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Corrective Action Request (CAR) Form

Company Name : PT. UNIVERSAL STEELINDO DINAMIKA Reference Standard : ISO 9001:2015
Audit Date : Auditor :
Audit Report Number :

Date of Verification
(Close Out)
Finding Clause Statement of the Systemic Due
Correction Root Cause Analysis PIC
reference concerned nonconformity Corrective Action Date
Client LMS

Date Acknowledged by Client Date Sign By Lead Auditor


16-17 Feb. 2017 20 07 2017
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Corrective Action Request (CAR) Form
Company Name : PT. UNIVERSAL STEELINDO DINAMIKA Reference Standard : ISO 9001:2015
Audit Date : Auditor :
Audit Report Number :

Date Acknowledged by Client Date Sign By Lead Auditor


16-17 Feb. 2017 20 07 2017
2|
Corrective Action Request (CAR) Form
Company Name : PT. UNIVERSAL STEELINDO DINAMIKA Reference Standard : ISO 9001:2015
Audit Date : Auditor :
Audit Report Number :

Please complete this form or alternatively complete your own internal corrective action form (including root cause analysis) then attach with objective evidence of actions taken
to contain, analyze and correct the non-compliance and for Major N/Cs forward to LMS Certification International for review (Max 7 days after Audit date).
Email to : auditor@lmscertification.co.id

LMS Certification International, PT


Office
tel +62 31 - 5018666
e-mail info@lmscertification.co.id
address Graha SA Office Building Lantai 8 BC 826
Jl. Raya Gubeng 19-21
Surabaya 60281 Indonesia
Visit our website at www.lmscertification.co.id / www.lmscert.com

Date Acknowledged by Client Date Sign By Lead Auditor


16-17 Feb. 2017 20 07 2017
3|