Section 1- NCR Identification (To be filled out by Identification)

Ref. No.: Date: Project No.:

Issued to: SSC: Discipline:

Detailed Location: NCR Grade: On Site/ Off Site:

Quality Phase: Group Element: Element:

Description:

Reference Documents: Assigned to:

Section 2- Correction Proposed & Agreed (to be filled out by Assignee and agreed by SSC/WSP)
Proposed Action to correct deficiency:

Proposed Completion Date:

Correction Type: Significant cost or delay impact:
Proposed Agreed by (name): Organisation:
(Signature)
Date:

Section 3- Correction Complete & Agreed (to be filled out by Assignee and agreed by SSC/WSP)
Correction Complete by (name): Organisation:
(Signature)
Date:

Agreed action complete and acceptable?:: Yes No

Completion Verified by (name): Organisation:
(Signature)
Date:

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