Non Conformity Report Form (NCR)

NON CONFORMITY REPORT Mod 141 - Rev03 - 030818
NAME
DATE OPENING NC
YearMonthDay
4 digit year, 2 digit month, 2 digit dayyyyy - mm - dd
# NC - Number
TYPE OF NON- CONFORMITY
OBJECT OF THE NON CONFORMITY
PRODUCT
PELLET CODE
SUPPLIER
ARRIVAL DATE
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
EXPIRATION DATE
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
PRODUCTION DATE
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
BATCH NUMBER
QUANTITY
DESCRIPTION:
ROOT CAUSE ANALYSIS:
IMMEDIATE ACTION TAKEN
Other
Corrective Action Plan
Other
Responsible Function For Corrective Action Plan
APPROPRIATE TIMESCALE
CORRECTION
sticking pellet
sticking pellet
Sieved
NAME OF EXECUTANT
Type Operator that make the correction
Date of Correction:
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
CLOSURE OF NON CONFORMITY
ONLY QUALITY LAB
NAME OF EXECUTANT
Type Operator that make the correction
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DATE OF CLOSURE NON CONFORMITY
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
DATE OF CLOSURE NON CONFORMITY
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
DATE OF CLOSURE NON CONFORMITY
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
YearMonthDay
PREVENTIVE ACTION PLAN ACTION TO PREVENT RECURRENCE
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Should be Empty: