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APPENDIX B (BC180049KN)
Sample Quality Control Plan FOR
<<Contractor Name>>
<<Contract Name>>
<<Contract Number>>
Disclaimer: The contractor is responsible for ensuring that this
document complies with all requirements of the Contract.
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 2 Rev. No. 2 April 2016
Table of ContentsA. Purpose .................................................................................................................................................................... 3
B. Scope ........................................................................................................................................................................ 3
C. Policy ........................................................................................................................................................................ 3
D. Quality Control Staff ................................................................................................................................................ 3
1. Organization Chart ............................................................................................................................................... 3
2. Quality Control Manager (QCM) or QC Point‐of‐Contact (QCPoC) ...................................................................... 3
3. Quality Control Inspector(s) (QCIs) ...................................................................................................................... 4
4. Quality Control Independent Materials Testing Lab (IMTL) ................................................................................ 4
E. Procedures ............................................................................................................................................................... 4
1. Daily Inspection Report (DIR) ............................................................................................................................... 4
2. Control of the Work ............................................................................................................................................. 5
3. Control of Special Processes ................................................................................................................................ 5
4. Non‐Conformances (NCRs) .................................................................................................................................. 5
5. Corrective Actions (CARs) .................................................................................................................................... 6
6. Audits ................................................................................................................................................................... 6
7. Handling and Storage of Equipment / Material ................................................................................................... 6
8. Training ................................................................................................................................................................ 6
9. Quality Control Records ....................................................................................................................................... 6
F. Inspection and Test Plan (ITP) .................................................................................................................................. 7
G. Attachments and Forms ........................................................................................................................................... 7
Attachment 1 – Organization Chart ............................................................................................................................. 8
Attachment 2 – Quality Control Manager (QCM) Qualifications and Resume ............................................................ 9
Attachment 3 – Quality Control Inspector(s) Qualifications and Resume(s) ............................................................. 10
Attachment 4 – Quality Control Independent Materials Testing Lab (IMTL) ............................................................ 11
Attachment 5 – Daily Inspection Report (DIR) ........................................................................................................... 12
Attachment 6 – Checklists for Control of the Work ................................................................................................... 13
Attachment 7 ‐ Non‐Conformance Report (NCR) and Instructions ........................................................................... 14
Attachment 8 – Non‐Conformance Report (NCR) Log ............................................................................................... 16
Attachment 9 – Corrective Action Report (CAR) and Instructions ............................................................................. 17
Attachment 10 – Material Receiving Register (MRR) ................................................................................................ 19
Attachment 11 – Inspection and Test Plan (ITP) Matrix ............................................................................................ 20
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 3 Rev. No. 2 April 2016
A. PurposeThe purpose of this Quality Control Plan is to address the contract requirements related to Quality in a clear
and concise document. Various contract documents have been used as references to create this document
including the following:
General Provisions (GPs)
Special Provisions (SPs)
TriMet’s Quality Assurance Program Manual
Technical Specifications (i.e. Divisions 1 thru 16)
B. ScopeThis QCP applies to all phases of work on the Contract and to all subcontractors and suppliers, except where
noted. If a subcontractor or supplier has a quality program specifically tailored for their scope of work on
the project, that document must be submitted to <<Contractors Name>> for approval and be filed as a
Quality Record. The Owner may also require copies of any standalone quality plans in order to perform QA
audits.
C. PolicyIt is the policy of <<Contractors Name>> that Quality be given the resources necessary to achieve the
contract requirements for quality. Quality Control has also been given the authority to stop work that is not
in compliance with the Contract requirements. This authority for Quality Control to stop work applies to all
crafts and trades on the project.
D. QualityControlStaffThe Quality Control Staff for <<Contractors Name>> is comprised of the following personnel:
1. OrganizationChartRefer to Attachment 1 for a current Organization Chart for the project. This Organization Chart shows
the lines of reporting and authority for the QC team and how quality relates to other members of the
project team to include Owner Representatives, Project Manager, Project Superintendent, Project
Engineers, etc.
2. QualityControlManager(QCM)orQCPoint‐of‐Contact(QCPoC)Refer to Attachment 2 for qualification information for the QCM/QCPoC in accordance with
requirements delineated in Special Provisions Section SP‐08.
Option 1 ‐ The QCM shall have no other duties on the project except management of this QCP. The
QCM will be onsite whenever permanent features of the Work are being constructed. During planned
absences of the QCM a QC Designee has been identified and included on the Project Organization Chart
(see Attachment 1).
