GLOBAL SUPPLIER QUALITY MANUAL - Sloan Valve Company

CORRECTIVE ACTION PREVENTIVE ACTION (CAPA) FORM
CAPA# Date: Part # Material #
Severity Level
Requester: CAPA Owner: Department:
Major
Customer Complaint Process Improvement Internal Audit Preventive Action
Management Request Corrective Action Other (describe) :
Non-conformance:
Immediate Action Immediate Action due to QA by :
Root Cause Analysis
Performed by:
Long Term Corrective Action to Prevent Re-Occurrence (Action Plan)
Estimated Completion Date:
Corrective Action Responsibility:
Identify Similar Products or Processes Where Corrective Action Is Applicable:
Preventive Action Responsibility:
Estimated Completion Date:
CAPA Team Members:
Corrective Action Plan Approval
Satisfactory Unsatisfactory
QA Plan Acceptance Signature
Date
Verification (QA Audit of CAR Implementation and Effectiveness)
Objective Evidence:
Verification Auditor:
Verification Approval
Satisfactory
Unsatisfactory
Verification Signature
Date
Audit Date:
Close Date
37 April 2010 GQA SUPPLIER MANUAL 1-2010 (Rev 2).docx