Special / Pass-Thru Characteristics Form

Water Valley Addendum (additions in yellow)

Part Number
Part Rev
Supplier

Date

PFMEA Severity [use AIAG]

Measurement Systems Analysis Capability Study

Special [S.C]

Status R/Y/G
PFMEA RPN
Functional

Special Gage? Sample Qty &

Gage Correlation (Duplicate Gage needed Production Subgroup
Special or Pass Through Characteristic Specification Impact of Failure Current PFMEA Process Controls Date of Study Gage Name / # R&R Complete? at BW Yes/No) Date Lot Qty Size X Bar sigma Cp Cpk Pp Ppk Corrective Action
Fit

Target Date

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Prevention:

Detection:

Date Sign
BW Supplier Dev. Representative

Supplier Representative:

674594220.xls
Page 1 of 1 Rev. Date: 27-MAY-08
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