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 4 Rev. No. 2 April 2016
Option 2 – The QCPoC will be the primary point of contact for the TriMet RE with regards to daily quality
concerns. The QCPoC will be onsite during work activities. During planned absences of the QCPoC a QC
Designee has been identified and included on the Project Organization Chart (see Attachment 1).
3. QualityControlInspector(s)(QCIs)Refer to Attachment 3 for qualification information for the QCI(s) proposed for use on this contract.
(Inspectors may be sourced from the QC IMTL to perform day‐to‐day material inspections and special
inspections defined in the Technical Specifications, drawings, and Special Provisions Section SP‐08.)
4. QualityControlIndependentMaterialsTestingLab(IMTL)The QC IMTL will be used to inspect and test materials (i.e. concrete, reinforcement, soil compaction,
welding – see Special Processes below, asphalt, etc.) when required by the contract documents and
technical specifications. Refer to Attachment 4 for information regarding the QC IMTL. Lab certification
for the proposed QC IMTL has been included, along with a list of lab equipment that requires regular
calibration and may be used on the project.
E. ProceduresThe following procedures will be utilized to provide a comprehensive quality control effort on this contract.
1. DailyInspectionReport(DIR)<<Contractor’s Name>> QC Manager (or QC Point‐of‐Contact) will complete a DIR (see Attachments and
Forms) for each day that work is performed on the project (weekends included). Each report will be
completed with relevant information for work performed that day and as a minimum will include the
following information:
Production related information (may be completed by the Superintendent and provided to QC)
Work performed (Contractor/Subcontractors) and personnel levels
Types of equipment on‐site and hours of operation during the report period
Weather related information
Quality related information (to be included by the QCM or designated representative)
Materials received on site, including quantities
Inspections and tests conducted/witnessed and associated results
Summary of any conversations/instructions given or received that are relevant to the work being
performed
Any deficiencies found during recurring or special inspections
Causes for the rejection of current work or Stop Work Orders
Proposed remedial activities implemented regarding existing non‐conformances
Signed by the individual responsible for QC
Attachments: Each DIR may have attachment(s), which may include such items as:
Results of independent tests conducted by IMTLs
Completed checklists created and used to control the major features of the work (see below)
Paperwork received as part of a material or equipment delivery
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 5 Rev. No. 2 April 2016
Daily Inspection Reports and all relevant attachments will be transmitted to the TriMet RE on a regular
basis, but no later than weekly (i.e. either each completed DIR will be transmitted to the RE daily or they
will be transmitted to the RE in a weekly package, typically the following Monday. (This item will be
confirmed between the QCM and the RE.)
See Attachment 5 for an example of the Daily Inspection Report (DIR) developed for use on this project.
2. ControloftheWorkFor each major feature of the Work <<Contractor’s Name>> will develop a sequential checklist that can
be used to verify and document that the Work is being done in compliance with the specifications.
Major features of the Work include:
Concrete
Field Welding
Steel Fabrication
Structural Steel Welding
Items that will be tracked on these checklists will include:
Preceding work has been satisfactorily completed/tested/accepted
Components or features of the work that will ultimately make it complete are being properly
installed or assembled (i.e. concrete formwork, reinforcing steel, clearances, cleanliness, etc.)
Hold or Witness Points that require Owner involvement
Signed by the individual responsible for the work (Superintendent/Foreman)
Signed by the QC Manager, confirming that items were verified
See Attachment 6 for checklists developed based upon the technical specifications and <<Contractor’s
Name>> means and methods. Checklists may be updated or added as the phases of work advance.
3. ControlofSpecialProcessesSpecial processes of the Work (welding, brazing, etc.) will require specific guidelines in addition to this
QCP describing how the work will be controlled. For work involving welding <<Contractor’s Name>> will
provide information for the proposed welder qualifications, weld procedures (WPSs) and special
inspectors required to oversee this work in accordance with AWS D1.1.
4. Non‐Conformances(NCRs)A non‐conformance is considered to exist when either material or equipment exhibits a deficiency in
either physical inspection characteristics or documentation. This procedure applies to all material and
equipment, including the actions associated with installation or construction that for any reason, fails to
conform to Specifications/Standards.
The QCM will initiate an NCR when an issue described above is noted on the project. The Owner may
also opt to issue an NCR if they feel the Contractor is not being responsive. Each NCR shall be
categorized based upon the root cause of the NCR. Root causes for the NCR may include
miscommunication, damaged, handling of materials, incorrect drawing, materials/supplier, failure to
follow plans/specs, quality control, survey, workmanship.
