RA,
To
Copies to
After completing this form, please forward to
Att. Bpk TYAS/Bpk Samsudin
Workshop Manager
Corrective Action Request Form
Control Number: QA/QC-CAR-001
: PT. PGAS SOLUTION ( Departement Manufactur & Repair )
PT. PGAS SOLUTION ( PIR )
PGN/PMO Representative
SECTION 1: To be completed by the requestor Today’s Date
Person(s) Requesting Corrective Action:
‘QA/OC Inspector ;
Zainal Abidin :
ENGINEER:
ARDIKA/A Rasyid
so
Location/Dept : PT. PGAS SOLUTION /Dep'
Manufactur & Repair
Location : Workshop Klender
Date: July 17,2019
Fabrikasi pipe spool MRS sbb:
1 Fabrikasi 7 unit MRS P3E1 ( Area Palembang )
2. Fabrikasi MRS G16 ( PT. Siloam Internasional
Hospial )
Berdasarkan Visual check dan pengukuran bahwa
Jarak pengelasan (welding seam) sangat
berdekatan,kurang dari $ mm tidak sesuai dengan
standard PGN berdasarkan Panduan Konstruksi
Baja no, Doc. PKP-CTE-ON-CS-001 Bab X (
Pengelasan ) para. 10.10.10 ,, Jarak minimal antar
seam harus 5 x tebal pipa atau 50 mm tergantung,
‘mana yang lebih besar
Dan juga desain drawing yang di ajukan belum
disetujui oleh pihak PMO-PGN namun konstruksi/
fabrikasi pipe spool MRS telah dilakukan
Berdasarkan hal terscbut maka hasil fabrikasi pipe
spool tidak bisa diterima ( Reject ). Oleh karena itu
PGAS Solution harus membuat baru sesuai standard
PGN,
THIS SECTION TO BE COMPLETED BY THE CORRECTIVE ACTION REVIEW TEAM
ONLY:
Type of CAR: [ X ]Process Correction [JRemedial
[Customer Concern
Action [ ]Prev. Action [ ]Work Order
Responsible person(s) to complete section 2: Dept. M&R
Date sent : 19 July 2019Ze
psn Corrective Action Request Form
001
energy for lite Control Number: QA/QC-CA\
SECTION 2: Process Correction Action Plan ~ To be completed by the responsible person(s)
Please respond to the originator within five (5) working days of receipt.
‘What is causing the problem or concern recorded in Section 1 to oceur? —
‘Use adional pape as necesany_ATtach any relevant ecors or documents
‘What action has been, or will be taken to correct the identified problem or concern?
Use akitional papers necessary. Attach any relevant records or documents
Implementation Date of the Above Stated Action: (If Applicable)
Date:
‘ompleted form or contact PMO by the required response date:
SECTION 3: Verification & Closeout Information. For Corrective Action Team Use
Only.
Has the documented action been implemented and is effective? [] Yes []No
Is the original requestor satisfied with the outcome of the action taken? [] Yes [] No
Notes
Verified and Closed-out by: Date: