Appendix 3 - Supplier PPAP Check List Form Rev Date: April 2011

SUPPLIER PPAP Check List

Supplier Name & Location: P&L Development and Manufacturing
Cooper Part Number: 1032130 Rev Level / Date: #1 27SE11
10/19/2011
(Note - always refer to the Cooper Standard Supplier Portal for the latest PPAP Checklist version)
YES NO N/A
x 2.2.1 Design Record
x A. Hard copy of engineering print or CAD/CAM math data is provided?
x B. Print indicates approved release number and release date?
x C. Print is 100% ballooned and sequential numbered for dimensions, notes and specifications?
D. All Material Specification(s) are provided in the PPAP package?
x
(Note that hard copy will not be printed out for Cooper interplant PPAP that have access to WIndchilll.)
E. All Engineering Specification(s) are provided in the PPAP package?
x
(Note that hard copy will not be printed out for Cooper interplant PPAP that have access to WIndchilll.)
F: For Polymeric (plastic) Parts if requested,. 1SO 11469/1043-1 or ISO 11499/1020 specification.
x
(Note that hard copy will not be printed out for Cooper interplant PPAP that have access to WIndchilll.)
Comments:

YES NO N/A
x 2.2.2 Authorized Engineering Change Documents
x A. Are there any changes authorized that are not yet captured by the current print?
Comments: Customer specific documents will be included as applicable.

YES NO N/A
x 2.2.3 Customer Engineering Approval
x A. Are CS or Customer Engineering Approvals Required? ECR - Engineering Change Request, SREA, Forever Req, etc.
x B. Are Approved Customer specific documents included?
Comments: Customer specific documents will be included as applicable. (e.g. Alerts, concerns, notices, SREAs, EWO, TWO, GM3660
[Engineering Source Approval], GM1411 [PPAP Worksheet] DV [Design Verification] and PV [Production Validation] forms)

YES NO N/A
x 2.2.4 Design Failure Mode & Effects Analysis (DFMEA)
x A. If design responsible, is a Design Failure Mode & Effects Analysis (DFMEA) present and in the latest AIAG format?
x B. Is he DFMEA UP-TO-DATE with a current revision?
x C. Are SEV 5-8 and OCC 4-10 identified as Key Characteristic? If none, is there evidence of redesign to reduce SEV or OCC?
x D. Is the document linked to the Drawing ? Part Number / Revision Level or Process/Part Name.
Comments: If the DFMEA is Proprietary, include a blank DFMEA with a Proprietary Information Statement.

YES NO N/A
x 2.2.5 Process Flow Diagram
x A. Is a Process Flow Diagram present?
x B. Is PFD up to date with a current revision?
x C. Is the document linked to the Drawing ?
x D. Is document linked to PFMEA and Control plan? Part Number / Revision Level or Process/Part Name.
Comments:

Page 1 of 37
 Appendix 3 - Supplier PPAP Check List Form Rev Date: April 2011

SUPPLIER PPAP Check List

Supplier Name & Location: P&L Development and Manufacturing
Cooper Part Number: 1032130 Rev Level / Date: #1 27SE11
10/19/2011
(Note - always refer to the Cooper Standard Supplier Portal for the latest PPAP Checklist version)
YES NO N/A
x 2.2.6 Process Failure Mode & Effects Analysis (PFMEA).
x A. Is a Process Failure Mode & Effects Analysis (PFMEA) present and in the latest AIAG format?
x B. Is PFMEA up-to-date with a current revision?
x C. Are SEV 5-8 with and OCC 4-10 identified as PHIC? If none, is there evidence of actions to reduce OCC?
x D. Are Sev 9 and 10 identified as CC?
x E. Is in agreement with PFD, Control Plan and WI's/SOP's? Key characteristics must be listed at specific operation/sequence.
x F. Are SEV Ratings Appropriate per the AIAG guidelines?
x G. Are DET Ratings Appropriate per the AIAG guidelines?
x H. Is the document linked to the Drawing (i.e. P/N, Release Date, Revision Date)?
x I. If no Actions are identified, is None indicated in each row/field?
x J. Are failures at one process step identified as the cause of failures at the appropriate subsequent step?
K. Are the RPN's calculated correctly?
Comments: If PFMEA contains proprietary information, a blank PFMEA is to be included in package with a Proprietary Information Sheet.

YES NO N/A
x 2.2.7 Control Plans
x A. Is a Control Plan present?
x B. Have all SC and Key Characteristics been identified and are controls adequate? (discuss with CS before submission if not sure)
x C. Is the Control Plan up-to-date with a current revision?
x D. Is there linkage to DFMEA (as applicable), PFMEA, PFD, and Operator Instruction?
x E. Reaction plans are identified and realistic?
x F. Is the document linked to the Drawing (i.e. P/N and Release Date)?
x G. Are both Process and Product Characteristics controlled?
H. Have all important Pass Through Characteristics (PTC) been identified and are controls adequate? (discuss with CS before submission if not
x
sure)
Comments:

YES NO N/A
x 2.2.8 Measurement. System Analysis Studies (MSA)
x A. Are MSAs included and usage of the latest AIAG forms?
x B. Are there MSA for all gages, measurement and test equipment used to control product?
x C. Are the MSAs using the ANOVA method?
x D. Raw data is included in PPAP and available in an Excel file?
E. Do the MSAs meet minimum requirements per AIAG (e.g. % Study Variance should be < 10% Good, 11% - 20% Marginal, 21% - 30%
x
Unacceptable - action plan required, > 30% No Good and may need to use new gage - action plan required).
F. Ford Specific: Does the % Contribution meet minimum requirements (e.g. % Contribution should be <1% is acceptable, 1% to 9% Marginal,
x
> 9% Unacceptable)?
G. Ford Specific: When using MiniTab, do the distinct categories meet minimum Ford requirements (e.g. > 10 Acceptable, 5 to 9 Marginal, < 5
x
Unacceptable)?
H. Ford Specific: When using MiniTab for attribute gages, do they meet minimum Ford requirements (e.g. Sample size should be 50 parts or
x
greater with a >90% Operator Repeatability, and Kappa > 0.70, Ford prefers > 0.90)?
I. Ford Specific: Are Destructive Gage R&R set up as "nested" and utilizing 3 operators, 5 parts (5 different batches each minimum), Multiple
x
replicates. (Note: you should assume that all parts within a single batch are the identical).
Comments:
Use of a specific brand of calibration software is not required. Software is to be tested with the Ford data set & evidence of passing included.

Page 2 of 37
 Appendix 3 - Supplier PPAP Check List Form Rev Date: April 2011

SUPPLIER PPAP Check List

Supplier Name & Location: P&L Development and Manufacturing
Cooper Part Number: 1032130 Rev Level / Date: #1 27SE11
10/19/2011
(Note - always refer to the Cooper Standard Supplier Portal for the latest PPAP Checklist version)
YES NO N/A
x 2.2.9 Dimensional Results
x A. Variable measurements for every (except reference) dimensions on part print are to recorded?
x B. Dimensional results required for every unique manufacturing process?
C. Is the AIAG Dimensional results form used? Part print information to be recorded on dimen. report, including level, date , org name,. part #,
x
etc.
D. Are there 6 pieces for all cells or production lines. For multiple cavities, molds, patterns and dies, 1 per cavity at least 6 parts to be
x
measured. Individual data readings and master(s) sample provided?
x E. Is tracing included for Optical Comparator required for inspection?
x F. If measured by CMM, reports included?
x G. Results indicate that dimensional verifications required by print and control plan have been completed and results indicate compliance?
Comments:

YES NO N/A
x 2.2.10 Material/Performance Test Results
x A. Is the AIAG Material and Performance Test Results form are used?
x B. Are records of each specified test included?
x C. Part print information to be recorded on Material/Performance Reports? Including engr. Level, date, p/n, etc.
x D. Any authorized engineering change documents not yet incorporated into the design record, but present in the part?
x E. Number, date and change level of specification to which part was tested?
x F. Date on which testing took place?
x G. Qty. tested if not stated within specification?
x H. Actual results?
x I. Material supplier's name (req'd) and code (if applicable)?
x J. Ford Specific: Is the DVP&R included?
Comments:

YES NO N/A
x 2.2.11 Initial Process Studies
A. Per AIAG, all Special Characteristics need to show acceptable initial process capability prior to submission based on 125 pcs. Minimum? If
x
non-normal data set, reason are supplied to support acceptability?
x B. Supplier shall obtain concurrence from the customer on which index is to be used? Use PpK (1.67 PpK)
x C. Gage R&R is to be performed in order to understand how measurement error impacts the study measurements?
x D. Initial studies will be provided in accordance with the Important Characteristics Summary sheet or Engineering designed drawing?
x E. Initial process studies are summarized with capability or performance indices?
F. Studies were evaluated using these common techniques? Ie. Xbar Chart, Capability Histogram, R Chart, Normal Prob. Plot, Last 25
x
Subgroups, Capability Plot. (MiniTab software provides all of theses.)
x G. Is the P Value >5%, if not has the study been evaluated for improvements?
x H. Raw data is included in PPAP?
x I. Electronic data format to be submitted either in Minitab, or the Raw Data provided in an Excel File.
J. If initial process studies are not satisfactory, is control plan modified for 100% inspection and Corrective action plan submitted to become
x
capable?
Comments:

YES NO N/A
x 2.2.12 Qualified Laboratory
x A. Testing performed by external qualified laboratory need to be certified to ISO/IEC 17025 or national equivalent?
x B. Scope of laboratory is Defined (whether internal or 3rd party lab)?
x C. If tested externally to supplier, results to be submitted on independent lab letterhead or their normal lab report?
x D. If tested externally to supplier, Name of lab, date of tests and standards used to run the tests need to be enclosed?
Comments:

Page 3 of 37
 Appendix 3 - Supplier PPAP Check List Form Rev Date: April 2011

SUPPLIER PPAP Check List

Supplier Name & Location: P&L Development and Manufacturing
Cooper Part Number: 1032130 Rev Level / Date: #1 27SE11
10/19/2011
(Note - always refer to the Cooper Standard Supplier Portal for the latest PPAP Checklist version)
YES NO N/A
x 2.2.13 Appearance Approval Report
x A. For parts having an appearance requirement on design record, a AAR must be completed for each part or series of parts?
x B. AAR and representative parts to be submitted to customer for disposition?
x C. AAR w/disposition and authorized customer signature to accompany PSW at time of submission?
x D. AIAG form CFG-1002.(AAR) to be used for submission?
Comments:

YES NO N/A
x 2.2.14 Sample Production Parts
x A. Supplier provides sample parts as specified by the Cooper using plant
x B. Include a note in the PPAP package indicating # of functional sample submitted to which Cooper plant
Comments:

YES NO N/A
x 2.2.15 Master Sample
x A. Master sample supplied and retained meeting PPAP requirements per AIAG?
x B. Master sample is properly identified and stored?
x C. Include a note in the PPAP package referencing supplier's internal procedure governing master samples and their storage?
Comments:

YES NO N/A
x 2.2.16 Checking Aids
x A. Supplier to certify all aspects of checking aid to agree with dimensional requirements?
x B. Supplier to certify all released changes have been incorporated into checking aid?
x C. Supplier to provide for Preventive Maintenance on any checking aid for the life of the part?
x D. MSA to be conducted in accordance with AIAG and customer requirements?
E. Checking Aids can include fixtures either variable and attribute gages, models, templates, Mylar's, etc. specific to the product being
x
submitted?
Comments:

YES NO N/A
x 2.2.17 Customer Specific
x A. Raw data for part weight (10 random parts) is included?
x B. Submit IMDS submission screen-shot provided?
x C. PV results data must be less than one year old?
x D. Submit Barcode Label form per CS Requirements?
x E. Submit Run @ Rate form (Appendix VII) per CS Guidebook?
x F. Submit Submission and Approval of the Tooling form (Appendix 21) per CS Guidebook?
x G. Submit Packaging form (Appendix 15) per CS Guidebook?
x H. Valid TS16949 or ISO9000 certification uploaded in CS supplier portal?
x I. Annual CQI-9 Heat Treat / Braze Assessment (Appendix 04) uploaded in CS supplier portal?
x J. Annual CQI-11 Plating Assessment (Appendix 18) uploaded in CS supplier portal?
x K. Annual CQI-12 Coating Assessment (Appendix 19) uploaded in CS supplier portal?
x L. Annual CQI-15 Welding Assessment (Appendix 22) uploaded in CS supplier portal?
x M. Annual CQI-17 Soldering Assessment (Appendix 23) uploaded in CS supplier portal?
x N. Annual Supplier Profile (Appendix II) uploaded in CS supplier portal?
x O. Product with Studs or Fasteners - Does the manufacture of stud/fastener have a PM on thread rolling tools to prevent usage of worn out tools?
P. Product with Studs or Fasteners - Does the print or engineering specifications define a thread lap criteria and how is this controlled each
x
production run?
Q. Product with Studs or Fasteners that get Heat Treated - Does the supplier/heat treater verify each batch for proper HT specification? Are
x
checks on parts for hardness and embrittlement adequate?
Comments

Page 4 of 37
 Appendix 3 - Supplier PPAP Check List Form Rev Date: April 2011

SUPPLIER PPAP Check List

Supplier Name & Location: P&L Development and Manufacturing
Cooper Part Number: 1032130 Rev Level / Date: #1 27SE11
10/19/2011
(Note - always refer to the Cooper Standard Supplier Portal for the latest PPAP Checklist version)
YES NO N/A
x 2.2.18 PPAP Submission Warrant Status
x A. Supplier shall submit the required AIAG's Forth Edition PSW form?
x B. Is the PPAP ready for submission?
x C. Has the warrant been signed by an authorized supplier representative?
x D. Does the part name exactly match the print included in the Design Record?
x E. Do the part numbers exactly match the print included in the Design Record?
x F. Is there a unique customer part number?
x G. Does Change Level and Date exactly match the print included in the Design Record?
x H. Note any Additional Engineering changes not included in the released level?
x I. Is supplier IMDS included?
x J. Is supplier P.O. included?
x K. Is the correct supplier and site code included?
x L. Is the correct Buyer and Buyer code included (as available)?
x M. Is the weight identified in Kg to 4 decimal places?
x N. Is the Customer and the Division appropriately identified?
x O. Is the correct submission level identified?
x P. Is the production rate per hour included?
x Q. Does the data to support the Production Rate exist in customer specifics?
x R. Has the mold/cavity/processes been included?
S. All fields have been completed. N/A has been inserted if any field is non-applicable?
Comments:

ACC REJ

DISPOSITION (for Cooper Standard to complete)

If the PPAP submission meets all Cooper-Standard requirements, checked the ACC box.
If the PPAP submission does not meet all Cooper-Standard requirements, checked the REJ box and note the reason for the rejection in the
specific comment sections above.
Comments:

Reviewed By: Christina Raynak 07/17/12

Supplier:
Supplier Quality Engineer / Manager Date

Reviewed By: '

CS Plant:
Cooper BU Engineer / Quality Engineer Date

At a minimum, the Supplier PPAP should be reviewed and dispositioned by the CS Supplier Quality Engineer or the CS Business Unit Engineer

Page 5 of 37
ENGINEERING CHANGE DOCUMENTS

Not Applicable
CUSTOMER ENGINEERING APPROVAL

SEE SUPPLIER PPPAP

DFMEA

NOT APPLICABLE
 PROCESS FLOW DIAGRAM
PART NUMBER: 1032130 DATE: 6/21/2012
PART DESCRIPTION: ECL: #1
Machined Valve, Ball 3 port PREPARED BY: Christina Raynak
FABRICATION

INSPECT
STORE
MOVE

PRODUCT AND

ITEM #

ITEM #
OPERATION PROCESS CONTROL
STEP DESCRIPTION CHARACTERISTICS METHODS
1 Receiving Inspection Correct Valve in Visual
of 1032131 Valve Package
2 Move Valves to
Machining Area
3 Maching Op Machine Radius on 1032130 Machine
Valve Cutting Program,
(1.7345 +/- .005) Operator Instructions,
First Piece Approval,
Inprocess Audit every
5 pcs.

4 Move Valves to
Washing Area
5 Wash Valves to No residue on Valves Operator Instruction,
remove any Dish Washer Cycle
Deburring
Contamination
6 Move Valves to Blow-
Off station
7 Compressed Air Remove any Chips Operator Instruction
Blow-Off from Valves
8 Move Valves to
Packaging & Shipping
Area
9 Labeling & Packaging Parts to be packed Operator Instruction,
Final Audit and labeled per Verification Form
Operator Instruction
10 Ship Product No damage when Visual
loaded

Page 11 of 37
 POTENTIAL FMEA Number: 1032130
FAILURE MODE AND EFFECTS ANALYSIS
(PROCESS FMEA) Prepared by: Dave Weber

Item: 1032130 Process Responsibility P&L DEVELOPMENT FMEA Date (Orig.) 6/21/2012
Model Year(s)/Program(s) 2013 DS/DJ Key Date 7/1/2012 FMEA Date (Rev.)
Core Team: Quality, Manufacturing, Engineering

