NON-CONFORMANCE REPORT (NCR)

PART-I: TO BE COMPLETED BY THE INITIATOR

Reference Standards / Procedures / Codes: NCR No: Date of Discovery:

Date of NCR:

Description of Non-Conformance:

Non-conforming Dept / Discipline / Organization:

_____________________________ _____________________________
Name and Signature of Initiator QA Manager

PART-II: TO BE COMPLETED BY NON-CONFORMING PARTY

Proposed Corrective Action (Immediate Correction):

Proposed date to complete the Correction: ____________________

Analysis of Root Cause & Proposed Action To Prevent Recurrence of Non-conformance:

Date for completion of action to prevent recurrence: ____________________

Signature Date
Department Mgr/Supv

PART-III: TO BE COMPLETED BY APPROVING PARTY (DICIPLINE MANAGER / ENGINEERING MANAGER): Proposed corrective action
is
(a) Accepted (b)Rejected (c) Other (Specify)

Signature Date
Discipline Manager/ Engineering Manager

PART-IV: TO BE COMPLETED BY VERIFYING PARTY

Corrective Action Taken:

Preventive Action Taken:

Name & Signature Name & Signature

Date Date
Dept Mgr/ Supv
Verified by:

Close out & Log Entry:

Date Signature

CLOSING REPORT FOR NCR_

Date:

F- QA-002_rev.01
 NON-CONFORMANCE REPORT (NCR)

ANALYSIS OF ROOT CAUSE:

PROPOSED CORRECTIVE ACTION:

PREVENTIVE ACTION:

REMARKS:

Verified By Reviewed By Reviewed By Reviewed By

Prepared By
(QC Supervisor) (QA Manager) (CM) (PM)

F- QA-002_rev.01