Form No

: MRR-AEC-01

Revision No

:0

Report No

Page No

of

INSPECTION REPORT

MATERIAL RECEIVED & INSPECTION REPORT

Customer

Date Received

WO No
-

Product Receiving Details

Comment / Remarks

Product Name / Code:

Manufacturer:

PT. KHI Purshase Order No:

Delivery Date:

Delivery Order No:

Quantity Order Received:

Type of Packaging:

Packaging Condition:

Good

Damage

Certification Received:

Yes

No

Order Completed:

Yes

No

PT. KHI Testing Required:

Yes

No

Date Sample Delivery to Laboratory: -

PT. KHI Test Report Received: Yes

No

Date Test Report Received: -

Product Batch Numbers

Certificate Number

Date of Manufacture

Expire Date
-

Comment / Remarks:

PT. KHI Pipe Industries

Prepared by

Reviewed by

QC Inspector

QC Supervisor

COOEC

HCML

Reviewed by

Reviewed by