8-D ACTION REPORT
Preventive Corrective Process Product Safety
AR#
Audit
Date AR Issued Customer Complaint # Originated By: Product/Process Related Information Part Number
Customer: RMA Number: Date:
Internal
External
Sales order job #
DMP Job #
Quantity Produced Disposition: Rework
Quantity Defective
Move to Dept.
Responsible Dept.
Sort
Change Req.
Scrap
Other
Personnel Information Individual Involved Clock # Date:
Statement of deficiency:
Immediate Action / Containment:
Interrupt process
Purge Stock
Stop/recall shipments
Dimensional verification
Schedule Replacements
Contact supplier/ Customer
Similar product and processes affected:
Description of deficiency:
Validation of AR: Disposition / Instructions to correct
Dept:
Date Due
Date Complete
Rework Router
Send RCA
Deviation
Cust. 8-D
Other
CA Cost
AR#
8-D ACTION REPORT
Root Cause Cause Code# Cause Code
Page 2
Corrective Action / Steps Taken to Prevent Recurrence
Dept. Supervisor: Dept. Supervisor: Dept. Supervisor:
Engineering/Other: Rev. A
Date Due
10/18/2007
Date returned
Date Due
Date returned
Date Due
Date returned
Date Due
Action Report-AR Date returned
Controlled in Software
When you fill in the Required Information, Save and return to QA Analyst Effectiveness Verified By: Verification Form/Tag: Internal Audits: Other:
Implementation / Objective Evidence Verified By: QA Signatures: Comments: Congratulate the team:
Date Due Date returned
Management Approval for Corrective Action Completion:
Management : Date Due: Date returned
Comments:
When you fill in the Required Information, Save and return to QA Analyst
Rev. A
Action Report-AR
Controlled in Software