PROPOSED CONSTRUCTION AND COMPLETION OF 2 BLOCKS OF OFFICE BUILDINGS,

RETAIL SPACES AND EXTERNAL WORKS ON PLOTS Z1 AND Z2, 3 LEVELS OF BASEMENT
PARKING AND ACCESS ROAD ON PLOTS Z1, Z2, Z3 AND Z4; AND UPGRADING WORKS TO
JALAN ALAMANDA WITH ASSOCIATED INFRASTRUCTURES AND LANDSCAPING WORKS
AT PRECINCT 1, WILAYAH PERSEKUTUAN PUTRAJAYA

NON CONFORMANCE REPORT (NCR)

PART 1 : TO BE COMPLETED BY INITIATOR
Classification: Quality / Health & Safety / Environment NCR No.: AZ/M&E/AFS/04
NATURE OF NON-CONFORMANCE (Tick where applicable)
Letter/ NCR ref
/ Customer complaint/ NCR PRSB/BPD/COMM/Z1-
Work Activity Item :
from Client Z4/AZSB/MECH/NCR/017-
2023_____________________
Product / material Item : _______________ Inspection / Test Item : ___________________

Specification Clause : ___________ Drawing Ref & Rev :___________________

Section 1: Details of Non-conformity

(please describe clearly and attached photo where applicable) ESTIMATED NON-
CONFORMANCE VALUE:
Services and Maintenance of Parcel Z1 for M&E Services During DLP

Reply Due Date : To be responded within 3 days after received RM : Subject to Contract
Department
Initiated by:
Approved by (PM): Received by:
Name : ___________________
Date : 08.05.23 . Name : ___________________ Name : ___________________
Date : ___________________ Date : ___________________

PART 2 : TO BE COMPLETED BY RESPONDER

Section 2: Proposed Correction
Use as is Repair / Reject / Re-work Others (please specify)
Attachment :
(if required)

Date Target to be Completed :

Section 3: Result of Investigation and Root Cause determination

Not comply the specification and required complete of services

Section 4: Proposed Corrective Action

To reinstate service and maintenance works

Proposed by: Proposed Corrective Action Agreed by (PM) :

Name : ___________________ Name : ___________________

Date : ___________________ Date : ___________________
PART 3 : VERIFICATION BY INITIATOR
VERIFICATION WORKS AND CLOSING NCR NCR close out
The above corrective actions have been carried out satisfactory and recommend for NCR to be closed Yes
No

Verified by (Initiator): Approved by (PM) :

Name : ___________________ Name : ___________________

Date : ___________________ Date : ___________________

Form.Ref.:AZ-IMSP-NCR-015/F1 (Rev.1.0) Revision Date: 01/03/2017