Process Step Action Results

Classification
Current Current

Occurrence
Responsibility

Detection
/ Function

Occurrence
Severity
Potential Potential Potential

Detection
Process Process Recommended & Target

Severity
RPN
Failure Effect(s) Causes(s) Actions Taken

RPN
Controls Controls Action Completion
Mode of Failure of Failure & Effective Date
Prevention Detection Date
Requirements
1 / RECEIVING PARTS OUT OF DIFFICULTY IN 7 SUPPLIER SHIPPED 2 1ST PIECE INPROCESS 6 84 None
SPECIFICATION PROCESSING PARTS OUT OF CHECK AT SET- CHECKS
SPECIFICATION UP

3 / MACHINING RADIUS NOT ASSY WILL NOT 8 ∆ 3 WRONG RADIUS TOOL 2 VERIFY 1ST PIECE 6 96 None
RADIUS ON MACHINED TO FUNCTION SET IN TURNING CORRECT TOOL APPROVAL,
VALVE PRINT PROPERLY CENTER SET IN MACHINE INPROCESS
AT START UP CHECKS

8 ∆ 3 WRONG TOOL OFF-SET 2 VERIFY 1ST PIECE 6 96 None

COMPENSATION IN PROGRAM TOOL APPROVAL,
PROGRAM COMPENSATION INPROCESS
IN PROGRAM AT CHECKS
SET-UP

8 ∆ WRONG PROGRAM 2 VERIFY 1ST PIECE 6 96 None

BEING USED CORRECT APPROVAL,
PROGRAM AT INPROCESS
SET-UP CHECKS

8 ∆ 3 EXCESSIVE WEAR ON 2 CHANGE RADIUS INPROCESS 6 96 None

TOOL CUTTING TOOL CHECKS
EVERY 600 PCS

5 / WASH CONTAMINATION MAY CAUSE ASSY 8 OPERATOR FAILED TO 2 OPERATOR VISUAL 8 128 None
VALVES FROM DEBURRING TO NOT FUNCTION COMPLETE THE WASH TRAINING,
PROCESS ON PROCESS VERIFICATION
VALVE FORM, ROUTER

7/ CHIPS FROM MAY CAUSE ASSY 8 OPERATOR FAILED TO 2 OPERATOR PARTS ARE 8 128 None
COMPRESSED MACHINING TO NOT FUNCTION COMPLETE BLOW-OFF TRAINING, PLACED IN A
AIR BLOW-OFF PROCESS ON OPERATION VERIFICATION GREEN BIN
PARTS FORM, ROUTER AFTER BLOW-
OFF OPERATION

Page 12 of 37
 POTENTIAL FMEA Number: 1032130
FAILURE MODE AND EFFECTS ANALYSIS
(PROCESS FMEA) Prepared by: Dave Weber

Item: 1032130 Process Responsibility P&L DEVELOPMENT FMEA Date (Orig.) 6/21/2012
Model Year(s)/Program(s) 2013 DS/DJ Key Date 7/1/2012 FMEA Date (Rev.)
Core Team: Quality, Manufacturing, Engineering

Process Step Action Results

Classification
Current Current

Occurrence
Responsibility

Detection
/ Function

Occurrence
Severity
Potential Potential Potential

Detection
Process Process Recommended & Target

Severity
RPN
Failure Effect(s) Causes(s) Actions Taken

RPN
Controls Controls Action Completion
Mode of Failure of Failure & Effective Date
Prevention Detection Date
Requirements
9 / LABELING & INCORRECT INCORRECT PART 5 MISLABELED, OLD 2 OPERATOR SHIPPING 8 80 None
PACKAGING LABELING OF NUMBER RECEIVED TAGS NOT REMOVED INSTRUCTION, PERSONNEL TO
FINAL AUDIT CONTAINER AT CUSTOMER VERIFICATION VERIFY
FORM PRODUCT PRIOR
TO SHIPPING

