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Form SQ-221-IV
Request 18901
I. General
Assignment Number 25768-230-YZA-JV01-10001 Project No. 25768
PO Number 25768-230-POA-JV01-00001 Rev No. 0
Material on Order General Service Control Valves
Surveillance Level 1 2 3 4 S/O No.
Prime Supplier: (visited) Sub-Supplier: N/A
Company Name: Flowserve India Control Private Company Name:
Limited
Street Address: Plot # 4, 1A, Road No. 8, Street Address:
City: Bangalore City
State/Province: Karnataka State/Province
Postal Code: 560066 Postal Code:
Country: India Country:
Quality Surveillance Plan / Material Acceptance Plan – Material Requisition/Specification Quality Surveillance
Activity Reporting
Within the table below identify the Quality Surveillance Plan or Material Acceptance Plan activity as required by the Quality Surveillance
Plan/Material Acceptance Plan or as required by the Material Requisition, Specification and/or Assignment Transmittal Special Instruction, as
applicable in the Activity Description area(s). Each time a point is performed and/or verified during a surveillance visit, record the date performed.
Material Acceptance Plan No.: (When Issued) Rev. No.
Point
Activity Description Performance Date(s) (Day-Alpha Month-Year)
No.
IV. Material released for Shipment with this Report No Yes SQ-231 attached
If yes, embed the completed SQ-231 Material/Equipment Release Form here or send the SQ-231 Form as a separate attachment
when submitting this report.
Report
Responsible CAR/QDR
No. Primary Date Anomaly
Condition Description for Correction or Closure Justification
– Component Resolved Code
or Action SDDR
Item No.
1-1
D. Correlated the procurement documents held by the supplier and the Supplier
Quality Representative.
E. Reviewed and discussed with the supplier the Purchase Order requirements
listed below.
E1) The technical, quality and the applicable requirements of the Purchase Order,
Specifications and Governing Codes and Standards.
E3) The requirements for quality surveillance at principal sub- suppliers’ plants.
E5) The requirements for witness and hold points including release for shipment.
E8) The requirement for the supplier to establish “Counterfeit, Fraud, Suspect
Items” procedure or program when required by the PO.
Project and/or Supplier Documents used for this Surveillance Table
For the “current” quality surveillance visit, identify the Project and/or Supplier Document(s) (Specifications, Data Sheets, Procedures, etc.) used in the
performance of quality surveillance activities. Identify the revision; general description and the “Review Code Status Number” as it applies to Project-
reviewed documents and N/A (not applicable) for Customer/Supplier documents that do not require submittal.
Review Code
Document No. Rev. Description Status
(1, 2, 3, 4, N/A, etc.)
On this assignment package was preplanned in accordance with the assignment transmittal and procedural
instructions. As part of this preplanning activity, it was verified that the assignment contained the required PO,
Specifications, and Quality Surveillance Plan/Material Acceptance Plan. These documents were reviewed for content
and understanding.
(indicate either one or the other, it is not both - Quality Surveillance Plan or Material Acceptance Plan)
On writer entered the Supplier’s facility to conduct the initial visit activity. Met with the following Supplier
personnel:
Name Title
As part of the introduction process, business contact information was exchanged. The contact information
for writer’s immediate supervisor and the Project PSQS/PSQR was provided as an alternate, where situations
may occur if writer cannot be reached in a reasonable time. The Supplier was instructed to contact the SQR
to arrange for coverage of surveillance activities in accordance with the assignment Quality Surveillance
Plan/Material Acceptance Plan.
(indicate either one or the other, it is not both - Quality Surveillance Plan or Material Acceptance Plan)
The Supplier was also provided the Project Surveillance Notification Letter, which is to be sent to the Project e-mail
address for notification of events. The Supplier has agreed to make both contacts to this SQR and Project. The
Supplier was instructed that final acceptance of material/equipment is made at the jobsite.
(If the assignment transmittal does not require this form, this paragraph is to be deleted in its entirety.)
VI-B Safety
Discussed with the Supplier their requirement that this SQR must adhere to in regards to environmental, safety and
health while in the Supplier office and manufacturing areas and that of sub suppliers that this SQR may be required to
visit to perform surveillance activities. Also discussed with the Supplier the SQR’s requirement that this SQR must
follow as required by Buyer’s procedures. The Supplier was informed that it is the Supplier’s responsibility to ensure
visitor safety and that this SQR will not enter areas of the shop or perform surveillance activities that will put this SQR in
an “at risk” situation. If the SQR determines an “at risk” situation, the Supplier will be informed to correct the
unsatisfactory safety condition before surveillance activities resume.
The Supplier’s minimum requirement is to wear . Of these two requirements discussed (Supplier’s and
Buyer’s requirements) the SQR will follow the more stringent of the two, being the requirement.
VI-C Supplier Quality and Expediting Application Suite – Supplier Performance Data
Discussed with the Supplier the Supplier Quality and Expediting Application Suite and the identification of anomalies
found during visits. It was explained that issues, anomalies, and nonconformances as found by this SQR will be
translated into anomaly codes and entered into the Surveillance Report. Project will then enter these codes into the
SQEAS database. Supplier Performance Data is used by projects to trend Supplier performance, and this may affect
the Supplier’s ability to quote and secure new work. Negative trends determined during the assignment may be used
for basis of back charge of SQR’s services for implementing the Supplier’s QA/QC program, where the Supplier fails to
satisfactorily implement. No Exception
(If the Supplier objects, identify here and in Table V. Note: There is no exception, regardless if the Supplier objects. SPD is a Buyers application tool.
The only time SPD is not applicable is when the Project indicates in the SQ-211 Assignment Transmittal that SPD is not to be utilized.)
Writer correlated all documents and revisions in the received assignment package with those held by the Supplier.
During this review the Supplier was explained the order of precedence of these documents as:
This review determined that all documents are in agreement with No Exceptions (with the Exception of):
(Identify only those documents and revisions where there are exceptions and identify in Section V, Nonconformance’s/Issues and SPD Table.)
VI-E1 Technical, Quality and Codes and Standards Reviews
Reviewed with the Supplier the key technical, quality requirements of the governing Codes and Standards and the
procurement documents and inclusive Specifications. Upon finalization of this review, it was determined that the
Supplier has
Discussed with the Supplier the engineering and quality verification document submittals required by the
PO/Specification that the Supplier must submit to Project for review and status. Discussed the required time frame for
submittal. Explained to the Supplier the document review codes. Explained to the Supplier any items manufactured to
Code 2 returned documents must have all comments incorporated into the material/equipment in order to be
acceptable.
It was also explained to the Supplier that any submitted document returned as Code 1 and has an attribute that
deviates from a contract PO/Specification/Code/Standard requirement that the Code 1 review is not the basis to except
the deviation. These types of deviations are required to be addressed separately to Project Engineering for written
approval as required by the PO documents.
The Project coded document needs to be provided to the SQR to execute surveillance activities.
The Supplier has made the following (No) submittals to date and returned Code status is identified where applicable:
VI-E3 Supplier and Subsuppliers/Contractors of Services
Discussed with the Supplier their intent to subcontract all or portions of the material/equipment. Discussed the possible
surveillance that may be performed at a particular Subsupplier/Contractor. The surveillance to be performed includes
the applicable portions as required by the Quality Surveillance Plan/Material Acceptance Plan. Project will determine if a
Subsupplier/Contractor will have surveillance overview. Addressed the PO contract right of access clause.
(indicate either one or the other, it is not both - Quality Surveillance Plan or Material Acceptance Plan)
Reviewed with the Supplier the Code/Standard requirements for the qualifications of welders, NDE, inspection,
examination and test personnel.
Writer requested and reviewed the following sample of special process personnel certifications/qualifications:
If this activity is not pertinent to perform at this time, this paragraph is to be deleted and the following paragraph would apply.)
Writer will later review certifications/qualifications of special process, examination and test personnel once they are
assigned to this order.
Reviewed with the Supplier the PO contract Quality Surveillance Plan/Material Acceptance Plan progressive, witness
point, and hold point requirements. Reviewed the notification time line requirement for witness and hold points as
defined by the PO contract documents. Notification will be made to this SQR and also to Project. Time line indicated by
the PO/contract as working days for North American facilities and working days for off shore facilities.
(indicate either one or the other, it is not both - Quality Surveillance Plan or Material Acceptance Plan)
The supplier was advised that bypassing a hold or witness point will be treated as a nonconformance, a Corrective
Action Report/Quality Deficiency Report will be issued and the operation will have to be repeated unless otherwise
directed by the project. It was also explained that hold points could only be waived by Project concurrence.
(indicate either one or the other, it is not both - Corrective Action Report or Quality Deficiency Report)
Discussed with the Supplier the requirement for the submittal of Quality Verification Documentation in accordance with
the PO/Specification. It was explained that the documentation is to be submitted to the SQR prior to release for
shipment so that it can be reviewed. Before submittal, it is the responsibility of the Supplier to pre-review and ensure
that the documentation is complete, accurate, legible, and traceable. Any documentation presented that does not meet
these criteria will be rejected. This SQR would also request review of inspection and test data, certifications of
qualifications of special process personnel, material test reports, etc., during the course of progressive, witness point,
and hold point surveillance activities. The Supplier will be informed with any issues with those records at time of these
in process and final reviews.
Discussed with the Supplier the requirement to have all deviations from PO/Specification/Code/Standard contract
requirements submitted to Project Engineering for review and disposition. It was stated that it is the responsibility of the
Supplier and not this SQR to notify the Project. Submittal is to be made in writing by the contract required SDDR form
or other written format if agreed by Project Engineering. Approved SDDR and/or other written approval are to be
presented to this SQR and the approved SDDR’s will require SQR counter signature and placement within the Quality
Verification Documentation package.
It was again explained that a Code 1 review status received from Project on a drawing or procedure does not constitute
a deviation approval.
Reviewed the Purchase Order and determined that the supplier is (or) is not required to establish a specific procedure
or program to address measures taken to prevent introduction of counterfeit, fraud or suspect items into the supply and
manufacturing proccess.
Where this is not an established requirement, the supplier was asked if there is an established procedure or program
addressing CFSI. The supplier response was….