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PLSB

Ref. No. Project Reported By Dept. CC

NON COMPLIANCE/CONFORMITY REPORT (NCR)


Date Issued

Document No. PLSB-FRM-054

Rev 0

Date 06/01/2010

Attention To Trade
CM / PM / PIC / Directors

Company

To be filled by Reporter Details of Nonconformity Photo Attached

Stop work immediately Continue with precaution ACT : Recommended Action SEC / REG : Action By Due Date

To be filled by Responsible Personnel Comment by the Accused If Necessary Date :

Please take note due to failure to comply NCR, you are hereby agreed the company to pay all cost may incurred to clear your non-compliance or incomplete works. Agreed By Verified By
(CM/PM/PIC)

Signature Signature

Date Date

To be filled by Assigned Personnel / MR Follow Up Action / Verification Comments / Remarks : NCR Status (tick or x ) Closed Done Closed-Done by RDS Open Not Done Issue New NCR Verified by Signature Date

Do not duplicate without PLSB authorization

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