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 6 Rev. No. 2 April 2016
A Request For Information (RFI) will not be used to address deficient work.
Attachment 7 (NCR Form) and Attachment 8 (NCR Log) have been included in the Attachments and
Forms section of the QCP.
5. CorrectiveActions(CARs)A corrective action required when NCR conditions become repetitive in nature, especially if they are due
to the same root cause. Repetitive NCRs indicate that a breakdown has occurred in the quality process,
and that the proposal to prevent recurrence of the unacceptable condition (NCR) was not implemented
effectively.
Attachment 9 (CAR Form) has been included in the Attachments and Forms section of the QCP. A CAR
Log (not included in the QCP) will be developed and maintained when appropriate and will be similar in
nature to the NCR Log.
6. AuditsThe QC Manager (or QCPoC) will schedule and perform quality audits of subcontractors/suppliers based
upon the scope of their activities to ensure that procedures from this QCP are being adhered to.
<<Contractor’s Name>> will also perform an internal audit of the QCP program managed by the QCM
(or QCPoC). The Owner may also choose to perform external audits of any aspect of the Contractors
QCP, either based upon trends (positive or negative), milestone achievements or regular cycles within
the contract.
7. HandlingandStorageofEquipment/Material<<Contractor’s Name>> has established a Materials Receiving Register (MRR) to manage the receipt and
handling/storage of equipment/material as items arrive on the Project and are ultimately incorporated
into the Work.
Unacceptable materials will be identified and segregated to prevent incorporation into the Work.
Identification will be achieved by physically (select one – tagging, marking with paint).
See Attachment 10 included in the Attachments and Forms section of the QCP for the MRR.
8. Training<<Contractor’s Name>> QC Manager (or QCPoC) will provide training on this Plan to site personnel with
direct responsibility for quality workmanship (Superintendents, Foremen, Laborers, Subcontractors, etc.)
and project management team members (Project Manager, Project Engineers, etc.). This training may
be performed concurrently with other on‐site training such as Weekly Toolbox Safety Talks or as a
standalone activity. Documentation, either in the form of a sign‐in list or a read and acknowledge form,
will be maintained for these training sessions as part of the Quality Control Records.
9. QualityControlRecords<<Contractor’s Name>> has established a list of Quality Control Records that will be indexed, filed and
maintained during the lifecycle of the contract. Items in this list currently include:
Quality Control Plans (QCPs) – including an Organizational Chart
QC Personnel Certifications
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 7 Rev. No. 2 April 2016
Certifications of Independent Material Test Lab(s)
Test Equipment Calibration Certifications
Daily Inspection Reports (DIRs)
Control of Work Checklists
Independent Material Test Lab Inspections and Reports
Non Conformance Reports (NCRs) and Log
Corrective Action Reports (CARs) and Log
Audit Reports (Internal and External)
Material Receiving Register (MRR)
Source Inspection Reports
Training Records
Inspection and Test Plan Matrix
All QC records will be protected from damage and deterioration and the records system has been set up
to provide for timely retrieval, traceability to, and identification with material, equipment and systems.
F. InspectionandTestPlan(ITP)/MatrixBased upon requirements delineated in the contract, an Inspection and Test Plan (ITP) matrix will be
developed and submitted for review/comment/approval by the Resident Engineer. The ITP is considered to
be part of the QCP. The ITP identifies required inspections and tests for each specification section to include
the required frequency, acceptance/rejection criteria, records to document compliance,
procedures/instructions to be used for the control of each activity and who will be performing the test. If a
feature of the work has a designated Hold Point, these shall be noted on the ITP.
The ITP matrix shall be used as a tracking mechanism to status the results of inspection and testing activities.
See Attachment 11 for the format proposed for the ITP matrix.
G. AttachmentsandForms
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 8 Rev. No. 2 April 2016
Attachment1–OrganizationChart(Attach a copy of the Contractor’s Organization Chart, delineating the lines of reporting for the QC staff and how it
relates to executive management for the Contractor.)
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 9 Rev. No. 2 April 2016
Attachment2–QualityControlManager(QCM)QualificationsandResume(Attach a copy of the QC Managers resume and qualifications demonstrating compliance with the contract.)
