PT.

BATTERY POWER SOLUTIONS INTERNATIONAL

CORRECTIVE ACTION REQUEST FORM/
FORM PERMOHONAN TINDAKAN PERBAIKAN/

AUDITOR : IQA CR NO. :

SECTION AUDITED : DATE :
NON-CONFORMANCE/ :
KETIDAKSESUAIAN

REVIEW BY
(QA/QC MANAGER)

CORRECTION ACTION/TINDAKAN PERBAIKAN

CAUSE OF NON-CONFORMANCE / PENYEBAB KETIDAKSESUAIAN

RESPONSIBLE BY : DATE :
(MGR-AUDITED DEPT)

CORRECTIVE ACTION / TINDAKAN PERBAIKAN

RESPONSIBLE BY : DATE :

FOLLOW-UP AUDIT REMARKS / TINDAK LANJUT

AUDITED BY DATE :

FM/IQA/004, Rev.01 P1/1