Executive Instruments Inc.

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Self Audit Report Agency Executive Instruments Inc. Phone 972 239 0231 Address 4141 Lindbergh Drive Fax 972 991 3271 Addison State T Zip 75001 Check applicable boxes below Original Equipment Manufacturer FAA Certified Repair Station Date: ( ) Approved ( ) Disapproved Other Reviewed By: Repair Station Certificate # N1R618K Key Personnel: A. Wayne Holmes President Gene Field Sales & Marketing Manager Paul A. Jonathans Quality Manager Terry H. Day Manager Customer Service Gary J. Dock Engineering Quality Systems MIL I 45208 MIL STD 45662 EASA 145 AS9100 FAR Part 145 Other QCF #175 Page 1 of 6

A. Quality Control Program General 1. Is there an established quality program? Are non certificated persons or vendors properly qualified and surveilled? Is there a sample of forms and how to complete them? 4. Is the certificate available for viewing by the public and the FAA? 5. Is there a procedure for revising the Quality Control Manual? 6. Is there a procedure to establish & maintain proficiency of inspection Personnel? 7. Is the security system periodically reviewed? 8. Are exit signs clearly identified and visible? 9. Do customer and /or regulatory authority representatives have access to quality management system documentation? B. C. Quality Control Program Administrative 1. Is administration of the quality vested in a responsible authoritative element? Is there a scheduled internal audit and surveillance program to verify compliance with established policies and procedures? Does the organization conduct management reviews? 4. Are records from management reviews maintained? Data Control 1. Is the OEM technical data used for all pertinent operations? Is the technical data current and up to date? Is the record of revision changes retained? 4. Are all deviations from OEM specifications properly approved? 5. Are all drawings and specifications referenced in the customer purchasing documents available at your facility? 6. Is there a method to ensure the proper revision of drawings and specifications are being utilized? 7. Does the organization have procedures in place for risk evaluations specifically those risks related to new technology and short time scale delivery? 8. Are all outdated drawings and specifications removed from all points of issue and use? 9. Is all supplemental documentation necessary to produce articles to conformance with the design provided to production personnel? QCF #175 Page 2 of 6

D. Corrective / Preventive Action 1. Is a corrective action system maintained? Do the corrective action procedures address corrections of the cause of defects as well as the corrections of defects? Does the organization determine action to eliminate the causes of potential nonconformities in order to prevent their occurrence? E. Customer Service 1. Is there a customer satisfaction survey procedure in place? F. Design 1. Are design changes submitted to the FAA (MIDO) for approval? Do design and development outputs identify key characteristics when applicable in accordance with design or contract requirements? At the completion of design and / or development, does the organization ensure that reports, calculations and test results demonstrate that the product definition meet the specification requirements for all identified operational conditions? G. Purchasing Inspection 1. Is control maintained over procurement sources? Are incoming purchases withheld from use until inspected? Are Records of inspection and testing maintained? 4. Are records of non conforming material maintained? 5. Does the inspection system provide for the review of all customer purchase orders for stated and referenced quality requirements? H. Stockroom 1. Are all materials properly stored? Are all materials properly identified? Are flammable items stored in fireproof cabinets? 4. Is there an active shelf life program? 5. Are only authorized persons allowed entry into the stockroom? 6. Does material in the stockroom have evidence of inspection? 7. Does computer balance match actual count of material in the stockroom bin? QCF #175 Page 3 of 6

I. J. K. 1. Precision Tool and Calibration Equipment Is any tooling which is used as inspection equipment proven for accuracy prior to use and at set intervals to assure accuracy? Where necessary to ensure valid results, is measuring equipment recalled to a defined method when requiring calibration? Is the calibrated equipment traceable to a nationally recognized standards organization? Processing Controls 1. Are controls maintained to prevent defects? Are controls maintained to ensure conformance specifications? Are methods and facilities provided to ensure conformance with any special process requirements? 4. Are certifications of personnel procedures and equipment maintained as required? 5. Are ESD procedures followed? 6. Are all production operations carried out in accordance with approved data? Inspection 1. Are inspections and test performed in accordance with OEM specifications? Are preliminary inspections performed on all incoming articles? Are hidden damage inspections performed on all articles that have been involved in an accident? 4. Is surveillance maintained over: A. Storage B. Preservation C. Marking D. Packing E. Shipping F. Shelf Life 5. Is 100 percent inspection performed at in process and final inspection? 6. Are incoming material sampling plans being followed? 7. Is non conformant material adequately segregated and identified? 8. Does material in the stockroom have evidence of inspection? QCF #175 Page 4 of 6

L. 9. Is there a visual inspection of all parts shipped? 10. Do packing slips contain all required information such as purchase order number, part number, quantity and serial number? 11. Does the quality system ensure proper methods of packing and shipping in order to prevent damage from handling or the environment? 1 Are inspection stamps controlled and designed distinctly different from customers and governments? 1 Do procedures indicate the persons authorized to issue airworthiness releases? Records 1. Are records kept of all tests and inspections? Are records retained for at least ten years? Is a copy of the actual work order forwarded with the invoice? M. 1. 4. Shops Is all work protected from: A. Damage B. Weather C. Loss D. Deterioration Is workspace arranged to prevent damage or contamination of inprocess work? Are competent personnel provided to: A. Do the Work B. Inspect the work C. Supervise workers Are the following stored and identified properly: A. Flammable Liquids B. Oxygen and other high pressure bottles C. Fire extinguishers 5. Are good housekeeping practices observed? QCF #175 Page 5 of 6

N. O. Drug Testing 1. Are Repair Station personnel covered under a FAA approved Drug and Alcohol testing program? Are adequate records of both new hire and random testing maintained? Training 1. Is there a formal training program? Is on the job training documented? Are training records maintained for all technicians, inspectors and supervisors? 4. Does the FOD (Foreign Object Damage / Debris) prevention program provide initial and periodic training to employees? Please include the following: Name of Principle Maintenance Inspector David Shugart ASI Please provide us with a copy of the following: See Website A. Air Agency Certificate and Operation s Specifications B. Letter approving your FAA Anti Drug Program C. Letter approving your FAA Alcohol Program. QCF #175 Page 6 of 6