TCM-F-IMS-014

Form (F)
QSE Division / Quality Department
Title Nonconformity Report (NCR)
Detail of Nonconformity NCR No. : Nonconformance Source:

Department/Area : Contractor Management Date : 22 Mei 2024 Internal Audit

Auditee/Owner Name : PT. PAMA Request/Complain

Auditor/Creator Name : PT. TCM / Eko Ariyanto Noncompliance
Others
Major Minor Observation

Detail of Nonconformance : Tidak ada unit excavator yang dilengkapi dengan cutting edge untuk Cleaning Coal

Immediate Cause : PT. PAMA tidak comit support unit cleaning coal menggunaikan cutting

Root Cause :

Document Reference : Dokumentasi Foto dan Vidio

Auditor/Creator: Auditee/Owner: Superior:

Eko Ariyanto
Date : 22 / Mei / 2024 Date : / / Date : / /

Corrective & Preventive Action

Verification
No. Activity PIC Due Date
Date Auditor/Creator
1 Pemenuhan dan pemasangan komponen PC Cutting untuk 1x PC 300 dengan CN Cristianus / Nasrullah 24 Mei 2024
Unit GSMEX022

Comment :

Review of Corrective & Preventive action Result Revision of Document

Follow up Result : SOP
Work Instruction
Evidence : Standard Parameter
Form
Conclusion : Others
Close
Not Close (Issue new NCR)
Postpone Comment :
Auditor/Superior:

Date : / /

Effective Date: 1 July 2011

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