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 10 Rev. No. 2 April 2016
Attachment3–QualityControlInspector(s)QualificationsandResume(s)(Attach the qualifications and resumes for QC Inspectors that support the QC Manager in his daily activities.
Inspectors may be sourced from the IMTL.)
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 11 Rev. No. 2 April 2016
Attachment4–QualityControlIndependentMaterialsTestingLab(IMTL)(Attach the IMTLs Lab Certification and a list of any equipment that requires regular calibration and may be used
on this project.)
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 12 Rev. No. 2 April 2016
Attachment5–DailyInspectionReport(DIR)DAILY INSPECTION REPORT
Project Name: Date:
Contractor: Contract No.:
QC Manager: Inspector: Initials Initials
Shift Day / Night Number of Personnel Major Equipment (updated as phases of Work change)
Weather Info Su
perintendent
Foreman
Equip Operators
Truck Drivers
Laborers
Trainee
/Apprentice
Flaggers
Excavator
Backh
oe/Load
er
Compacter/Roller
Bulld
ozer
Dump Truck
Skid Steer
Crane
Sweep
er Truck
Water Truck
Concrete Pump
24hr Precipitation
Temperature
Wind
Max Humidity
Contractor/Subs/Equip Hours Worked
Weather Data: http://www.weather.com/weather/pastweather/hourly/97211 Rainfall Data: http://or.water.usgs.gov/non-usgs/bes/multnomah.rain
CONSTRUCTION ACTIVITY: Craft/Trade, Location, Activity
QC TEST(S) CONDUCTED / OBSERVED / RESULTS:
MATERIALS RECEIVED FOR INCORPORATION INTO THE WORK: (see MRR Log for detailed information)
COMMENTS / PHONE MESSAGES / VERBAL INSTRUCTIONS:
MEETINGS / DISCUSSIONS / VISITORS TO PROJECT:
POTENTIAL ISSUES:
EROSION CONTROL:
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 13 Rev. No. 2 April 2016
Attachment6–ChecklistsforControloftheWork
EXAMPLE
Concrete Pre‐Placement Checklist
Date: Contractor / Sub:
Placement Date: Estimated CY: Supplier:
Estimated Pour Time: Actual CY Placed: Concrete Mix #:
Actual Pour Time:
Placement Location:
Item / Feature of Work
Foreman/Supt. (Init. and Date)
Constr. QC Rep (Init. and Date) Comments
Survey
Line/Grade/Alignment
Formwork
Subgrade Material
Rebar Size/Grade
Rebar Clearance
Anchor Bolts
Embedded Items
Electrical
Utilities
Blockouts
Other
Pre‐placement Approval – Contractor QC Representative (Print/Sign Name and Date)
Print / Sign: Date:
Additional Comments / Notes:
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 14 Rev. No. 2 April 2016
Attachment7‐Non‐ConformanceReport(NCR)andInstructions
<<Contractor Name>>
N O N - C O N F O R M A N C E R E P O R T ( N C R )
1. Contract No.
2. Location
3. Date
4. NCR No.
5. Contractor/Subcontractor/Supplier
6. Specification Section/Dwg No.:
7. Originator of NCR: Other
Contractor DoR/EoR
8. Nonconformance Description: 9. Root Cause Code for Nonconforming Condition (Select the most appropriate item or mark ‘o’ and provide an explanation):
c. Miscommunication d. Damaged h. Handling of Materials i. Incorrect Drawing m. Materials/Supplier
o. Other (please explain):_______________________________________________________________________________
p. Failure to follow Plans/Specifications q. Quality Control s. Survey w. Workmanship
10. Responsible Person’s Proposed Disposition:
Reject Repair* Rework* Use-As-Is *Provide Guidelines Below for Repair or Rework Process Date Name (Print) Title Signature
11. Responsible Person’s Proposal to Prevent Recurrence of Unacceptable Condition: 12. QC Manager’s Concurrence with the Proposed Disposition and Proposal for Prevention: QC Manager Date Name Title Signature
13. Designer/ Engineer of Record (DoR/EoR) Disposition of Proposed Remediation: (if applicable) Accepted Rejected Comment(s): Date Name (Print) Title Signature
14. RE’s Disposition of Proposed Remediation: Accepted Rejected Comment(s): TM Resident Engineer Date Name Title Signature
15. TriMet Quality Assurance (ALL NCR items are tracked by TriMet QA for Trending Purposes)
NCR Condition and proposed remediation have been noted: Yes No TM QA Manager Date Name Title Signature
16. QC Manager’s Verification: Disposition completed. Item Ready for Re-inspection (or NA for Use-As-Is) Yes NA QC Manager Date Name Title Signature
17. RE’s Verification: Disposition completed. Item Re-inspected/Acceptable: Yes No TM Resident Engineer Date Name Title Signature
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 15 Rev. No. 2 April 2016
NON-CONFORMANCE REPORT FORM INSTRUCTIONS Blocks 1 through 11 are completed by the Originator of the NCR document.
