    11 Sesame seeds and products thereof

    Page 2 of 3
    No. Materials Comment
    (not added-not
    used /added-used)
    12 Sulphur dioxide and sulphites at concentration of more than 10 mg/kg or 10
    mg/litre expressed as SO2
    13 Lupin and products thereof
    14 Molluscs and product thereof

    Page 3 of 3

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