M/S ANIMA ENGINEERING

Corrective and Preventive Action Form REVISION NO. : 00

From
CAPA No : Environmental
Nonconformity from audits Suggestion for improvement complaints/notices/external Other …………………
AE/OHS/001 incident
parties
Training
Revision No : 00 Document control System failure Wrong instructions Contractor fault Operator fault
Raised by:       ASSIGN TEAM : Date:       Reference Doc :
Description:       Reference Date :

Proposed immediate action - Corrective Action:      

Completed by:       Date:       Remarks:      

Root cause analysis required: Yes No

Underlying / root cause:      

Determined by:       Date:       Remarks:      

Proposed action for long term solution - Preventive action

Closed out by:       Date:       Remarks:      

Issued Resolved On: ____________________

Continuing to be Reviewed: ______________ Next Planned Assessment: ___________________

________________________________________ _______________
Corrective / Preventive Action Plan Preparer’s Signature Date of Signature