No.

Dokumen SAN-MR-FR-013
FORMULIR
No. Revisi
Tanggal berlaku 18/02/2023
DAFTAR DISTRIBUSI DOKUMEN
Halaman 1 dari 4

Bagian Status Revisi

Resource
Human
Jawab Teknis
Penanggung
Marketing
Direktur
No. Dokumen Nama Dokumen Keterangan

Gudang
00 01 02 03 04

1_001_SAN_CDAKB Pedoman Mutu √ √ √ √ √

1_002_SAN_CDAKB Kebijakan Mutu √ √ √ √ √
1_003_SAN_CDAKB Sasaran Mutu √ √ √ √ √
1_004_SAN_CDAKB Prosedur Tetap Audit Internal √ - √ - -
1_005_SAN_CDAKB SK Tim Audit Internal √ - √ - -
1_006_SAN_CDAKB Form Daftar Hadir Audit Internal √ - √ - -
1_007_SAN_CDAKB Form Daftar Periksa Audit Internal √ - √ - -
1_008_SAN_CDAKB Form Jadwal Audit Internal √ - √ - -
1_009_SAN_CDAKB Form Laporan Hasil Audit Internal √ - √ - -
1_010_SAN_CDAKB Form Program Audit Internal √ - √ - -
1_011_SAN_CDAKB Form Rangkuman Hasil Audit Internal √ - √ - -
Form Tindakan Perbaikan Audit
1_012_SAN_CDAKB √ - √ - -
Internal
1_013_SAN_CDAKB Prosedur Tetap Manajemen Risiko √ √ √ √ √
1_014_SAN_CDAKB Form Analisis Risiko √ - √ - -
1_015_SAN_CDAKB Form Manajemen Risiko √ - √ - -
Prosedur Tetap Pengendalian
1_016_SAN_CDAKB √ √ √ √ √
Dokumen
1_017_SAN_CDAKB Form Daftar Induk Dokumen Internal √ - √ - -
1_018_SAN_CDAKB Form Daftar Induk Dokumen Eksternal √ - √ - -
1_019_SAN_CDAKB Form Daftar Induk Rekaman Arsip √ - √ - -
1_020_SAN_CDAKB Form Distribusi Dokumen √ - √ - -
Form Identitas Status Pengendalian
1_021_SAN_CDAKB √ - √ - -
Dokumen
1_022_SAN_CDAKB Form Perubahan Dokumen √ - √ - -
1_023_SAN_CDAKB Prosedur Tetap Pengendalian Catatan √ √ √ √ √
1_024_SAN_CDAKB Form Daftar Catatan Mutu √ - √ - -
1_025_SAN_CDAKB Form Label Arsip √ - √ - -
1_026_SAN_CDAKB Form Peminjaman Catatan Mutu √ - √ - -
1_027_SAN_CDAKB Form Laporan Pemusnahan Catatan √ - √ - -
1_028_SAN_CDAKB Prosedur Tetap Tinjauan Manajemen √ - √ - -
1_029_SAN_CDAKB Form Program Tinjauan Manajemen √ - √ - -