10 / SHIPPING PRODUCT SCRAP/REWORK/ 4 SHIPPER FAILED TO 2 OPERATOR SHIPPING 8 64 None

DAMAGED WHILE SORTING OF FOLLOW PROCEDURES INSTRUCTION PERSONNEL TO
HANDLING PRODUCT VERIFY
PRODUCT PRIOR
TO SHIPPING

Page 13 of 37
 CONTROL PLAN
Prototype Pre-Launch ✘ Production
Control Plan Number Key Contact/Phone Date (Orig.) Date (Rev.)
Dave Langley / 989-820-5699 6/21/2012
Part Number/Latest Change Level Core Team Customer Engineering Approval/Date (If Req'd.)
1032130 / #1 Quality, Manufacturing, Engineering
Part Name/Description Supplier/Plant Approval/Date Customer Quality Approval/Date (If Req'd.)
Machined Valve, Ball 3 Port Christina Raynak / 6-21-12
Supplier/Plant Supplier Code Other Approval/Date (If Req'd.) Other Approval/Date (If Req'd.)
P & L Development PLDE01
MACHINE, CHARACTERISTICS SPECIA METHODS
PART/ PROCESS NAME/
DEVICE L PRODUCT/PROCESS EVALUATION/ SAMPLE REACTION
PROCESS OPERATION
JIG, TOOLS CHAR. SPECIFICATION/ MEASUREMENT CONTROL PLAN
NUMBER DESCRIPTION NO. PRODUCT PROCESS
FOR MFG. CLASS SIZE FREQ. METHOD
TOLERANCE TECHNIQUE
RECEIVING CORRECT VALVE IN VISUAL PER LOT VISUAL QUARANTINE
INSPECTION OF PACKAGING PRODUCT,
1032131 VALVE CONTACT
1
SUPPLIER FOR
RESOLUTION

MACHINING CNC ∆3 MACHINE 1032130 ∆3 1.7354 +/- .005 MICROMETER 1 1ST CUTTING QUARANTINE
TURNING RADIUS ON CUTTING PIECE, PROGRAM, PRODUCT,
CENTER VALVE PROGRAM EVERY 5 OPERATOR CONTACT
3 PCS INSTRUCTION, SUPERVISOR
IN-PROCESS FOR
CHECKS RESOLUTION

VALVE WASH PART REMOVE WASHER NO RESIDUE ON VISUAL, PART 100% PER LOT VISUAL QUARANTINE
WASHER DEBURRING CYCLE VALVES ROUTER PRODUCT,
CONTAMI- CONTACT
5 NATION SUPERVISOR
FOR
RESOLUTION

COMPRESSED BLOW-OFF REMOVE NO CHIPS ON VISUAL, PART 100% PER LOT OPERATOR QUARANTINE
AIR BLOW-OFF STATION CHIPS FROM PARTS ROUTER INSTRUCTION, PRODUCT,
PARTS IN-PROCESS CONTACT
7 CHECKS SUPERVISOR
FOR
RESOLUTION

LABELING & PROPER PARTS TO BE VISUAL 1 CARTON OPERATOR QUARANTINE

PACKAGING LABEL AND PACKED AND INSTRUCTION PRODUCT,
FINAL AUDIT PACKAGING LABELED PER VERIFICATION CONTACT
9 OPERATOR FORM SUPERVISOR
INSTRUCTION FOR
RESOLUTION

Page 14 of 37
 CONTROL PLAN
Prototype Pre-Launch ✘ Production
Control Plan Number Key Contact/Phone Date (Orig.) Date (Rev.)
Dave Langley / 989-820-5699 6/21/2012
Part Number/Latest Change Level Core Team Customer Engineering Approval/Date (If Req'd.)
1032130 / #1 Quality, Manufacturing, Engineering
Part Name/Description Supplier/Plant Approval/Date Customer Quality Approval/Date (If Req'd.)
Machined Valve, Ball 3 Port Christina Raynak / 6-21-12
Supplier/Plant Supplier Code Other Approval/Date (If Req'd.) Other Approval/Date (If Req'd.)
P & L Development PLDE01
MACHINE, CHARACTERISTICS SPECIA METHODS
PART/ PROCESS NAME/
DEVICE L PRODUCT/PROCESS EVALUATION/ SAMPLE REACTION
PROCESS OPERATION
JIG, TOOLS CHAR. SPECIFICATION/ MEASUREMENT CONTROL PLAN
NUMBER DESCRIPTION NO. PRODUCT PROCESS
FOR MFG. CLASS SIZE FREQ. METHOD
TOLERANCE TECHNIQUE
SHIPPING SHIP NO DAMAGE WHEN VISUAL PER LOT SHIPPER QUARANTINE
PRODUCT LOADED PROCEDURE PRODUCT,
CONTACT
10 SUPERVISOR
FOR
RESOLUTION

