Production Part Approval
Dimensional Test Results
ORGANIZATION: PART NUMBER:
SUPPLIER CODE: PART NAME:
NAME OF INSPECTION FACILITY: DESIGN RECORD CHANGE LEVEL:
INSPECTION DATE: ENGINEERING CHANGE DOCUMENTS:
SPECIFICATION SPECIFICATION
SPECIFICATION ORGANIZATION MEASUREMENT RESULTS (DATA)
DRAWING DIMENSION TOLERANCE
ITEM QTY. Sample Sample Sample Sample Sample Sample
Nominal Minus (-) Plus (+) MINIMUM MAXIMUM Dev Dev Dev Dev Dev Dev OK NOK
TESTED 1 2 3 4 5 6
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
0.00 0.00 X
Blanket statements of conformance are unacceptable for any test results.
SIGNATURE TITLE DATE