Performance Verification report for cotton inserter 1

This article contains information about Performance Verification report for cotton inserter

Performance Verification report for cotton inserter


To ensure that the Cotton Inserter is capable of inserting the cotton pieces as per set length.


Applicable to Cotton insertion by using cotton inserter machine in container packing line.

Site of study:

Packing Department

Location: _______________.

Validation Team:

Representatives from:

Packing                 : ________________

Quality Assurance : ________________

Engineering            : ________________

Description of the Equipment to be Validated / used:

Equipment                        : Cotton Inserter

Code No.                          : __________

Make                                : __________

Cotton inserter machine Qualification done on: ____________

 Standard Operating Procedure (SOP) to be followed:

 SOP for Operating of Cotton inserter machine POP: ________________


  1. Cotton in roll form. : _____________
  2. Speed of machine. : _____________
  3. Standard weight of cotton to be inserted. : _____________
  4. Size of container                                           : _____________



Sr. No.






Calibration done on



Calibration due on





Sr. No.


Name Training Status Availability of reports Checked By


 Precautions :

Proper safety aspects must be followed.

 Validation details of Verification of cotton inserter

Carry out Validation as per the Validation Protocol.

Comparison of length with weight of cotton :

1. 100 MM 1 GM
2. 200 MM 2 GM
3. 300 MM 2.5 GM
4. 400 MM 3 GM
5. 500 MM 5 GM

Based on above annexure length of cotton to be set as required on amount of cotton to be filled in the container as per specification / batch Packing Record.

1. Equipment:
2. Product:
3. Batch No:
4. Item code for cotton:
5. A.R. No. of cotton:
6. Container fill Value:
7. Date of experiment:

Acceptance criteria:

  1. The container should contain exact quantity set in program.
  2. The product should not get damaged.
  3. Weight of cotton should be within the limit

Type of Validation:

Concurrent Validation:


One validation exercises every two year.


Details of Deviation (if any):


Deviation Report Number Deviation Report Dated Checked by

Details of Out of Specification (if any):

OOS Report Number OOS Report Dated Checked by

Observation and Results:

Weighing Balance code No: _______________                  Calibration done on:_______

Standard fill value of cotton per container: ___________    Calibration due on:________

Number of cotton pieces: _______________



Date. Time  
Quantity of cotton observed ±   10  %
Rejection observed if any
1 2 3 4 5  


Date. Time  
Quantity of cotton observed ± 10 %
Rejection observed if any
1 2 3 4 5  


Summary of finding of experiment (inference):






Team Approval:



_____________          _______________            _____________

Packing                      Quality Assurance               Engineering


Date:                           Date:                                    Date:




Review: (Inclusive of follow up action, if any)







Approved by:



__________________                                   ____________

Quality Assurance                                            Plant Head


Date:                                                                Date:









SOP         : Standard Operating Procedure

OOS         : Out of Specification

A.R.          : Analytical Reference

No.            : Number

You may also like...

Leave a Reply

Your email address will not be published. Required fields are marked *