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NON CONFORMITY REPORT

PT. Sertco Quality


Page : 1 of 1

To : NCR No. : ......../SQ/NCR/...../..../2013

Attention : Date :
Subject : C.c. :

NON CONFORMITY DESCRIPTION

Corrective action :

Agreed date for completion of corrective action :


User Signature :

Evaluation for completion of corrective action :

Inspector Signature :

Surveillance performed by
Name Signature

Inspection Centre : PT. Sertco Quality


Diffusion: 1. SQ Office 2. Client 3. Migas

F.SQ-F-014.17 Rev. 0 Form Laporan Ketidaksesuaian