Crude Oil Export Facility Reconstruction Project

for South Oil Company, IRAQ

(SEALINE PROJECT)

Corrective Action Request Form

CORRECTIVE ACTION REQUEST FORM

CONTROL NO. ___ (8)___
To: ( LO Onshore Construction Manager )
Copies to: SOC, PMC Amman Office

SECTION 1 [Non-Conformance Observation]*

Person Initiating Corrective Action

Date: 30-01-2014

(PMC Inspector)

Signature:

Suresh Raghavan

Pipeline-welding

Location/Dept

Describe the problem. Use additional paper if necessary. Attach any relevant records or
documents.

What is the problem?

What is your suggested solution?

LO need to take necessary

1- According to WPS HAK0348,

actions to provide crayons to

minimum preheat temperature is 125 C

each joint welding groups(at

and maximum inter pass temperature is

least 2 for a joint) to ensure

250C. During surveillance noted,

minimum specified

welders not keeping any device (thermo

temperature before and during

meter or crayons) with them to

welding)
.

measure the temperature.

Type: []Corrective Action [ ]Preventive Action [ ]Suggestion [ ]SOC Customer

Concern
[* All above Section 1 data to be completed by the Initiator for review by the Employer/PMC
before issue.]
Issued by Employer

Received by Contractor

(Site Representative)

(Site Representative)

Name: Suresh Raghavan

Name:

Signature:

Signature:

Date: 30/01/14

Date:

Checked by
PMC Site Representative

Reviewed by
PMC Const. Manager

Approved by
PMC Project Leader

Name: Suresh Raghavan

Name:

Name:

Signature:

Signature:

Signature:

Date:30/01/14

Date:

Date:

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Crude Oil Export Facility Reconstruction Project

for South Oil Company, IRAQ
(SEALINE PROJECT)

Corrective Action Request Form

SECTION 2: Corrective Action Plan

[To be completed by the Contractor.]
Please respond to the Employer/PMC within five (5) working days of receipt.
What is causing (or may cause) the problem or concern recorded in Section 1 to occur?

Use additional paper as necessary. Attach any relevant records or documents.

What action has been or will be taken to correct the identified problem or concern?

Use additional paper as necessary. Attach any relevant records or documents.

Implementation Date of the Above Stated Action (if applicable): ________________________

Signature:_____________________________________
Date:____________________________
[Please return completed form or contact the Employer/PMC by __________________ at the
latest]

Page 2 of 3

Crude Oil Export Facility Reconstruction Project

for South Oil Company, IRAQ
(SEALINE PROJECT)

Corrective Action Request Form

SECTION 3: Verification & Close-Out Information

[To be completed by the Initiator.]
Has the documented action been implemented and was it effective? [ ] Yes [ ] No
Is the original Initiator satisfied with the outcome of the action taken? [ ] Yes [ ] No
Notes:

Verified and Closed Out by:_____________________________________________

Date:_____________________
Checked by PMCs Site Representative:___________________________
Date:_____________________

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