Sitio Rizza, Brgy.

San Jose
Antipolo City
Telefax No. 434-2653
www.nexorpipes.com
admin@nexorpipes.com

DOCUMENT CHANGE NOTICE

Date: ___________________________________________________ Control No:________________________________
Document No: ______________________________________________ Rev. No :__________________________________
Document Title: _____________________________________________________________________________________________

Document For : Creation Revision Cancellation

Reason for creation/revision/cancellation :

___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
_________________________________________________________________________________________.

Changes to be made:
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
_________________________________________________________________________.

Approved by General Manager / Administrative Officer :

Requested By: _____________________ _____________________________________

( Originator ) ( G. Mngr./ Adm Officer )

Received By: ____________________

(Document Controller )
No. of Interfacing Department:

ADM Katheryn T. Vallester

HRD Mary Alvi S. Ayran
SALES Melanie Manrique
PUR Gennalyn Lacdao
PRO Joefert D.C. Quiza
DCC Ralph Esteban
IQA Ralph Esteban
QA Ernie Balsamo Jr.
MCD Sherwin Loremia
MAI Joefert D.C. Quiza

QSP-form#16/rev.00/03-05-09
 DOCUMENT CHANGE NOTICE
Date: ___________________________________________________ Control No:______________________________
Document No: ______________________________________________ Rev. No :________________________________
Document Title: _____________________________________________________________________________________

Document For : Creation Revision Cancellation

Reason for creation/revision/cancellation :

_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________

Changes to be made:
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
____________________________________________________________________________________________________

Requested By: Review By:

Signiture over printed name Signiture over printed name

( Originator ) (QMR)
Checked By: Approved By:

Signiture over printed name Signiture over printed name

(Document Controller ) (President / ADM manager)
Interfacing Departments
ADM
HRD
SALES
PUR
PRO
DCC 1
DCC 2
IQA
QA
MCD
MAI

QSP-form#16/rev.01/11/11/19
 DOCUMENT CHANGE NOTICE
Date: Control No:
Document No: Rev. No :
Document Title:

Document For : New Document Revision Cancellation

Reason for creation/revision/cancellation :

Changes to be made:

Requested By: Review By:

Signiture over printed name Signiture over printed name

( Originator ) (QMR)
Checked By: Approved By:

Signiture over printed name Signiture over printed name

(DCC) (President / Manager)

QSP-form#16/rev.02/05/21/2021