1
1_030_SAN_CDAKB Form Jadwal Tinjauan Manajemen √ - √ - -
1_031_SAN_CDAKB SK Wakil Manajemen √ √ √ √ √
Form Daftar Hadir Tinjauan
1_032_SAN_CDAKB √ - √ - -
Manajemen
1_033_SAN_CDAKB Form Jadwal Tinjauan Manajemen √ - √ - -
1_034_SAN_CDAKB Form Notulen Rapat √ - √ - -
Form Tindakan Perbaikan Tinjauan
1_035_SAN_CDAKB √ - √ - -
Manajemen
1_036_SAN_CDAKB Struktur Organisasi √ - √ - -
1_037_SAN_CDAKB Proses Bisnis √ - √ - -
1_038_SAN_CDAKB Analisis Internal Eksternal √ - √ - -
2_001_SAN_CDAKB Prosedur Tetap Distribusi - - √ - √
2_002_SAN_CDAKB Form Surat Jalan - - √ - √
Prosedur Tetap Penanganan Produk -
2_003_SAN_CDAKB - - √ √
Kembalian
2_004_SAN_CDAKB Form Daftar Produk Kembalian - - √ - √
Form Surat Pengantar Produk -
2_005_SAN_CDAKB - - √ √
Kembalian
Prosedur Tetap Pemeliharaan Dan
3_001_SAN_CDAKB - - - √ √
Instalasi
3_002_SAN_CDAKB Form Permohonan Perbaikan - - - √
3_003_SAN_CDAKB Form Bukti Perbaikan - - - √
3_004_SAN_CDAKB Form Bukti Instalasi - - - √ √
3_005_SAN_CDAKB Form Daftar Alat Ukur - - - √ √
3_006_SAN_CDAKB Form Kalibrasi - - - √ √
3_007_SAN_CDAKB Form Surat Perintah Kerja - - - √ -
3_008_SAN_CDAKB Prosedur Tetap Higiene Perorangan - - - √ -
3_009_SAN_CDAKB Prosedur Tetap Pembersihan Gedung - - - √ -
3_010_SAN_CDAKB Form Jadwal Pembersihan Ruangan - - - √ -
3_011_SAN_CDAKB Form Catatan Pembersihan Ruangan - - - √ -
3_012_SAN_CDAKB Prosedur Tetap Pest Control - - - √ -
3_013_SAN_CDAKB Form Pengendalian Hama - - - √ -
3_014_SAN_CDAKB Prosedur Tetap Pengurusan Perizinan - - - √ -
3_015_SAN_CDAKB Form Daftar Izin Edar - - - √ -
3_016_SAN_CDAKB Prosedur Tetap Sistem Komputerisasi - - - √ -
Form Daftar Peralatan Dan Perangkat -
3_017_SAN_CDAKB - - - √
Lunak
3_018_SAN_CDAKB Form Jadwal Validasi - - - √ -
3_019_SAN_CDAKB Prosedur Tetap Cara Mencuci Tangan - - - √ √
Prosedur Tetap Keselamatan Dan
3_020_SAN_CDAKB - - - √ √
Kesehatan Kerja
Prosedur Tetap Penanggulangan
3_021_SAN_CDAKB - - - √ √
Kebakaran
Prosedur Tetap Penanggulangan
3_022_SAN_CDAKB - - - √ √
Listrik Padam
Prosedur Tetap Penanggulangan
3_023_SAN_CDAKB - - - √ √
Gempa Bumi

2
3_024_SAN_CDAKB Form Daftar APAR - - - √ √
3_025_SAN_CDAKB Form Daftar Tanda Peringatan - - - √ √
4_001_SAN_CDAKB Prosedur Tetap Penerimaan Karyawan √ - - √ -
4_002_SAN_CDAKB Surat Pengangkatan Karyawan - - - √ -
4_003_SAN_CDAKB Form Permintaan Karyawan - - - √ -
4_004_SAN_CDAKB Form Biodata Calon Pelamar - - - √ -
Form Test Dan Psikotes Calon -
4_005_SAN_CDAKB - - √ -
Karyawan
4_006_SAN_CDAKB Form Wawancara - - - √ -
4_007_SAN_CDAKB Form Evaluasi Wawancara - - - √ -
4_008_SAN_CDAKB Form Perjanjian Kerja Waktu Tertentu - - - √ -
4_009_SAN_CDAKB Prosedur Tetap Pelatihan Karyawan √ - - √ -
4_010_SAN_CDAKB Form Jadwal Pelatihan Internal √ - - √ -
4_011_SAN_CDAKB Form Permintaan Pelatihan - - - √ -
4_012_SAN_CDAKB Form Absen Pelatihan - - - √ -
4_013_SAN_CDAKB Form Evaluasi Pelatihan Karyawan - - - √ -
4_014_SAN_CDAKB Form Matriks Kompetensi - - - √ -
4_015_SAN_CDAKB Form On Job Training - - - √ -
4_016_SAN_CDAKB Form Penilaian Kerja Karyawan - - - √ -
Prosedur Tetap Pemeriksaan
4_017_SAN_CDAKB √ - - √ -
Kesehatan Karyawan
Form Jadwal Pemeriksaan Kesehatan
4_018_SAN_CDAKB - - - √ -
Karyawan
Form Hasil Pemeriksaan Kesehatan
4_019_SAN_CDAKB - - - √ -
Karyawan
4_020_SAN_CDAKB Form Data Karyawan Peserta BPJS - - - √ -
4_021_SAN_CDAKB Prosedur Tetap Lembur - - - √ -
4_022_SAN_CDAKB Form Lembur Kerja - - - √ -
4_023_SAN_CDAKB Prosedur Tetap Cuti Dan Izin - - - √ -
4_024_SAN_CDAKB Form Cuti - - - √ -
4_025_SAN_CDAKB Form Izin - - - √ -
4_026_SAN_CDAKB Form Ketidakhadiran Karyawan - - - √ -
4_027_SAN_CDAKB Form Rekapitulasi Cuti Karyawan - - - √ -
Prosedur Tetap Pemutusan Hubungan
4_028_SAN_CDAKB √ - - √ -
Kerja
4_029_SAN_CDAKB Form Pemutusan Hubungan Kerja - - - √ -
4_030_SAN_CDAKB Form Persetujuan Pengunduran Diri - - - √ -
Form Penyerahan Atribut
4_031_SAN_CDAKB - - - √ -
Kepegawaian
Form Mapping Ketersediaan
4_032_SAN_CDAKB √ - - √ -
Karyawan
4_033_SAN_CDAKB Form Uraian Tugas Direktur √ - - √ -
Form Uraian Tugas Penanggung
4_034_SAN_CDAKB - - √ √ -
Jawab Teknis
5_001_SAN_CDAKB Form Proposal Promosi √ √ - - -
5_002_SAN_CDAKB Form Kebutuhan Sarana Promosi √ √ - - -

