NON.CONFORMANCE REPORT XO.

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Project: NSK- 66
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neceivCa by Concessionairo's ReP:

Name IE Rep: fl oi*tvarn b"rn$.Ot NCR Categories
Signature: fr3a'.rn6.r- ,/ Signature:

MAJOR MINOR
Date: t1 I tt I s-a )-a
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Date: ,lt . "lpnlo .
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Root Causes of NC:

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"

Corrective Action ProPosed I I

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Siguature of Cono*r$r# TargetCompletiondate: .tE ,/ 1,"t9,21 ,

Posal: YES / NO

Signature of Contactor's rep :Actual olosing date:

!
','.'i:
[eview of corrective action & closing of NCR:
IE Rep:

Signature:

Date: