Office of Operations
21st Century Operations Using 21st Century Technologies
Table of Contents

Appendix C. Sample System Problem / Change Request (SPCR) Form

This appendix contains a sample System Problem/Change Request (SPCR) form. This form is used to formally record and describe a system problem and/or to request a change to a Configuration Item (CI) (i.e., document, drawing, hardware and software) and track its review, assessment and approval or rejection by the CCB.

SPCR Form Responsibility

The SPCR originator, Change Assessment and Resolution (CAR) Leader (if necessary), CM Manager, and CCB Chair all have responsibilities in completing different sections/items on the SPCR form. These responsibilities are detailed below.

  • The Originator (SPCR form white area items 1 through 15) - the originator starts the SPCR process. After determining that the problem/proposed change affects a CM controlled item, the originator completes items 1 through 15 on the SPCR form. If an assessment is required or no specific action is being recommended, the SPCR needs to be assigned to a CAR leader and items 7, 8 and 15 should be left blank. The originator should complete items 9, 10, 11, 12 and 13, if known. If the originator cannot determine if the SPCR affects a CM controlled item or if the SPCR needs to be assigned to a CAR leader, the originator should contact the CM Manager.
  • The CAR Leader (SPCR form white area items 1 through 15) - the CAR leader (assigned by the CM Manager) is responsible for the accuracy of the information provided by the originator and for the completion and/or validation of items 7 through 15.
  • The CM Manager (SPCR form shaded area items 16 through 27) - the CM Manager has the overall responsibility for the integrity of the form including the accuracy of the original information on the form and for completing or revising information during the SPCR life cycle. The CM Manager assigns the SPCR numbers (items 25 and 26) and maintains the SPCR History (item 27).
  • The CCB Chair (SPCR form items 28 and 29) - the CCB Chair signs and dates the SPCR form validating the CCB Action (approval or rejection) for SPCR disposition and authorizes the recommended action for approved SPCRs.

SPCR Item Description

Listed below is a description of each individual item on the SPCR form that follows. The number of the item corresponds with the number in each box of the form.

1. Originator: –Name of individual initiating the requested change.

2. Organization: –The name of the organization/group the originator represents.

3. Date: – Date that originator completes the SPCR.

4. Subject: – An appropriate subject title depicting the problem or requested change.

5. Type of Change:

  1. Stand Alone – The "stand alone" SPCR is one that is normally a simple change. This could be a wording change to a document, a view change on a drawing or a simple change to software that normally does not affect any other area and requires no additional assessment by others. In this type of change the originator knows exactly what document number, drawing number or software version is affected.
  2. Assessment Required – Used when investigation is required for total change impact on all areas. This will require an assignment of a CAR Leader to study the problem and prepare supporting information for a recommended action.

6. Reason for Change:

  1. Defect/Error – Reason for change is due to a defect or error to the original baseline item or past revision or version.
  2. Improvement – An improvement to existing hardware, software, etc.
  3. Addition – This reason results in change to existing CM data due to additional new requirements.

7. Affects: – A change may affect one or more of the following. Check all that apply.

  1. Software – Indicate if requested change affects software.
  2. Hardware – Indicate if requested change affects any hardware. Note that all hardware and cabling requested changes must be depicted in drawing concepts.
  3. Documents – Indicate if requested change affects any documents.

8. Priority:

  1. Emergency – This is authorized if a problem or change request must be resolved quickly to avoid a major impact to a particular operation, design, method, etc. Depending on when the problem is found in relationship to a scheduled CCB meeting, this priority SPCR may be acted upon by the CM Manager and Program Manager in advance of meeting. If an SPCR is handled as an emergency, it still must be brought before the CCB to establish results and closure.
  2. Urgent – An urgent request is one that can normally can wait for the next scheduled CCB meeting but the originator feels that it has a high impact to operations, design, methods, etc. An urgent request is one that should be acted on quickly and perhaps as a priority item.
  3. Routine – A routine request is one that should be implemented to best-fit schedule.

9. CSCI(ver): – The name (and version) of the affected Computer Software Configuration Item. If it is found that the originator or CAR Leader has missed a CSCI or entered an incorrect number or version, the CM Manager will make the appropriate change or addition as a result of the CCB meeting.

10. HWCI(ver): – The name (and revision) of the affected Hardware Configuration Item. If it is found that the originator or CAR Leader has missed a HWCI or entered an incorrect number or revision, the CM Manager will make the appropriate change or addition as a result of the CCB meeting.

11. Other Impacts: – If the problem or requested change will impact other areas such as operational or maintenance procedures, software build, training, personnel, cost, schedule, etc. indicate here and include a description of the impact(s) in item 14.

12. Related SPCR(s): – If there are other related SPCRs enter their identification numbers. If this is an SPCR that was generated as CM Manager action to track different parts (e.g. hardware, software and/or documentation) of the original problem/change request separately leave this item blank. The CM Manager will complete this item and items 27 and 28 to indicate related (child and parent respectively) SPCRs.

