Engineered Components & Systems India Pvt Ltd

Bnaglaore
Request for Deviation Waiver
(Supplier fill in)
Hari Bhargo Engineering
Stamping & Toolings
supplier
name Peenya Bangalore contact phone 9844778324

Part name PALTE drawing No. V 26-001 Apply dept. QA

Applicant MURALIDHRA apply time effective time expiration time

1/2/2020 1/2/2020

quantity 50 batch No. 20- (12/19) Reviewed by Murali

(Description of non-conformance):

Item： PLATE

Free from Scratch

Drawing &Marks Flatness Measurment of Deviation
spec： Part( Specfication 0.70 Max)
Sl no Flatness Jud
Current Mark observed
1 0.64 0
Mark -Part 2 0.58 o
3 0.52 o
4 0.62 o
5 0.54 o

(Root cause of non-conformance):

Die Mark while Doing Secondary Operation for Flatness

(Corrective and preventative step) :

Die plate re ground for a voiding mark , for secondary operation

(filled in by AST):
(Signature): (Signature): (Signature):

(date): (date): (date):

(sourcing dept.) (quality dept.) (supply chain)
(filled in by Business Unit)
department) (Comment) (Signature)

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