Page 15 of 37
 Production Part Approval Page 21 of 37 Pages

Dimensional Test Results

ORGANIZATION: P & L Development and Manufacturing PART NUMBER: 1032130
SUPPLIER / VENDOR CODE: 1PLDE01 PART NAME: Machined Valve, Ball 3-Port
INSPECTION FACILITY: P & L Development and Manufacturing DESIGN RECORD CHANGE LEVEL: #1 27SE11
ENGINEERING CHANGE DOCUMENTS:

DIMENSION / SPECIFICATION / TEST QTY. ORGANIZATION MEASUREMENT NOT

ITEM OK
SPECIFICATION LIMITS DATE TESTED RESULTS (DATA) OK
1 22.04mm (1.7354) +/- .13 (.005) 5/7/12 6 1.7342 x
1.7345 x
1.7348 x
1.7341 x
1.7342 x
1.7340 x
2 Surface Roughness 5/7/12 6 Pass x
3 Make from molded… Noted x
4 Break sharp… Noted x
5 Significant… Noted x

Blanket statements of conformance are unacceptable for any test results.

SIGNATURE TITLE DATE

C. Raynak QA Manager 5/7/2012

March CFG-1003
2006
MATERIAL/PERFORMANCE TEST RESULTS

NOT APPLICABLE
QUALIFIED LABORATORY

NOT APPLICABLE
APPEARANCE APPROVAL REPORT

NOT APPLICABLE
SAMPLE PRODUCTION PARTS HAVE BEEN SH
E BEEN SHIPPED PER RELEASES.
MASTER SAMPLES HAVE BEEN RETAINED
AND IDENTIFED.
TAINED
CHECKING AIDS

NOT APPLICABLE
 Weight Measurement for 1032130

1) .0157
2) .0158
3) .0156
4) .0157
5) .0157
6) .0158
7) .0158
8) .0156
9) .0157
10) .0157

Sum of 10 = 0.1571/ 10 = .0157

Appendix XV - Packaging Form Rev - 2 Rev Date - April 2010

Packaging Information Form

ISSUE DATE: 05/30/12
PACK EFFECTIVE DATE: 05/30/12
SUPPLIER NAME: P&L Development and Manufacturing
SUPPLIER 4025 Arrow St.
ADDRESS: SUPPLIER NUMBER: 1PLDE01
Oscoda, MI 48750
SUPPLIER CONTACT: Christina Raynak
PHONE #: 989-739-5203
FAX #: 989-739-5205

PART INFORMATION DIMENSIONS LENGTH: 2"

PART NUMBER: 1032130 WIDTH: 2"
NAME: Machined Valve, Ball 3 Port HEIGHT: 2"
REVISION LEVEL: #1 WEIGHT: .0157kg

PACKAGING INFORMATION CONTAINER REQUIRED PACKAGING DIGITAL PICTURES ATTACHED: x

CONTAINER TYPE IF EXPENDABLE IF RETURNABLE

RETURNABLE CORRUGATED CONTRUCTION CONTAINER FEATURES CONTAINER STYLE

x EXPENDABLE SINGLE WALL PALLET BOX PALLET BIN - SOLID SIDES

x DOUBLE WALL DROP DOWN SIDE PALLET BIN - COLLAPSIBLE SIDES

TRIPLE WALL BREAK AWAY PALLET BIN - 1 OR MORE DROP DOORS

DIMENSIONS (INCHES) OTHER CARTON SMALL MANUAL TOTE - STRAIGHT SIDES

18" OUTSIDE LENGTH STACKING STRENGTH HAND HOLES SMALL MANUAL TOTE - NESTABLE

18" OUTSIDE WIDTH (BURST OR ECT) OTHER SMALL MANUAL TOTE - COLLAPSIBLE

18" OUTSIDE HEIGHT OTHER

27 WEIGHT (POUNDS TARE) CONTAINER STYLE ADDITIONAL INFORMATION OWNERSHIP

17.75 INSIDE LENGTH REGULAR SLOTTED (SEE REVERSE SIDE) SUPPLIER PURCHASED - SUPPLIER OWNED

17.75 INSIDE WIDTH x HALF SLOTTED PICTURES ON PAGE 2 CSA PURCHASED - SUPPLIER OWNED

17.75 INSIDE HEIGHT PALLET BOX AND MAINTAINED

OTHER CSA PURCHASED - CSA OWNED

OTHER - DESCRIBE ON BELOW

PALLET LOAD CONFIGURATION

DIMENSIONS (Inches) PALLET MATERIAL PALLET STYLE NUMBER OF PARTS IN CONTAINER

LENGTH (RUNNER) HARD WOOD HEIGHT SINGLE WING NUMBER OF CONTAINERS ON PALLET

WIDTH (DECK BOARD) SOFT WOOD WEIGHT DOUBLE WING NUMBER OF PARTS PER PALLET

HEIGHT PAPER FLUSH WING GROSS WEIGHT PER CONTAINER WITH PARTS

WEIGHT PLASTIC BLOCK PALLETIZED LOAD HEIGHT

METAL OTHER (INCLUDING PALLET)

