Non Conformity Report Format

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Project:

Location:
Report No: XXX-XXXX-NXXX
Insp. Lot

NON
CONFORMITY
REPORT
Prep. By:
Prep. Date:

Tel.
Start Date:

2013.10.21

2013.10.21

Discipline:
Completed
Date:

Block /
Zone /
System:

Priority
Order:

Subject:
Problem:

Cause:

Proposal:

Attachment:
Decision:
( )Use as is
( )Repair
Reject
( )Other
Comment:

( )Rework

( )

Ref. Doc.:
Approved By:
Owner:

ABS Class:

Ref. Doc
Prepared by:

COMMENTS:

Received
by:

Approved by:
PQ

Results:

STATUS:

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