1. Enter the contract number 2. Enter the physical location of the NCR (survey stationing, platform, turnout number, building grid …) 3. Enter the date the NCR item was noted/confirmed as an NCR, not the date the NCR was written/issued 4. Enter the unique NCR number obtained from the NCR log 5. Enter the contractors, subcontractors, installers or suppliers complete name that is responsible for the NCR 6. Enter the applicable technical specification section and paragraph or drawing number reference 7. Check one box indicating whether the Originator is the DoR/EoR, Contractor or Other 8. Describe the nonconformance in detail. Provide a brief description of contract requirements 9. Select a code (c,d,h,i,m,p,q,s,w) or select and describe in o – Other, the root cause of the non-conformance
NOTE: If the NCR is initiated by someone other than the Contractor or Responsible Person, Blocks 1-9 need to be completed by the Initiator and then the form needs to be sent to the Responsible Person/Contractor for completion of Blocks 10 and 11.
10. Check one box indicating the proposed disposition for the non-conformity. Options Include: Reject: Removal of the non-conforming item from the site. Repair: Restoring or modifying an item to a condition that will make it acceptable for its intended
use. This disposition may require concurrence from the Designer of Record and/or the Engineer of Record, as determined by the Owner. Include a description of the proposed repair procedure.
Rework: Reprocessing an item to conform to the specified requirements. This disposition requires a description of the proposed rework procedure.
Use-As-Is: Accepting a non-conforming item as meeting the intent of the contract documents. This disposition may require concurrence from the Designer of Record and/or the Engineer of Record, as determined by the Owner.
Attach any supporting information as needed to describe the Repair or Rework process. This may include sketches, drawings, product data sheets, calculations, etc.
11. Person(s) Responsible for Remediation proposal to prevent recurrence of this unacceptable condition. Proposals may include additional training in construction practices, increased inspection activity, removal of person performing deficient work, etc.
Blocks 12 through 17 12. Completed by the Contractor’s QC Manager. Confirm that all information included in Blocks 1-11 is
appropriate and complete. 13. If determined to be applicable by the Owner (CMGC contract) or the D/B team (Design/Build contract),
Block 13 is completed by the Designer/Engineer of Record's representative. Mark the appropriate box indicating acceptance or rejection of the disposition proposed in Block 10. If 'Rejected' is marked please provide a brief description of the basis for the rejection. Complete the date, name, title and signature entries in the block.
14. REQUIRED - Block 14 is completed by the Owner's representative. The Owners representative is the Resident Engineer. Mark the appropriate box indicating acceptance or rejection of the disposition proposed in Block 10 and any subsequent conditions imposed by the DoR or the EoR representative(s). If 'Rejected' is marked please provide a brief description of the basis for the rejection. Complete the date, name, title and signature entries in the block.
15. REQUIRED - Block 15 is completed by the TriMet Quality Assurance Manager. ALL NCR items are tracked by TriMet QA for trending purposes and possible issuance of a Corrective Action. Complete the date, name, title and signature entries in the block.
16. REQUIRED - Block 16 is completed by the Contractor’s QC Manager. Indicate if the non-conforming item has attained the disposition status proposed in Block 10, as agreed upon by the Owner/DoR/EoR and is ready for reinspection, by checking 'Yes'. If the proposed disposition of the NCR condition was ‘Use-As-Is’ then the NA block should be checked since reinspection is not necessary. Complete the date, name, title and signature entries in the block.
17. REQUIRED - Block 17 is completed by the Resident Engineer or their delegated/designated inspector. Indicate if the non-conforming item has attained the disposition status proposed in Block 10, as agreed upon by the Owner/DoR/EoR/Contractor by checking 'Yes' or 'No'. Complete the date, name, title and signature entries in the block.
Upon completion of Block 17 the NCR document may be distributed and filed per document control guidelines.