OTHER HEIGHT PALLETS CAN BE STACKED IN TRANSIT

COST 0.002 PACKAGING COST PER PIECE

TRANSPORTATION INFORMATION

CARRIER TO BE USED: UPS FREIGHT CHARGES: COLLECT PREPAID

CSA SHIP TO LOCATION: SCHEDULED PICK UP TIME(S):

SCHEDULED PICK UP DAY(S): x MONDAY x TUESDAY x WEDNESDAY x THURSDAY x FRIDAY WEEKLY BI-WEEKLY MONTHLY BI-MONTHLY OTHER:

(CHECK ALL THAT APPLY)

SUPPLIER TO COMPLETE

Reviewed by C. Raynak 5/30/12

Signature Date

CSA USE ONLY

Approved Packaging
Signature Date

Approved Transportation
Signature Date

Approved Purchasing
Signature Date
 Part Submission Warrant
Part Name Machined Valve, Ball 3 Port Cust. Part Number 1032130
Shown on Drawing Number 1032130 Orig. Part Number 1032130
Engineering Change Level #1 Dated 27SE11
Additional Engineering Changes N/A Dated N/A
Safety and/or Government Regulation Yes ✘ No Purchase Order No. C256000038 Weight (kg) 0.0157

Checking Aid Number N/A Checking Aid Eng. Change Level N/A Dated N/A
ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION

P & L Development and Manu 1PLDE01 CSA Leonard Plant

Organization Name & Supplier/Vendor Code Customer Name/Division

4025 Arrow St. Patrick Schereden ABH02

Street Address Buyer/Buyer Code

Oscoda MI 48750 USA 2013 DS/DJ

City Region Postal Code Country Application

MATERIALS REPORTING

Has customer-required Substances of Concern information been reported? Yes No ✘ n/a

Submitted by IMDS or other customer format: Supplier IMDS # 251 967 003

Are polymeric parts identified with appropriate ISO marking codes? ✘ Yes No ✘ n/a
REASON FOR SUBMISSION (Check at least one)
✘ Initial submission Change to Optional Construction or Material
Engineering Change(s) Sub-Supplier or Material Source Change
Tooling: Transfer, Replacement, Refurbishment, or additional Change in Part Processing
Correction of Discrepancy Parts produced at Additional Location
Tooling Inactive > than 1 year Other - please specify

REQUESTED SUBMISSION LEVEL (Check one)

Level 1 - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to customer.
Level 2 - Warrant with product samples and limited supporting data submitted to customer.
✘ Level 3 - Warrant with product samples and complete supporting data submitted to customer.
Level 4 - Warrant and other requirements as defined by customer.
Level 5 - Warrant with product samples and complete supporting data reviewed at organization's manufacturing location.

SUBMISSION RESULTS
The results for ✘ dimensional measurementsmaterial and functional testsappearance criteria statistical process package
✘ Yes
These results meet all design record requirements: NO (If "NO" - Explanation Required)
Mold / Cavity / Production Process CNC Machining
DECLARATION
I affirm that the samples represented by this warrant are representative of our parts, which were made by a process that meets all
Production Part Approval Process Manual 4th Edition Requirements. I further affirm that these samples were produced at the production
rate of _300_/_1_ hours. I also certify that documented evidence of such compliance is on file and available for your review. I have noted
any deviation from this declaration below.

EXPLANATION/COMMENTS: MASTER SAMPLE IDENTIFED WITH GREEN TAG AND RETAINED.

Is each Customer Tool properly tagged and numbered? Yes No ✘ n/a

Organization Authorized Signature Christina Raynak Date 7/17/12

Print Name Christina Raynak Phone No. 989-739-5203 Fax No. 989-739-5205
Title Quality Manager E-mail craynak@pl-dev.com
FOR CUSTOMER USE ONLY (IF APPLICABLE)

PPAP Warrant Disposition: Approved Rejected Other

Customer Signature Date

Print Name Customer Tracking Number (optional)

March CFG-1001
2006