Corrective / Preventive Action Request

Part Name CAR No.

Part Number Affected Model
Supplier Lot Size
Address GRN No.
Originator Recipient
Date Date
1. Problem Statement: Photographs / sketch preferable
Specification Actual

Defect Frequency Total Quantity Rejected

2. Containment: Response is mandatory with in 24 hours.

Seggregation / Rework / Salvage lying at TAFE as WIP

Seggregation / Rework / Salvage at Supplier end WIP

Disposition of qunantity at Transit

Deviation Approval
3. Root Cause Analysis & Verification: Consider Man,Machine,Method,Material for each cause
Occurance Root Cause ( The cause which makes the problem occur)

Escape Root Cause ( The cause which has allowed the problem to go undetected to the customer)

System Root Cause ( System cause is one allows the Escape and Occur Causes to occur)

4. Corrective/Preventive Action & Verification:Plan a corrective action for every Occurrence, Escape and System root
cause.

5. Implementation:

Implementation Date: Effective with Serial No./Lot No.:

6. Documentation & Recognition: Standaradisation and Motivation

Verified by: Date Originator Approval: Date

SQA 01 002