Level: Tier:

Document Type:

Sub Element: Supplier Quality

Doc Number: SRS-QA1014-1

Rev: A

Effective Date: 27 Jun 2018

Supplier Corrective Action Request (SCAR)

Contact Information

(to be completed by Baker Hughes)

Supplier’s Name & Address: SCAR Number:

PT. NUSCACO ANTI KOROSI INDONESIA 201164448

Supplier SAP ID Number: Issue Date:

10108610 30 September 2019

Supplier Contact: Supplier Contact phone & email:

TONI ERLANDA, ST +62 21460 8686 & tonierlanda100@gmail.com

BHGE Contact/Initiator: BHGE Contact phone & email:

SUMALI +62 542.764.579 & sumali.sumali@bakerhughes.com

BHGE Location: BHGE Location Physical Address:

BHGE - Indonesia Tenaga Uap, Kalijapat, Ancol Timur, Jakarta Utara, Indonesia

Non-conformance Description

(to be completed by Baker Hughes)

Reason for request:

Quality System
Site Audit or Assesment
Quality Performance Rating
Product or Service Nonconformance
Repetitive Nonconforming Condition
Field Nonconformance
Other: Desktop Audit
On Time Delivery

Part No.: Serial/Batch/Tracking No.: WO/PO No.:

/conversion/tmp/scratch/466130205.docx MA-GLB-En-100030B_BHGE Rev. C

Copyright 2018 Baker Hughes, a GE company, LLC (“BHGE”) (unpublished work).  All rights reserved.  The information contained in this document is confidential and
proprietary property of BHGE and its affiliates.  It is to be used only for the benefit of BHGE and may not be distributed, transmitted, reproduced, altered or used for
any purpose without the express written consent of BHGE.

Uncontrolled when printed or transmitted electronically Page 1 of 4 Baker Hughes, a GE company – Confidential
 Level: Tier:

Document Type:

Sub Element: Supplier Quality

Doc Number: SRS-QA1014-1

Rev: A

Effective Date: 27 Jun 2018

Supplier Corrective Action Request (SCAR)

PPA 52248 & PPA 52249 NA 4510337384

QN No. / Report No.: Complaint Quantity: Total Delivered Quantity:

NA NA 2

Requirement: (The BHI, API or ISO requirement that was not in compliance)

7.2 Competence

The organization shall:

a) determine the necessary competence of persons doing work under its control that affects the performance and
effectiveness of the quality management system;

Description of Problem: (A thorough description of the problem identified to ensure complete understanding of the issue, including how the
requirement was not met, and a description of how the observed condition has impacted or could impact the product)

There is no evidence to show that the Management Representative (MR) assigned has received training Quality
Management System as per ISO 9001:2015, where MR have responsibility to ensure PT Nuscaco Anti Korosi Indonesia
NAKI Quality Management System is effective implemented.

As confirmed during interview MR, that Quality Management System training or awareness has not been carried out
for employees who have task involved in NAKI's QMS implementation.

MR responsibility to ensure NAKI's QMS, but identified during desktop audit that does not involve top management
NAKI.

Objective Evidence: (Such as pictures, drawings, sketches, etc)

MR Qualification which related Quality Management System implementation QMS Auditor, QMS Awareness, etc.

There is no evidence training QMS delivered to employees.

Severity High Medium Low

:
Requires an initial response within 24 to Requires an initial response within 7 Requires an initial response within 15
48 hours. calendar days. calendar days.

Initial Response Required by Additional Comments:

Date:
Corrective action completed with evidence
15 October 2019

/conversion/tmp/scratch/466130205.docx MA-GLB-En-100030B_BHGE Rev. C

Copyright 2018 Baker Hughes, a GE company, LLC (“BHGE”) (unpublished work).  All rights reserved.  The information contained in this document is confidential and
proprietary property of BHGE and its affiliates.  It is to be used only for the benefit of BHGE and may not be distributed, transmitted, reproduced, altered or used for
any purpose without the express written consent of BHGE.

Uncontrolled when printed or transmitted electronically Page 2 of 4 Baker Hughes, a GE company – Confidential
 SRS-QA1014-1 Rev: A

Effective Date: 27 Jun 2018

Supplier Corrective Action Request

Initial Response - Investigation and Root Cause Analysis

(to be completed / Provided by Supplier)

Immediate Correction / Containment : (In your Containment Actions, please include all activities to Contain this issue with all product
you have on hand, as well as any actions taken to address any inventory at BHGE or its agents).

conduct auditor training as evidenced by a Auditor certificate

Cause:

Component Failure
Not Following Procedures
Design
Training
Inadequate Procedures
Unconfirmed

Root Cause / Cause Description: (Human Error / Carelessness is not an acceptable root cause. In your Root Cause, please include your
efforts to determine Root Cause, your evidence that the Root Cause has been positively identified and confirmed, as well as results of your
investigation as to how the Root Cause occurred).

not yet certified internal auditors

Corrective Action / Corrective Action Plan: (Actions to eliminate the causes of nonconformities to prevent their recurrence. In your
Corrective Actions, please include your actions to eliminate the issue(s) in existing inventories and current builds, as well as Lot / Date Code
identification for product with the actions applied). If it is a major project then a specific corrective action/quality improvement project plan with tasks.
responsibilites and due dates is required.

schedule internal auditor training and be approved by top managemen

Risk Management (Preventive Actions): (In your Risk Mitigation Actions/Preventive Actions, evaluate the need for action to eliminate
the cause(s) of the nonconformity to ensure it does not occur or could potentially occur in similar products / processes and to prevent future escapes.
Provide traceability information identifying all product which has been corrected or verified as compliant.

     

Action Plan Target Completion date: (Date the implementation of the above action is expected to be complete)

November 20, 2019

Corrective Action Implementation

(to be completed / Provided by Supplier)

Evidence of Corrective Action implementation: (Attach copies of revised documents (procedures, drawings, work instructions,

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 SRS-QA1014-1 Rev: A

Effective Date: 27 Jun 2018

Supplier Corrective Action Request

etc), photographs, training records, etc. demonstrating that the corrective actions were implemented as planned. Your internal corrective action
documents may also be submitted to support your responses)

Attached

Verification of Corrective Action Effectiveness: (For Verification of Effectiveness, include detailed results of internal audits, follow-
up checks, data (product/process monitoring results),etc., demonstrating that the implemented Corrective Actions have effectively eliminated the
source of the problem.)

Attached

Follow up/Notes:

     

Completed
Toni Erlanda Title: Management Repsentative
by:

Telephone
(+62) 81212601918 Email: tonierlanda100@gmail.com
#:

Effectiveness Review

(to be completed by BHGE)

Summary of Supplier Action Implementation and Effectiveness Evidence Review:

     

Follow Up Audit / Data Verification Required?

Scheduled Audit Date:      
Yes No

Will actions taken prevent recurrence? Yes

Date Effectiveness Reviewed:      
No

Effectiveness of Action Taken / Comments:

     

Approved by:       Date:      

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