Welcome to Bourbon Plastics, Inc.

Superior Quality, Distribution, and Service Engineered to Your Specifications.

Type of survey: Self Customer on Premises

Company/Division:

Address:

City: Zip:

Phone: Fax:

Approximate number of people in workforce:

Manufacturing: Engineering:

Other: Total Number:

Quality Contact:

Products/Services provided to Bourbon Plastics (include part number):

Factory Square Footage: Floors:

MANAGEMENT RESPONSIBILITY
Please answer all questions

1. Does the supplier have industry's standards available for reference?
Yes        No

2. Are organization and management policies clearly defined and documented?
Yes        No

3. Are functional responsibilities for quality defined?
Yes        No

4. Is there an organizational chart?
Yes        No

5. Does the quality organization have the independent reporting authority required to be
     effective?
Yes        No

6. Is the quality function adequately staffed to maintain effective control and assurance?
Yes        No

7. Is the focus of the quality system prevention (as opposed to detection)?
Yes        No

8. Is a quality system established, implemented, and maintained?
Yes        No

9. Are instructions and procedures available at all quality stations?
Yes        No

10. Failure mode and effect analysis with process control plans are utilized and effective at
       the work station?
Yes        No

11. Rejections are referenced back to FMEA for adjustment and other appropriate action.
       Documentation available?
Yes        No

12. Is there a management representative with the authority and responsibility to ensure
       standard compliance?
Yes        No

13. Are documented procedures consistent with international standards and customer
       requirements?
Yes        No

14. Are the critical characteristics of products established and designated?
Yes        No

15. Is action taken to minimize the probability and effect of failure?
Yes        No

16. Are contracts documented and maintained to ensure requirements are understood within
       suppliers capabilities prior to accepting orders?
Yes        No

17. Are provisions established to document and utilize changes throughout the organization?
Yes        No

18. Are records of contract reviews maintained?
Yes        No

MANUFACTURING AND CONTROLS

19. Are work instructions/procedures utilized and checked for capability with drawing
       requirements?
Yes        No

20. Are special requirements designated on applicable work instructions?
Yes        No

21. Are process capabilities performed on every new product?
Yes        No

22. Are instruments used to measure product maintained and updated for precision?
Yes        No

23. Are traceability procedures established to identify raw material throughout the process?
Yes        No

24. Do product identification/route sheets/barcodes accompany material throughout the
       process?
Yes        No

25. Do departments sign off route sheets/tags as their process ends?
Yes        No

26. Are there adequate work stations for process?
Yes        No

27. Are there adequate supporting procedures for each element of the quality manual?
Yes        No

28. Are visual aids available at work stations (per requirements)?
Yes        No

29. Is 1st piece/batch performed?
Yes        No

30. Is random inspection performed?
Yes        No

31. Is final inspection performed?
Yes        No

32. Do inspection plans include acceptance criteria?
Yes        No

33. Are all results documented?
Yes        No

34. Are control plans/FMEA/specifications available and used for inspection?
Yes        No

35. Is test and inspection equipment available and utilized?
Yes        No

36. Is the test area adequate?
Yes        No

37. Is raw material data on file for reference and traceability?
Yes        No

38. Is material supplied is checked for compliance to requirements?
Yes        No

39. Documented procedures defining control of incoming material are in place?
Yes        No

40. Staging areas for incoming material is well marked and controlled suitably
       (tested versus untested)?
Yes        No

41. Inspections are documented and records are kept for traceability to shipments/lots?
Yes        No

42. Forms are stamped/initialed and dated?
Yes        No

43. Tags/stickers are used to release materials?
Yes        No

STATISTICAL TECHNIQUES

44. SPC methods are used for ongoing control?
Yes        No

45. Has personnel been properly trained?
Yes        No

46. Are control charts utilized?
Yes        No

47. Is corrective action taken when process shows a lack of control?
Yes        No

48. Are valid acceptance sampling plans specified and properly used in inspection and
       production?
Yes        No

MEASUREMENT AND TEST CONTROL

49. Are there written instructions for calibrations of measuring and test equipment?
Yes        No

50. All equipment meets appropriate requirements for accuracy and precision?
Yes        No

51. Is equipment found unsuitable for use is quarantined?
Yes        No

52. Are customers notified if suspect material is shipped?
Yes        No

53. Is calibration performed in an environmentally safe area?
Yes        No

54. Is production tooling included in calibration system?
Yes        No

55. Is employee owned equipment included in calibration system?
Yes        No

56. Is there a computerized system?
Yes        No

57. Are calibrations made against national standards?
Yes        No

58. Are records/logs kept which indicate which equipment was calibrated, by whom,
       date, due date, unique identification?
Yes        No

59. Are stickers applied to equipment to prove calibration and calibration due date?
Yes        No

FIRST PIECE INSPECTION

60. Are there documented procedures for initial pre-production (if required by customer)?
Yes No

STORING, HANDLING, PRESERVATION, PACKAGING, SHIPMENT

61. Are documented procedures available to department responsible?
Yes        No

62. Are customer special requirements available to department responsible?
Yes        No

63. Are material and parts identified to prevent mixing?
Yes        No

64. Are storage areas clearly marked?
Yes        No

65. Do storage areas protect material from damage and deterioration?
Yes        No

66. Is material segregated to prevent unauthorized use?
Yes        No

PERSONNEL, TRAINER, AND EDUCATION

67. Is there documented employee training files (matrix)?
Yes No

68. Is training effectiveness verified by means of examination or other techniques?
Yes No

RECORD AND CHANGE CONTROL

69. Is there a formal release system for drawings and specifications?
Yes        No

70. Does the system ensure that the latest revision is available to department?
Yes        No

71. Are records retained per established procedures and for specified times?

Yes        No

72. Are records available to customers upon request?
Yes        No

CONTROL OF NON-CONFORMING PRODUCT

73. Are there documented procedures for identification/segregated (where space allows)
       to a designated area?
Yes        No

74. Is there a formal material review board?
Yes        No

75. Are non-conformances recorded to permit defect analysis?
Yes        No

76. Are reworked parts reinspected and/or tested according to the control plan?
Yes        No

COSTS OF QUALITY

77. Are there documented procedures for collection of cost of quality?
Yes        No

78. Does evidence exist that quality costs are effectively being collected, analyzed and
       used for management review and action?
Yes        No

CORRECTIVE ACTION AND RECURRENCE PREVENTION

79. Do written procedures define suppliers corrective actions?
Yes        No

80. Is there documentation supporting the corrective action?
Yes        No

81. Is the corrective action system used as a basis for production improvements?
Yes        No

QUALITY SYSTEM AUDIT

82. Are there formal procedures for internal quality audits?
Yes        No

83. Does the internal audit cover all system elements outlined in the standard requirements?
Yes        No

84. Are audit findings available to all levels of personnel as well as management?
Yes        No

85. Are there documented corrective actions for internal audits?
Yes        No

Type of survey:	Self Customer on Premises
Company/Division:
Address:
City:		Zip:
Phone:		Fax:

Manufacturing:		Engineering:
Other:		Total Number:
Quality Contact: