Scribd
Upload
28 views3 pages

EMS CPAR Form (9-27-10)

Uploaded by

f09ai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
28 views3 pages

EMS CPAR Form (9-27-10)

Uploaded by

f09ai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd

Corrective and Preventive Action

U.S. Department of Commerce


Request (CPAR) R1 DRAFT 9/27/10
CPAR #
PART 1 - ORIGINATION
1. Originator
Name Organization Phone E-Mail

2. Type
Corrective Action Preventive Action
(Actual Nonconformance) (Potential Nonconformance)
3. Source
Audit - Internal Customer Complaint / Feedback

Audit External Product / Service Problem

4. Date of CPAR Request / / 5. Audit Number, if applicable


6. Process / Procedure, if known
Document Title / Number Reference Paragraph
ISO 14001:2004, Para. _______

7. Description of Problem (Cite Objective Evidence)

EMS CPAR-FORM Rev 2 Page 1 of 3


Effective Date: 3/20/06
EMS CPAR-FORM Rev 2 Page 2 of 3
Effective Date: 3/20/06
PART 2 - ASSIGNMENT & PROPOSED ACTION
8. Assigned to
Name Organization Phone E-Mail

9. Root Cause of Problem

10. Investigative Action To Take

11. Due Date


_ /__/__
12. Action Taken

13. Action Verification

14. Effectiveness of Action Taken

15. Action Approval


____/____/____

EMS CPAR-FORM Rev 2 Page 3 of 3


Effective Date: 3/20/06

You might also like