To: NIPPON KAIJI KYOKAI Date: APPLICATION FOR MANAGEMENT SYSTEM AUDIT I, the undersigned applicant, request the NIPPON KAIJI KYOKAI, to provide the certification services as described below in accordance with the Certification of the “Rules for Management Systems”. Annual Renewal Occasional (due to: ) □ Initial □ □ □ Transfer of Management System Certification □ Kind of Audit (Name of Existing Certification Body: ) ISO 9001:2015 ISO 14001:2015 ISO 45001:2018 □ □ □ JIS Q 9001:2015 JIS Q 14001:2015 JIS Q 45001:2018 □ □ □ Applicable Standards (If you apply for different kinds of audits for ISO 50001:2015 □ OHSAS 18001:2007 □ multiple applicable standards, please apply for JIS Q 50001:2015 □ the audits for each applicable standard.) Certification No.: (No entry for Initial Audit) Organization Name: Address : (*) Top Management: Name Position Name and Address Management Representative for Management System: (when available) Name Position Person in Charge: Name Position Tel. Fax. E-Mail (Please fill in an appropriate organization or departmental e-mail address.) Scope of Certification (Refer to description of existing certificate) * No. of People (including part-time worker, temporary worker, cooperative company worker Number of Personnel etc.) (involved in the scope of Application of Shift Work □: No □: Yes certification) (Please fill out the attachment 1 with details.) Expected Date of Audit Contract with Consultant No Yes Name of Consultant: □: □: Information for Management System Documents (Please fill in the title, document number, revision number and or revised date, etc.) Remarks Please fill out the attachment 1 about details of each site. (Name & address of sites, scope, number of people etc.) *; Applicant as stated below as stated above □: □: & - Organization Billing address - Tel. No. Fax. No. - Name & Position - Signature
To: NIPPON KAIJI KYOKAI Date: APPLICATION FOR MANAGEMENT SYSTEM AUDIT I, the undersigned applicant, request the NIPPON KAIJI KYOKAI, to provide the certification services as described below in accordance with the “Rules for Certification of the Management Systems”. Kind of Audit □ Initial □ Annual □ Renewal □ Occasional (due to: ) □ Transfer of Management System Certification (Name of Existing Certification Body: ) Applicable Standards □ ISO 9001:2015 □ JIS Q 9001:2015 □ ISO 14001:2015 □ JIS Q 14001:2015 □ ISO 45001:2018 □ JIS Q 45001:2018 □ ISO 50001:2015 □ JIS Q 50001:2015 □ OHSAS 18001:2007 (If you apply for different kinds of audits for multiple applicable standards, please apply for the audits for each applicable standard.) Name and Address Certification No.: (No entry for Initial Audit) Organization Name: Address : (*) Top Management: Name Position Management Representative for Management System: (when available) Name Position Person in Charge: Name Position Tel. Fax. E-Mail (Please fill in an appropriate organization or departmental e-mail address.) Scope of Certification (Refer to description of existing certificate) Number of Personnel (involved in the scope of certification) * No. of People (including part-time worker, temporary worker, cooperative company worker etc.) Application of Shift Work □: No □: Yes (Please fill out the attachment 1 with details.) Expected Date of Audit Contract with Consultant □: No □: Yes Name of Consultant: Information for Management System Documents (Please fill in the title, document number, revision number and or revised date, etc.) Remarks *; Please fill out the attachment 1 about details of each site. (Name & address of sites, scope, number of people etc.) Applicant & Billing address □: as stated below □: as stated above - Organization - Tel. No. Fax. No. - Name & Position - Signature
FORM_QA-50-60E.docx