555579693.

xlsx PSR Summary

Problem Solving Report Date Opened:

D0 - Customer Reported problem:

Date Reported: Qty Rejected: Customer Reject No.

Customer Name: Customer Contact: Phone No.

D1 - Team
Role Name Function Phone Email
Champion
Leader
Member
Member

D2A - Problem Statement

D2B - Problem Description

Brief Problem Description
What:
Where:
When:
How big:
D3 - Containment Action(s)
No. Action Description Resp Date Verification (Methods and Results)
Initiated Comp

D4A - Occur root cause

Verification (Methods and Results) Date Verified:

D4B - Escape Root Cause

Verification (Methods and Results) Date Verified:

D5/D6 - Permanent corrective actions (occur and escape)

No. Action Description Resp Date Validation (Methods and Results)
Target Comp

D7 - Preventive Actions
No. Action Description Resp Date Validation (Methods and Results)
Target Comp

This document is Electronically Controlled in the Policies and Procedures website on Imagine. Printed copies are
considered uncontrolled. F02-PR-ACC-05
555579693.xlsx PSR Summary

D8 - Team/ Individual Recognition & Approval

Approval: (electronic approval is acceptable if kept as record attached to the 8D summary)

Signature Name Title Date

Quality Lead

Operations Lead
If applicable

If additional signatures required

If additional signatures required

If additional signatures required

This document is Electronically Controlled in the Policies and Procedures website on Imagine. Printed copies are
considered uncontrolled. F02-PR-ACC-05