SRU BLOCK (EPCC-7 PACKAGE)

VISAKH REFINERY
MODERNIZATION PROJECT
(VRMP)

NON CONFORMANCE REPORT

Reference number:
Project Title: Visakh Refinery Modernization Project
NCR No:
Project No.: JI-2040
Petrofac/Supplier/ Sub-contractor Name: Purchase Order / Subcontract No.:

Department/ Discipline: Description of Product (if applicable):

Description of Deficiency [ Non-conformance]:

Part - 1

Control of Reference:

NCR Originator: Date:

NCR Acknowledged by:

Location: ☐ Home office ☐Site ☐Supplier

Date:
Shop
Disposition* (Correction for functions like Engineering, Procurement):

☐ Use as it is. ☐ Repair ☐ Rework ☐ Reject

Part - 2

Justification (Correction) Description:

Proposed by: Planned Completion Date:

Petrofac Approval for Disposition: ☐ Approved. ☐ Approved with comments. ☐ Rejected.
Part - 3

Name: Signature: Date

Client Approval required for Disposition? ☐ Yes. ☐ No. If Yes, Concession Request reference:
________

Name: Signature: Date

Root Cause:
Part - 4

Corrective Action (to prevent recurrence):

Proposed by: Planned Completion Date:

Verification of Disposition / Corrective Action Completion:
Part - 5

By: ………………………………………… Date: …………………………………………

Part 6

NCR Close out: -

By: ………………………………………… Date: …………………………………………

Note:
Part- 1 & Part- 5 shall be completed by the Originating Function in relevant stages.
Part- 2 & Part- 4 shall be completed by the Receiving Function and returned in agreed time frame
Part- 3 & Part- 6 shall be for Petrofac Project Quality Representative to complete
* Disposition for functions like Engineering, Procurement etc is not applicable, correction details to be filled

Attachment-1, Ref Doc. No.: 2040-Q-PLN-CO-0003-0001 Page

Attachment-1, Ref Doc. No.: 2040-Q-PLN-CO-0003-0001 Page