CORRECTIVE/PREVENTIVE ACTION REQUEST (sample)
|CORRECTIVE/PREVENTIVE ACTION REQUEST |CPAR No. | |
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| |Corrective Action | |Preventive Action | |Opportunity for Improvement |
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| |Source |Reference |Comments |
| |Internal Audit | | |
| |External Audit | | |
| |Customer Complaint | | |
| |Product Deficiency | | |
| |Previous CPAR | | |
| |Other: | | |
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|Description of Nonconformance, Risk or Opportunity for Improvement: |
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|Initiator: | |Signature: |Date: | |
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|Received and Entered into CPAR System by: |Signature: |Date: | |
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|Assigned to: |Reply Due Date: | |
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|Root Cause: |
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|Actions Taken or Planned: |
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| |Planned Completion Date: | |
|Submitted by: | |Signature: |Date: | |
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|Comments by Approval Authority: |
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|Approved by: | |Signature: |Date: | |
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|Followed Up by: | |Signature: |Date: | |
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|Effective? | |Yes | |No |Evidence: |
| | | | | | |
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|Closed Out by: | |Signature: |Date: | |
|Alloys International Form 8.5.1 Rev 01-04-06 |
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