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MCDOC02055294 - QM Sample Inspection Report
MCDOC02055294 - QM Sample Inspection Report
Company Name
Project
SIR Recipient (please send all sampling documents to following E-Mail address)
Level of Component Q-Qualification: "C" = Only SIR Short text stating reason for sampling:
In case of Level A or B please expand the sheet and select the enclosed CQP-items
Please select the enclosed items related to this SIR
19 BSH Sample Inspection Report (cover sheet) (Items nr. 11, 18, 19 and 22)
a Measuring Report / c Material Report/ e Appearance g Reliability Test 11 Supplier declaration (RoHS, REACH)
Process capability analysis
22 (Ppk;Cpk)
Dimension Check Material Test
b Functional Test d Haptics/ Acoustics/ f Surface Check h Other: 18 Machine capability analysis (Cm;Cp)
Odors
We confirm, …
Supplier Part No. Delivery Note Date BSH Tool No.
1.
that the presented samples were
manufactured under standard conditions using Delivery Note No. Quantity Delivered (total) Number of Tool
to be completed by supplier
Limited Release,
###Quantity/ until Date #NAME?
###No Release
New Samples by
(Date)
#NAME?
#NAME? #NAME?
Name / Department Phone & Fax / E-Mail Date Signature
QM department Remark: Independent of the requested items the supplier has to document all applicable records, have to make them available
Milestones / on request and is responsible to ensure the part quality.
Synchronisation
points for: Prior to placement of order this document has to be agreed between BSH QM and Supplier.
The signed component qualification planning has to be send to the responsible BSH QM within 2 weeks after receipt
Planned without explicit request. This document is part of the release documents.
Level of Component Q-Qualification ### date
A B C Delivery
No. Item
date
Comments
BSH Part Classification
1 BSH specification X X X -
2 Feasibility study X X -
4 Production Layout X -
6 Control Plan X -
9 Design Release X -
12 FMEA Process E -
e Appearance -
f Surface check -
g Reliability test -
h Other: -
20 Reference samples -
23 -
24 -
25 -
Remark
Item-No.:
Nominal value Upper allowed Lower allowed Additional Information Actual value (Supplier) Actual value (Customer
Drawing deviation deviation
Field: 1 2 3 1
#NAME? Page: 1 of
#NAME?
#NAME?
Quantity Ordered:
#NAME?
date:
date:
Modify tool by BSH
Change Drawing
Correct tool by
supplier
New target
Actual value (Customer) value
2 3
Remark
Item-No.:
Nominal value Upper allowed Lower allowed Additional Information Actual value (Supplier) Actual value (Custome
Drawing deviation deviation
Field: 1 2 3 1
#NAME? Page: of
#NAME?
#NAME?
Quantity Ordered:
#NAME?
#NAME?
Correct tool by
supplier
New target
Actual value (Customer) value
2 3
Remark
Item-No.:
Nominal value Upper allowed Lower allowed Additional Information Actual value (Supplier) Actual value (Customer
Drawing deviation deviation
Field: 1 2 3 1
#NAME? Page: 1 of
#NAME?
#NAME?
Quantity Ordered:
#NAME?
#NAME?
date:
date:
Modify tool by BSH
Change Drawing
Correct tool by
supplier
New target
Actual value (Customer) value
2 3
Remark
Item-No.:
Nominal value Upper allowed Lower allowed Additional Information Actual value (Supplier) Actual value (Customer)
Drawing deviation deviation
Field: 1 2 3 1 2
Page: 1 of
#NAME?
#NAME?
Quantity Ordered:
#NAME?
#NAME?
date:
date:
Modify tool by BSH
Change Drawing
Correct tool by
supplier
New target
Actual value (Customer) value
1.
2.
3.
4.
5.
6.
7.
8.
9.
Comments
#NAME?
#NAME?
Quantity Ordered:
#NAME?
#NAME?
complete by BSH
MPP MPP
(Material) (Measure)
Remark
Department:
delivery specification
1935/2004 and/or FDA
EU RoHS Directive 2011/65/EU
carried out?
Self-colouring / Selbsteinfärbung SIR- or
REACH Candidate List RP-no.
Colour index Supplier of Raw Modification / Modifikation
Part Material Manufacture of Farbe (first release of
Change History name
Remarks
possibly concerning DIN/ISO Raw Material
Trade Name
(concerning
Material
Lieferant (Material)
EU RoHS
compliant
EU RoHS
compliant
EU REACH this raw material
manufacturer) only if deviating to B SVHC connected to
without with
PPN c. Layer Candidate list part name)
version
10
B metal parts B
10
C rubber parts C
D oil/resin/paste/grease D
E others / mix E
Px Address Applic.
Abbrv.
FCGA
FCGB
FCGCa
FCGF
FCGI
FCGL
FCGM
FCGNa
FCGNb
FCGNb (2)
FCGS
FCGT
FCGWr
FCPB
FCPI
FCPN
FCPNa
FCPT
FCPV
FCPR
PCP/TE-TPB
PDC
FDCD
FDCE
FDCE
FDCI
FDCL
FDCM
FDCNb
FDCCh
FEDM
FEDNa
PED
PLC
FLCC
FLCCn
FLCD
FLCI
FLCL
FLCN
FLCNa
FLCP
FLCW
FRFC1
FRFC2
FRFCa
FRFE
FRFG
FRFI1
FRFI2
FRFP
FRFWr