MATERIAL NON-CONFORMITY REPORT

PROJECT TITLE: _______________________________________________________________________________________________

CONTRACT NO:_____________________________________
NCR CONTROL NO:______________________________________________
SUPPLIER:____________________________________________________________________________________________________

INSPECTION REQUEST NO: RE-INSPECTION REQUEST NO:

TIME:____________________________ DAY:______________________________________
DATE:____________________________________
PURCHASE DATE:______________________________________________________________________________________________________

MATERIAL CODE & DESCRIPTION:________________________________________________________________________________________

CUSTOMER REFERENCE SPECIFICATION:___________________________________________________________________________________
Violation Description:

NCR Issued By: _______________________________________________ (Name & Designation)

DATE:________________________________ NCR Closure Expected Date:______________________________
NCR received & accepted By:__________________________________________(Name & Designation)
DATE:________________________________
Corrective Action:

Preventive Action:

Root Cause Analysis:

Corrective & Preventive Action Accepted By:___________________________________________(Name & Designation)

Root Cause Analysis Accepted By:___________________________________________(Name & Designation)

APPROVED APPROVED WITH COMMENTS NOT APPROVED, REDO

MNCR Accepted & Closed By QA/QC Manager: __________________________________________ (Name & Designation)
Final Date of Closure by QA/QC Manager:________________________________________________

CNCR Accepted & Closed By SAOO/TSD/CPMD Egineer: _____________________________________________________(Name & Designation)

Final Date of Closure by PID:________________________________________________

MNCR Accepted & Closed By PID: __________________________________________ (Name & Designation)

Final Date of Closure by PID:________________________________________________

Form # (R/QS/04/02 Rev.1)