Corrective Action Request Form

• CAR Number

• Brief headline to identify issue

• Date Raised

  Date

• Issued to Department

  Select Hollowcore T Beam Precast Stairs Precast - General Welding Yard Contracts Design Sales

  • Hollowcore
  • T Beam
  • Precast Stairs
  • Precast - General
  • Welding
  • Yard
  • Contracts
  • Design
  • Sales

• Request Initiated By

Describe the Issue

• Describe the issue, problem or nonconformance in detail

• Type of issue

  Select Corrective Action (Existing Issue) Preventive Action (Potential Issue) Opportunity for Improvement / Suggestion

  • Corrective Action (Existing Issue)
  • Preventive Action (Potential Issue)
  • Opportunity for Improvement / Suggestion

• Source (How was it identified)

  Select Employee Customer Supplier / Subcontractor Feedback External Audit Finding Internal Audit Finding Management Review Action Item Other Issue - Enter Source Below

  • Employee
  • Customer
  • Supplier / Subcontractor Feedback
  • External Audit Finding
  • Internal Audit Finding
  • Management Review Action Item
  • Other Issue - Enter Source Below

Root Cause of the Problem

• Root Cause of Problem (Required for all corrective and preventive issues; optional for suggestions for improvement.)

• Why?

• Why?

• Why?

• Why?

• Why?

Short Term / Containment Action

• Details of any short term or containment action taken

Actions taken to eliminate root cause, resolve issue and prevent recurrence

• Enter Detail of Action Taken

• Action Taken by Name:

• Date Action Completed

  Date

EVALUATIONS PERFORMED TO ENSURE EFFECTIVENESS

• Enter details of how the action was evaluated to ensure it was effective

• Action Evaluated/Closed by:

• Date of Evaluation:

  Date