Factory code：
工厂检查调查表
Questionnaire for Factory Inspection
申请人名称: Name of Applicant:
制造商名称:
Name of Manufacturer:
生产厂名称: Name of Factory:
中 国 质 量 认 证 中 心 China Quality Certification Center
1.1 工厂注册名称：
Name of the factory:
工厂地址：
Address of the factory:
电话(含区号): 传真： 邮政编码： Tel: Fax: Post Code
电子邮件： E-mail:
抵达工厂的最佳交通路线（最近的火车站、机场；如可能，请附一张当地地图） The Optimal route to factory [local Railway station, airport (with the map if possible)]
1.2 制造商注册名称：
Name of the manufacturer:
制造商注册地址：
Address of the manufacturer:
电话(含区号): 传真： 邮政编码： Tel : Fax: Post Code:
电子邮件： E-mail:
2. 申请人注册名称：
Name of the applicant:
地址： Address:
电话(含区号): 传真： 邮政编码： Tel: Fax: Post Code:
电子邮件： E-mail:
认证联系人： 部门及职位： 电话： Contact person of certification: Department/position: Tel:
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3.
工厂质量负责人姓名、工作部门及职位、联系电话
The name, department/position and telephone of principal on quality assurance
质量负责人姓名： 部门及职位： 电话：
Name of the principal: Department/position: Tel:
4. 工厂员工总数（如申证产品生产仅是其中一部分，请注明与申证产品生产、管理有关的员工人数）
Total amount of employees in the factory (If the production for the certified product is just one part of the whole production, please indicate the amount of employees for the production and management on the products applied for certification)
5.1 申证产品申请编号、名称、型号规格、商标
The application No., name, model /specification and trade mark of the products applied for certification
5.2 申请产品认证依据的标准
Pursuant standards of the products applied for certification
6.1 工厂是否按认证实施规则的要求建立文件化质量体系？提供①组织机构图②质量手册目录③程序文件
目录。
Has the factory established and maintained a documented quality system according to the requirement of the implementation rules for certification? Provide ①the chart of organization structure ②the list of the quality manual ③the list of the documented procedures .
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6.2 由工厂完成的申证产品生产工艺流程 (请提供生产流程图并填写附表1：关键生产设备明细表)
Indicate the production process on the products applied for certification, which is performed by factory. (Please provide the production flow chart, and fill in the Appendix 1-- List of Key Production Equipments.)
6.3 说明由分承包方提供的关键零部件和原材料（如已通过CCC认证或其它同等的产品认证的，请注明）
Indicate the critical parts and materials, which are provided by the subcontractors.
(Please give clear indication if the parts have passed the CCC or other equivalent product certifications.)
6.4 具体说明为了确保最终产品符合相应标准，企业在进货检验、过程检验和最终检验中具备了哪些项目
的检验能力。（请提供一份检验文件目录清单并填写附表2：主要检测仪器、检测设备明细表）
To ensure that the final products conform to corresponding standards, please specify on which items the factory has inspection ability during in-coming inspection, process inspection and final inspection. (Please provide a list of inspection documents and fill in Appendix2-- List of Main Test Instruments and Equipments).
7. 说明申请认证产品已获得的其它认证机构颁发的认证证书和认证标志。
Please indicate the Certificates and the Marks been got by the products for which the Certification have being applied.
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8.
工厂的质量体系是否已通过质量体系认证？（如有， 请提供证书复印件）。请说明最近一次审核的日期及结论。
Whether or not the factory has obtained the certificates of quality system certification (please provide the copy of the certificates) and indicate the date and conclusion of last audit).
希望安排检查的时间：
Date of factory inspection expected:
工厂休息日： 工厂上下班时间：
Off day of factory: Time of factory on/off duty:
可否在休息日检查 (Whether or not the inspection could be done on off day):
可以(yes) 可商议(discussible) 不可以(no)
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10. 是否同意认证机构的检查员在正常生产时，经与质量保证负责人接洽后，可以进入涉及认证产品生产
及管理的所有场所？
Whether or not the inspectors of Certification Body are allowed to access all sites for production and management on products applied for certification under consulting with quality principal during regular production?
工厂代表签章： Signature and stamp of the representative of the factory:
日期： Date:
注：本表签字人应对所填写的信息的准确性负责。
Note: The undersigned person shall be responsible for the veracity of the information filled in this
questionnaire.
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附表1 Appendix 1
关键生产设备明细表 List of Key Production Equipments
工厂名称： Name of factory:
共 页第 页
page of
主要技术参数 Main technical parameters 台数 Quantity 工位 Location 序号 No. 生产设备名称 Name of equipment 制造商 Manufacturer
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附表2 Appendix 2
主要检测仪器、设备明细表 List of Main Test Instruments and Equipments
工厂名称： 共 页第 页 Name of factory: page of
序号 No. 检测仪器、设备名称 Name of instruments & equipments 制造商 Manufacturer 测量范围 精度 Measure scope Precision 台数 Quantity 工位 Location
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