@ etseweoy evectRi¢ Gye Arab Cantatars NON-CONFORMANCE REPORT — (CT internat Audit (1) [_] Operational (0) 1 Supplier (8) Hl Subcontractor (Se) Issued To: aRABcoNTRACTORS tanzania [NCR Ref:7000-IVP-ACTAN-NHMOO1- Location _:_sNuPe [Date Prepared: 25.10.2022 TWACEE TSE PLAN SVDPS42 HSE INSPECTION AND TESTIN 3.1to se ae [Clause No, [Standard Clause Ref: | van aGeMENT PLAN 36 juality System! Procedure! Document againsl which NCR is raised In accordance to the Project HSE-ITP Att.01 periodical inspections shall be conducted for all site ‘equipment and tools as per the mentioned plan. The inspector shall inspect the equipment, tool, facility, et. and report the deviations to the concemed parts. ‘These non-conformities shall be registered in the corrective action plan to track the actions status, to analyze the deviations and to obtain the trends which will be used as a lesson leamed for the upcoming process, The involved contractor shall correct the nonconformities and request for re-inspection. N ance Finding Description Equipment fourth quarter safety inspection was conducted, and findings (concerns) were collected into the attached comment sheet, sub-contractor didn’t take the necessary corrective actions, also sub-contractor ‘was required to correct the nonconformities and request for the re inspection, NIAP104 ALOT Rev 03 20 Feb. 2020 Page tof3@ eLSeweoy ‘Ge Hah Contractors NON-CONFORMANCE REPORT Fee Root Causes) [)Materiat J Machine []Monpower [] Method [7] Design [Process 5] qiher Initiated by (Signature) Cost Center Manager (Signature) (Name) Gift Flustian Yusht (ame) Date 25.10.2022 Date 25.10.2022 Original: D4 Departmen Copy: OAC Co {Sted to Suhconpstors, PCS De Cer, Procaronent Depart for NR sued Suppers, Cnraca Depart fr NCR ybcoumaciors, Sup JVIAPIDA AILGY Rev.03.20 Feb, 2 Proposed Correstion Action Proposed Comective/Preventive Action(s) Repair Reject Use “As Is” © The contractor shall correct the nonconformities and request for re-inspecton. Each driver shall conduct the daily visual inspection before work start, HSE team will double check these facilities. Target Date of Completion: 10.11.2022 Target Date of Completion; 10.11.2022 Initiated By: Gift Fustian Mushi Signature: Je-°P Date: 25.10.2022 Proposed Correstive Action Acceptance Accepted Rejected Comment Remarks Name: Signature: Date: FOLLOW-UP CHECK Findin Gee Veritied iby Cost Centet Manager Date Date ‘R CLOSE 01 INITIATOR AGE | OWNER sacl “Approval | approval a poten Name [Name I [Name Pag 2012eLseweoy ELECTRIC Ee ab Concacars NON-CONFORMANCE REPORT — Signature T Signature | Signature | Job Title I Job Title Job Title Date Date Date ‘rinks Ot Deparment Cops Q4EC. Cat Cor. Ptrencn Depa or NCR ana Sepia Coarse fr KO [Boned Sbconracos, PCS Dyparmen for NCR edo Subcontractors, Supplier JVIAP TOA At.07 Rev 03 20 Feb. 2000 Page 3or3