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Non-Conformity Report
Format No. QS/FM/03
Rev.1
Page 1 of 2
IDENTIFICATION
ProjectTitle:
JobNo.: Date:
Client: NCR ReportNo:
Subject: NCR IssuedTo:
Originator: Contractor/Vendor:
Location: Reference Document:
Found During What Activity
☐IncomingInspection ☐ InProcessInspection ☐ Final Inspection ☐Other(s)_____________________
DECRIPTION
OF
NON-CONFORMANCE
Description of the nonconformity & possible root causes (Note the applicable specifications, standards,
requirements, procedures, references, drawings, activities, etc.; use a continuation page if necessary)
Name: Signature &Date
PROPOSED
DISPOSITION
☐ Use as Is
☐ Repair/ Rework
☐ Reject
☐ Returnto Vendor
☐ Other_________________________________
________________________________________
________________________________________
PROPSED CORRECTIVE ACTION
☐ By RSATPL ☐ BY Vendor
ROOTCAUSE
ANALYSIS
Name: Signature &Date
CORRECTIVE
ACTION
Name: Signature &Date
Non-Conformity Report
Format No. QS/FM/03
Rev.1
Page 2 of 2
CLOSURE
OF
NON-
CONFORMITY
Verification of Implementation of CA
Name: Signature &Date
Annexure
Sl.NO Description Remarks

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Ncr new format

  • 1. Non-Conformity Report Format No. QS/FM/03 Rev.1 Page 1 of 2 IDENTIFICATION ProjectTitle: JobNo.: Date: Client: NCR ReportNo: Subject: NCR IssuedTo: Originator: Contractor/Vendor: Location: Reference Document: Found During What Activity ☐IncomingInspection ☐ InProcessInspection ☐ Final Inspection ☐Other(s)_____________________ DECRIPTION OF NON-CONFORMANCE Description of the nonconformity & possible root causes (Note the applicable specifications, standards, requirements, procedures, references, drawings, activities, etc.; use a continuation page if necessary) Name: Signature &Date PROPOSED DISPOSITION ☐ Use as Is ☐ Repair/ Rework ☐ Reject ☐ Returnto Vendor ☐ Other_________________________________ ________________________________________ ________________________________________ PROPSED CORRECTIVE ACTION ☐ By RSATPL ☐ BY Vendor ROOTCAUSE ANALYSIS Name: Signature &Date CORRECTIVE ACTION Name: Signature &Date
  • 2. Non-Conformity Report Format No. QS/FM/03 Rev.1 Page 2 of 2 CLOSURE OF NON- CONFORMITY Verification of Implementation of CA Name: Signature &Date Annexure Sl.NO Description Remarks