13. DOC/DRW No.(rev): – Enter all affected document and drawing numbers (and revisions). If it is found that the originator or CAR Leader has missed a document or drawing number or entered an incorrect number or revision, the CM Manager will make the appropriate change or addition as a result of the CCB meeting.

14. Description of Problem/Change: – The description of the problem or change request should be complete enough for the CCB and/or the CAR Leader to understand. If the space provided is not adequate, or if additional documentation is required, a continuation sheet should be used. In this case, a general paragraph must still be entered with the "Additional Data Attached" block checked. If the description of problem/change is continued on additional sheets, include the heading "Description of Problem/Change Cont'd. – SPCR No. ____ Sheet ___ of ___" on each additional sheet. The CM Manager will add the SPCR No. to the continuation sheet(s). Number the Description of Problem/Change continuation sheets consecutively starting with one and include the total number of continuation sheets used.

15. Recommended Action: – A paragraph must be entered for the recommended action. If the space provided is not adequate, or if additional supporting information is required, a continuation sheet should be used. In this case, a general paragraph must still be entered with the "Supporting Data Attached" block checked. Supporting data is any information that the CCB may need to validate the recommended action. This may be information such as cost impact (hours or dollars), schedule delays, other alternate approaches and their results. If the recommended action is continued on additional sheets, include the heading "Recommended Action Cont'd. – SPCR No. ____ Sheet ___ of ___" on each additional sheet. The CM Manager will add the SPCR No. to the continuation sheet(s). Number the Recommended Action continuation sheets consecutively starting with one and include the total number of continuation sheets used.

16. CAR Leader: – The name of the CAR Leader assigned by the CM Manager.

17. Date Due: – The date set by agreement between the CM Manager and the CAR Leader to have analysis complete. This date should be a minimum of 3 days prior to a scheduled CCB meeting.

18. CCB Mtg: – The date of the CCB meeting.

19. Name: – If the CCB requires additional information to be submitted prior to change approval, the name(s) of the individual(s) assigned to provide the information are listed.

20. Assignment: – A brief explanation of the individual's task assignment is listed.

21. Due Date: – The date that the task assignment is due.

22. CCB Action: – SPCR disposition. Not valid without the signature of the CCB Chair's signature in item 28 and the date in item 29.
  1. Pre Approved – Checked if the CCB gives tentative approval based on the future submittal of additional information.
  2. Approved – Checked when CCB authorizes changes to be made to existing CM controlled items.
  3. Rejected – Checked if the CCB determines that the proposed SPCR is not valid.
23. Notes: – The CM Manager will enter any pertinent information as a result of the CCB meeting. 24. Update Assignments:
  1. Doc/Dwg/Software No. – Everything under CM control has a number assigned to it. The number of the document, drawing or software to be updated is listed here.
  2. Old Rev/Ver – For documents and drawings the letter entered will be the current revision. For software, the current version number will be entered.
  3. New Rev/Ver – For documents and drawings the letter entered will be next letter higher than the old letter. For software, the version number will be assigned by the CCB. Note- There may be times when a software version cannot be assigned for a future build. In this case the word "open" will be used.
  4. Update By – The name of the individual responsible for the actual update. If an individual cannot be named, then the organization/group's name will be entered.
  5. QA By – The name of the individual responsible to ensure the integrity of the updated item(s).
  6. Due Date – The date that all data is due back from QA for re-entry into CM Library/Repository. This will be determined by the CM Manager.
25. SPCR No.: – The SPCR tracking number issued by the CM Manager. A four-digit number starting with 0001. For a parent SPCR, the CM Manager should also enter in item 12 (Related SPCRs) the list of child SPCRs created. If this is a child SPCR, enter the parent SPCR number followed by the child's letter designator, e.g. 0001A. 26. Parent No.: – Use for child SPCRs only. When an original SPCR is split, resulting in two or more SPCRs the number of the original (parent SPCR is entered). 27. SPCR History
  1. Log Date – The date when the SPCR was received by the CM Manager and entered into the status log.
  2. Ready CCB – The date that the SPCR is ready for the CCB.
  3. CCB Date – The CCB action date for the disposition of the SPCR.
  4. Close Date – The date that all work is completed, validated and returned to CM Library/Repository.
  5. CM Manager – The name of the individual that validated the SPCR and reviewed updated item(s).

28. CCB Chair Signature: – Signature of CCB Chair (or designee) validating the CCB Action (item 22) for the SPCR disposition.

29. Date: – Date signed by CCB Chair.

SH 1 of ____ (bottom right of form) – If attachments are included as part of the SPCR, add their number and enter the total number of sheets.

Screen capture of a blank SPCR form as described above.

Previous | Next
Office of Operations