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Quality Inspection Report 1/1: Job Number Project Page of

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Job Number Project Page of

Quality Inspection Report 1/1

CONTRACTOR: _____________________________ REPORT NUMBER:

TYPE OF INSPECTION: Preparatory Inspection. Initial Inspection. Follow-up Inspection. Completion Inspection.

DESCRIPTION/INTENT OF INSPECTION: _____________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

COMPONENTS/MATERIALS REVIEWED: ____________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

CONTRACTOR PERSONNEL CONTACTED: __________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

APPLICABLE CONTRACTOR PROCEDURES, CHECK LISTS, INSTRUCTIONS: ____________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

RESULTS OF INSPECTION: _________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

DEFICIENCIES NOTED: ____________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

RECOMMENDED CORRECTIVE ACTION: ____________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

NON-CONFORMANCES: ___________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

QA Inspector Signature: Date:

D-2

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