Project Non-Conformance Report

PBS Number: PA or TA Number:

DBS Number: Report Number:

Section: To be completed by the contractor

Contract number and Item number(s):

Contract Title:

Contractor:

Item Identification:

Requirement:

Description of the non-conformance:

Proposed remedial Action:

☐ Use as ☐ Rework ☐ Reject
is

List of Attachments:

Proposed non-conformance category:

☐ Minor
Non-conformance (Report should be sent to company for information and remedial action implemented)

☐ Major
Non-conformance (Remedial action to be implemented only after company written acceptance)

Contractor’s Responsible Officer:

Name: Date:

Signature:

Contractor’s Quality Officer:

Name: Date:

Signature: