TS-070-024-Att2 2.00 2009-6-9 上海通用汽车有限公司供应商潜在质量风险申报单 DECLARATION FORM FOR POTENTIAL QUALITY RISK FROM KEY SUPPLIERS OF SGM 申报日期 DeclarationDate: 年Y 月M 日D 供应商跟踪编号Tracking Code: 供应商名称Supplier Name 供应商地址Supplier Address 申报人姓名Declarer’s Name 申报人联络地址、邮编 Declarer’s Address 申报人电子信箱 E-Mail SGM联络人姓名SGM Contactor’s Name SGM联络人电子信箱 E-Mail 电话/手机 Telephone/MB SGM联络人部门职务 Declarer Title 电话/手机 Telephone/MB 申报人部门职务 Declarer Title 潜在质量风险申报内容： Content of the declaration of potential quality risk 1. 2. 3. 4. 5. 供应商经营战略、经营环境、关键质量岗位人员发生重大变化，可能产生潜在质量风险； Main change occurs in the supplier’s business strategy，business environment and the key quality staff, which may cause potential quality risk. 供应商紧急工艺过程更改，缺乏时间对此更改进行充分验证，可能产生潜在质量风险； Supplier urgent production process change and no enough time for validation, which may cause potential quality risk. 供应商紧急产品设计更改，缺乏时间对此更改进行充分验证，可能产生潜在质量风险； Supplier urgent product design change and no enough time for validation, which may cause potential quality risk. 供应商内部发现质量问题，经确认缺陷零件或可疑零件已发运SGM； Supplier finds quality problem internal and the defect parts or suspected parts have been shipped to SGM. 供应商的相同或相似零件在其他客户处发生重大质量问题或者可能引起召回，经确认缺陷零件或可疑零件也涉及已发运或待发运SGM的； Serious quality problem occurs in other client on the same or similar part, or it will cause a recall. The defect parts and suspected parts include the parts which have been shipped to SGM or is about to be shipped to SGM. 6. 7. 8. 供应商处批量零件返修后重新发运的； Supplier batch retrofit parts are shipped. 供应商处发生内部批量零件让步放行的； Supplier batch concessional parts are shipped.其它供应商认为需要申报的潜在质量风险问题。 Other potential quality risk which needs to be reported.对上述通知、申报潜在质量风险具体说明(可附报告)Detail description of declaration of potential quality risk(Attachment)： 影响零件和车型 Influenced Part & Platform No 零件名称 Part Name 1 2 3 4 5 6 零件号 Part No. 影响日期或批次信息 Effected Batch/Lot Number 影响数量 Effected Qty 影响车型 Effected Platform 备注 Notes 希望SGM提供协助的具体要求 What kind of assistance is needed from SGM?
TS-070-024-Att2 2.00 2009-6-9 上海通用汽车有限公司供应商潜在质量风险申报单(附件) DECLARATION FORM FOR POTENTIAL QUALITY RISK FROM KEY SUPPLIERS OF SGM(Attachment) 上海通用汽车供应商质量与开发初步评估结果和要求(SGM填写)：SGM SQ&D initial evaluation results and requirement 是否递交上海通用汽车FPET小组评审 ? Need to submit to SGM FPET for review? 是 否 上海通用汽车FPET小组评估的结果和要求（SGM填写）：SGM FPET evaluation results and requirement 上海通用汽车应对措施和结案纪录(SGM 填写)：SGM Containment and Close record 供应商潜在质量风险申报处理结果（申报后2个月内由SQE反馈供应商） Supplier’s potential quality risk declaration result(feedback from SQE to supplier in 2 months after declaration) 上海通用汽车采购部供应商质量工程师 SGM SQE： 上海通用汽车采购部供应商质量与开发科 SGM SQ&D 年（Y） 月 (M) 日(D)
