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DEVIATION FORM

MACHINE NO:
DATE &
TIME
PART NAME:

CAVITY NO:
SHIFT
CUSTOMER NAME:

LOCATION:

PROBLEM DESCRIPTION:

PROBLEM INITIATED INFORMED TO


PERSON(Department) (Department)

PROBLEM DEVIATION: DEVIATED PERSON

CONTAINMENT ACTION TAKEN

RESPONSIBLE PERSON NAME & SIGN

PERMANENT ACTION TAKEN


RESPONSIBLE PERSON NAME & SIGN

QS MANAGER & DEVELOPMENT PDC INCHARGE


DEVIATION FORM
PDC INCHARGE
QA/F32/00

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