100 Bed Isolation INCR No.

: HOS-SQM-NCR-001
Hospital for COVID-
19 Date: 30 Apr.2020

NON-CONFORMANCE REPORT (NCR)

DISCIPLINE CIVIL MECH. ELECT/INST TELECOM ARCHTL OTHERS

Impact
Originated By: Affected Area
High Middle Low
Name
Mohammed Tariq Aziz Damaged Corridor Material X

VIOLATION ROOT CAUSE

During our inspection for the delivered material, it has Used material and preservation in factory was bad
been noticed that most of the flat pack elements are either
damaged, dirty or not preserved in factory storage and it
is not complying as requirement of ACWA Power.

From: Originator’s Signatu Designation Department

M/S*
Anwar Mohiuddin re QC Supervisor Quality Control

Problem Notified to Signatu Designation Department

M/S* Sudhir Menon re Operation Manager Fabrication
CORRECTIVE ACTION: PREVENTIVE ACTION:
Action Taken to Eliminate the Problem Action Taken to Eliminate or Minimized the occurrence of the
Problem
(a) (b)

Assign To: Name (By: N/M/S**) Designation Target Date/ACD Task Completed By: Name Signature Completion
Date
.

Implementation Verified By: Designation Signature NCR Closed Originator’s Signature

Name
NCR Open

Verified By: Concurred By:

ACWA Power ACWA Power

*M/S- manager or Supervisor **N/M/S-Notified Manager or Supervisor You may use another sheet if Necessary
NCR Form No.: NCR 01 Revision Status: 0