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 16 Rev. No. 2 April 2016
Attachment8–Non‐ConformanceReport(NCR)Log
Non‐Conform
ance Report Log
Date
Closed by
RE
RE
Disposition
DoR/EoR
Approval
Proposed
Disposition
Date
Noted
Issued To
Originator
Description
NCR No.
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 17 Rev. No. 2 April 2016
Attachment9–CorrectiveActionReport(CAR)andInstructions
<<Contractor Name>>
C O R R E C T I V E A C T I O N R E P O R T ( C A R )
1. Contract No.
2. Item Location(s)
3. Date
4. CAR No.
5. Responsible Organization
6. Specification/Drawing No.
7. Originator of CAR Contractor Owner
8. Previously Issued NCRs, DNs or AFRs
9. Response Due Date
10. Reviewed By (Supervisor)
11. Description of Recurring Condition and Contract Requirement
12. Root Cause of Problem
13. Action Taken to Prevent Recurrence
14. Response Prepared By
15. Response Date
16. CAR Implementation Date
17. Originators Disposition □ Acceptable □ Unacceptable
18. Signature Date
19. Verification of Corrective Action (Provide Description)
20. QA Disposition □ Acceptable □ Unacceptable
21. Signature Date
22. Confirmation of Corrective Action (Provide Description)
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 18 Rev. No. 2 April 2016
CORRECTIVE ACTION REQUEST FORM INSTRUCTIONS
Blocks 1 through 11 are completed by the Originator 1. Enter the contract number 2. Enter the location of the incident(s) 3. Enter the date the CAR is prepared and issued 4. Enter the unique CAR number 5. Enter the contractor’s, subcontractor’s, installer’s or supplier’s complete name 6. Enter the applicable specification section/paragraph or drawing number reference 7. Check one box indicating whether the Originator is the Contractor or the Owner 8. Reference the previously issued Deficiency Notices (DNs), Non-Conformance Reports (NCRs) or Audit Finding
Reports (AFRs). (If an AFR is referenced, the appropriate Finding Number shall also be noted.) 9. Enter the date the reply is due back to the Originator. (Normally this is ten working days after the date of
issue.) 10. Signature of the Originator's supervisor or manager 11. Provide a description of the recurring deficient condition and the applicable standard from the contract
documents Blocks 12 through 16 are to be completed by the individual or organization responsible for responding to the CAR
12. Describe the root cause(s) for the issuance of the original deficiency paperwork and the CAR document 13. Describe the corrective action, action to prevent recurrence, or action necessary to correct the deficiency 14. Signature of the individual preparing item No. 12 15. Enter the date the response in Block 13 was completed 16. Enter the proposed effective date of the CAR implementation
Blocks 17 through 19 will be completed by the Originator
17. Review the proposed resolution and check the appropriate box 18. Signature and date for person assigning the status to Block 17 19. Enter a brief explanation of why the Corrective Action was determined to be acceptable or unacceptable
Blocks 20 through 22 will be completed by TriMet Quality Assurance
20. Review the implemented resolution and check the appropriate box 21. Signature and date for person assigning the status to Block 20 22. Enter a brief explanation of why the Corrective Action was determined to be acceptable or unacceptable
When the CAR is closed/completed
The original remains in the Originators files Copies are sent to the TriMet Resident Engineer and Quality Assurance
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 19 Rev. No. 2 April 2016
Attachment10–MaterialReceivingRegister(MRR)
Material Receiving Register (M
RR)
NCR No.
(if ap
pl)
Basis of Accep
tance: 1
‐Certification of Compliance *; 2‐Certified
material test report from m
anufacturer*;
3‐Visual in
spection for conform
ance ; 4‐Approved submittal; 5‐O
ther
* ‐ Attach documents to the DIR and in
clude in
Contactors QC Records file
Basis of
Acceptance
(See Below)
Identification
No.
Quan
tity
& Unit
Description
PO Number
Supplie
r
Date
Received
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 20 Rev. No. 2 April 2016
Attachment11–InspectionandTestPlan(ITP)Matrix/Status
Inspection and Test Plan (ITP) Matrix
Approved
By (Q
CM,
IMTL, e
tc)
Report
Rcvd, o
n
File
Results
(Pass/Fail)
Hold
Point
(Y/N
)
Test or Insp
Type (A, C
, I,
Visual, T
BD)
Frequency
Testing
Requirements
Item
Description
Sub
Section
Spec
Section
Appendix B; Sample Contractor’s Quality Control Plan Contract No. XXX
Page 21 Rev. No. 2 April 2016