Trouble Report: I. Definition of Problem / Trouble

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FORM Form No. F-PR03.

01

Form Title : Revision Level 06

A. P. Carton Box, Inc.


Maxon Compound Effective Date 2021 November 11
South Ave. Lot 9-13 Block 10
CEZ, Rosario, Cavite
Tel. No. : (046) 437-2242 / 437-2243 / 437-2477 / Trouble Report
437-2830
Fax. No. : (046) 437-2245 Page of

Control No. Date

I. DEFINITION OF PROBLEM / TROUBLE (User fill in)


Note: Any problem occur in the production shall notify the department head and or superior and shall apply stop, call and wait

procedure before proceeding to production.


Machine Equipment Others
Tools Electrical

Date : Time : Operator / User :

Date of Last Occurrence of the Problem : No. of Occurrences :

a.) Brief Description of the Problem Drawing :

b.) Possible Cause of the Problem

Potential to occur elsewhere? Yes No

Where:

Prepared By :
User (signature over printed name) Date

II. CORRECTIVE MEASURE (Maintenance fill in) (Note: Attach Service Report in case of external repair)

Analysis : Machine Related Problem Product Related Problem

a.) Action Taken c.) Parts Replaced & Repaired d.) Cost

b.) Preventive Measure

Repair Time Start: Repair Time Finished:


Repaired by:
Maintenance (signature over printed name) Date

Checked by:

Active Period: 1 year/Archive Period: 2 years


Production Manager (signature over printed name) Date

Active Period: 1 year/Archive Period: 2 years

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