REV : 0

NON CONFORMANCE REPORT /

CORRECTIVE AND PREVENTIVE ACTION REQUEST DATE: 26 Mei 2022

(NCR/CPAR) PAGE: 1 of 2

SECTION A – DATA INFORMATION

CPAR No: W2022A-MTDF-QC-340-NCR-EP-0001 Issued Date: 28 April 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:

Pemasangan besi fillet pond tidak dimasukkan di antara besi wall sisi dalam dan luar, melainkan di atas
sisi dalam besi wall pond.

Name of originator: Title: Signature: Date:

Elrio Putra QC Inspector 26 Mei 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:

 REV : 0
NON CONFORMANCE REPORT /
CORRECTIVE AND PREVENTIVE ACTION REQUEST DATE: 26 Mei 2022

(NCR/CPAR) PAGE: 2 of 2

Based on Drawing: Aktual:

Pemasangan besi Fillet Wall Pond berdasarkan gambar desain Pemasangan aktual besi Fillet Wall Pond

Dokumentasi