3
5_003_SAN_CDAKB Form Pemantauan Sarana Promosi √ √ - - -
5_004_SAN_CDAKB Prosedur Tetap Penanganan Komplain - √ - - -
5_005_SAN_CDAKB Form Keluhan Pelanggan - √ - - -
Form Laporan Hasil Evaluasi Keluhan
5_006_SAN_CDAKB - √ - - -
Pelanggan
5_007_SAN_CDAKB Form Monitoring Keluhan Pelanggan - √ - - -
Prosedur Tetap Survey Kepuasan
5_008_SAN_CDAKB - √ - - -
Pelanggan
5_009_SAN_CDAKB Form Database Pelanggan - √ - - -
5_010_SAN_CDAKB Form Survey Kepuasan Pelanggan - √ - - -
5_011_SAN_CDAKB Form Purna Jual - √ - - -
5_012_SAN_CDAKB Form Checklist Perbaikan Purna Jual - √ - - -
Prosedur Tetap Recall Dan Simulasi
5_013_SAN_CDAKB - √ - - -
Recall
6_001_SAN_CDAKB Prosedur Tetap Pembelian - √ - - √
6_002_SAN_CDAKB Form Perencanaan Pembelian - √ - - √
6_003_SAN_CDAKB Form Permintaan Pembelian - √ - - √
6_004_SAN_CDAKB Form PO - √ - - √
6_005_SAN_CDAKB Form Seleksi Calon Pemasok - √ - - √
6_006_SAN_CDAKB Form Daftar Pemasok - √ - - √
6_007_SAN_CDAKB Form Evaluasi Pemasok - √ - - √
6_008_SAN_CDAKB Prosedur Tetap Warehouse - √ - - √
6_009_SAN_CDAKB Form Bukti Penerimaan Barang - √ - - √
6_010_SAN_CDAKB Form Bukti Penyimpanan Barang - √ - - √
6_011_SAN_CDAKB Form Stock Opname - √ - - √
6_012_SAN_CDAKB Form Data Persediaan - √ - - √
6_013_SAN_CDAKB Form Delivery Order (DO) - √ - - √
6_014_SAN_CDAKB Form Kontrol Kondisi Gudang - √ - - √
6_015_SAN_CDAKB Form Kebersihan Gudang Produk Jadi - √ - - √
Berita Acara Pemusnahan Alat
6_016_SAN_CDAKB √ √ √ √ √
Kesehatan
6_017_SAN_CDAKB Prosedur Tetap Penandaan - √ - - √
6_018_SAN_CDAKB Form Lampiran Label Status Produk - √ - - √