BHUNESHWAR RAM

VENDOR CODE: BJ22

FORM NO: TSL/WB/CSMS/BJ22/5S/CAPA REV: 02 EFFECTIVE DATE: 1ST JAN 2020
CORRECTIVE/PREVENTIVE ACTION RECORD
CPAR
CPAR#

INITIATOR: DATE:
IMMEDIATE CAUSE:

Quality Issue Procedural Issue

Behavioral issue Machine malfunction
Psychological issue Environmental issue
Physical issue Human Error
Non Conforming Product Capability/ Management issue

DESCRIPTION OF ISSUE: ____________

____________

CPAR ASSIGNED TO: RESPOND BY:

WHAT WAS DONE TO REMEDY THE ISSUE?: (CORRECTIVE ACTION) ___________

___________

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ROOT CAUSE:

WHAT ACTION WAS TAKEN TO PREVENT THE CAUSE OF THE ISSUE? :( PREVENTIVE ACTION)

____________

____________
COMPLETED BY: DATE:

(THE AREA BELOW IS TO BE FILLED OUT BY VENDOR)

REVIEW FOR EFFECTIVENESS: ____________________

______________

______________

AUDIT REQUIRED:  YES  NO

Reviewed by: Date: