Issued No.

CAR
Date
(Corrective Action Report) Page of

Classification(CAR )

Customer Complaint Management Review

Action
Team Internal Audit findings Performance / Process Performance
External Audit findings Risk Assessment
Issued HSE Issue New Process
Team Identified problems Others

Problem Description

Dead line for action plan submitted:

Issued by : Date : Action Team : Date :

Root cause & action plan

Root cause Action (to be) Taken Dead line Verified By

Prepared by Date Approved by(Action Date QHSE Dept. Date

Dept/Div.): Manager :

Evaluation of the action

Verified by : Approved :

Satisfactory: Yes No Remark :

Improvement Activity:
Yes No

DK/QAP/QHS/12-FR/03-R6 / Issue Date Oct. 2, 2017