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NON CONFORMANCE REPORT /

CORRECTIVE AND PREVENTIVE ACTION REQUEST DATE: 02 Juni 2022

(NCR/CPAR) PAGE: 1 of 2

SECTION A – DATA INFORMATION

CPAR No: W2022A-MTDF-QC-340-NCR-EP-0002 Issued Date: 02 Juni 2022
Process Owner
Dept/Contractor: PT. Aimtop Nuansa Kimia PT. Aimtop Nuansa Kimia
/Discipline:
Kontrak Jasa Pembangunan ATU Permanen
Contract Title: Contract No: Kontrak No. 3900516002
Terintegrasi di CPP Matindok
Ref. Document/ Kontrak No. 3900516002, Lampiran A1, poin
NC Location: CPP Matindok
Standard & Clause 2.8.3

Description of non-conformance found:

Pola bengkokan pada ujung tulangan Slab Control Room panjang aktual terpasang hanya 4 cm untuk
besi 10mm. Berdasarkan "Standar Detail Pekerjaan Konstruksi Beton" Doc. No. WW2022A-MTDF-CV-
340-DTL-001, disebutkan minimum E.I. adalah 8d.

Name of originator: Title: Signature: Date:

Elrio Putra QC Inspector 02 Juni 2022

SECTION B - CORRECTIVE AND PREVENTIVE ACTION PLAN

Action Plan:

Name of Process Owner: Title: Signature: Target Date to Close Out:

SECTION C – FOLLOW UP & VERIFICATION

Verification Result:

Verified by (Name): Title: Signature: Date:

Need further follow up action? Yes No

SECTION D – CLOSE OUT

Close out of NCR/CPAR: Yes No

Closed out by (Name): Title: Signature: Date:

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NON CONFORMANCE REPORT /
CORRECTIVE AND PREVENTIVE ACTION REQUEST DATE: 02 Juni 2022

(NCR/CPAR) PAGE: 2 of 2

Bengkokan Ujung Tulangan Besi d = 10 mm

Dokumentasi