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प्रणाली · 120 कागजातCulvert-Tank Installation Integrated Industry Suite को भाग

Quality Incident and Corrective Action Report Form

फारम · FORM-31362

संस्करण 1

Use this form to report a quality incident and record the corrective action taken. The person reporting the incident completes Part A, and the investigation and corrective action follow in Parts B to D.

It records the contacts to notify, the reporter's details, where and when the incident happened, what happened and its impact, the immediate response, witness details and the supervisor's sign-off.

It then records the investigation, the root cause, a register of preventative actions with due dates and responsible people, the approval of the course of action, and the sign-off that the actions are complete and effective.

Written by SafetyDocs safety experts, who have been writing safety documents since 2004.

Quality incident/corrective action report form

फारमVersion 1

Name:: —
Contact No:: —

Email:: —

Name:: —
Contact No:: —

Email:: —

Part A. To be completed by the person reporting the incident

Title (Mr, Mrs, Ms, Miss): —
Last name:: —
Other name/s:: —
Phone (W):: —

Phone (H):: —
Phone (Mob):: —
Email address:: —

Incident location:: —

Date and time of incident:: —

Description of incident

Actual/potential impact?

Immediate action response taken

What do you think could have been done to prevent this incident from occurring?

Any other comments or observations?

Witness details (if applicable)

Name of Witness 1:: —

Phone:: —

Name of Witness 2:: —

Phone:: —

Name of Witness 3:: —

Phone:: —

Name of Witness 4:: —

Phone:: —

Supervisor/s sign-off

Name:: —
Signed:: —

Date:: —
Phone:: —

Name:: —
Signed:: —

Date:: —
Phone:: —

Part B: Investigation checklist

What factors caused the incident (e.g. management, the work environment, equipment, maintenance, individual)?

What do you think could have been done to prevent this incident from occurring?

Any other comments or observations?

Part C: Corrective action report

Corrective action

Root cause and preventative action to be taken to reduce the risk of the incident happening again

Root cause:: —

Recommended preventative action		Responsible person	Action status	Date completed

Part D: Approved actions

Print name:: —

Signature:: —

Verification that corrective actions have been completed/implemented and are effective

Signed off by:: —

Position:: —
Signature:: —

Date of incident closure:: —

यसको मार्गदर्शन र नमुना प्रविष्टिहरू लक गरिएका छन्

फारमको बनावट कस्तो छ तपाईं देख्न सक्नुहुन्छ। जुनसुकै डिभाइसमा भर्न, प्रिन्ट गर्न वा आफ्नो बनाउन यो लिनुहोस्।

एडिटर निःशुल्क चलाएर हेर्नुहोस्यो प्रणाली लिनुहोस्

ब्राउजरमा यो कस्तो देखिन्छ

यो प्रणाली लिनुहोस्

निःशुल्क साइन अप गर्नुहोस्, अनि कसरी लिने छान्नुहोस्। हरेक कागजात तपाईंको लाइब्रेरीमा, प्याकको नाम दिइएको फोल्डरमा जान्छ।

सशुल्क प्लानहरूमा समावेश
आफ्नो प्लानका टेम्प्लेट क्रेडिट प्रयोग गर्नुहोस्। यसको मूल्य 20 हो।
प्लान र मूल्य तुलना गर्नुहोस्
एकपटक किन्नुहोस्
$999.90 एकपटक तिरेपछि सधैँ तपाईंकै। निःशुल्क प्लानमा पनि चल्छ।

एडिटर निःशुल्क चलाएर हेर्नुहोस्निःशुल्क साइन अप गर्नुहोस्

साइन अप गर्न कार्ड चाहिँदैन। प्रारम्भिक पहुँच सदस्यहरूले जुनसुकै प्लानमा 30% छुट पाउँछन्।

यसले के समेट्छ

26 फिल्ड

Name
Contact No
Email
Title
Last name
Other name/s
Phone
Email address
Incident location
Date and time of incident
Name of Witness 1
Name of Witness 2

र थप 14

टेम्प्लेटहरू कसरी काम गर्छन्

यसलाई पैसा तिर्नुअघि नै चलाएर हेर्नुहोस्।

निःशुल्क पूर्वावलोकन
हरेक टेम्प्लेटका कामका चरण, खतरा र पहिलो काम पढ्न खुला छन्। साइन अप चाहिँदैन।
एडिटर चलाएर हेर्नुहोस्
कम्प्युटर वा फोनमा, डेमो SWMS लाई आफ्नो कम्पनी, काम र साइटअनुसार मिलाउनुहोस्।
निःशुल्क साइन अप गर्नुहोस्
तपाईंको विवरण र लोगो सर्छन्। यो टेम्प्लेट विवरण भरिएरै खुल्छ।
क्रेडिट प्रयोग गर्नुहोस् वा एकपटक किन्नुहोस्
सशुल्क प्लानहरूमा हरेक महिना टेम्प्लेट क्रेडिट आउँछ। वा सधैँका लागि यो एउटा किन्नुहोस्।

Quality Incident and Corrective Action Report Form