NON CONFORMANCE REPORT CONTRACT NUMBER NAME OF CONTRACTOR NCR NUMBER ISSUED DATE : .................. : .................. : …............... : …............... Part/Item Description Part/Item Location References : …............................................................. .............................................................. ....... : .............................................................. ............................................................... ......... : .............................................................. ................................................................ ........ Nature of Non conformity: Damage Material Workmanship Safety Non conforming Condition : ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ............................................................ Reported by : (..Nama supervisor..) (…Tanggal...) Validated by : (..Nama Team Leader..) (...Tanggal...) Proposed Corrective Action : ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. ................................................................................. PT REKADAYA ELEKTRIKA CONSULT TIM SUPERVISI KONSTRUKSI ( ........Diisi Nama PROJECT......)

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Prosedur ini dibuat untuk menjamin setiap ketidaksesuaian pekerjaan/produk terhadap persyaratan/spesifikasi yang telah ditetapkan yang timbul diupayakan penanggulangannya secara terkoordinasi, mulai dari identifikasi ketidaksesuaian, penerbitan NCR, pengendalian dan pemantauan status NCR sampai dengan tahap closing NCR guna menjamin kesesuaian pekerjaan/produk tetap dapat terpenuhi untuk men-support Taking Over Certificate/TOC proyek dan kepuasan pemberi kerja/Owner.

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NON CONFORMANCE REPORT

CONTRACT NUMBER NAME OF CONTRACTORNCR NUMBERISSUED DATE

: .................. : ..................: …...............

: …...............

Part/Item DescriptionPart/Item LocationReferences

: …..................................................................................................................................: ......................................................................................................................................: ......................................................................................................................................

Nature of Non conformity: Damage Material Workmanship SafetyNon conforming Condition : ......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Reported by : (..Nama supervisor..) (…Tanggal...) Validated by : (..Nama Team Leader..) (...Tanggal...)

Proposed Corrective Action : ........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Proposed by : (..Name supervisor..) (…Tanggal...) Description of Corrective Action done by Contractor : .......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Owner Acceptance After Rework (Reinspection) _______________________________ Date :

Conclusion

Closed Open Date :

..................................... ................................................ ......................................... Owner Supervision Consultant Contractor

PT REKADAYA ELEKTRIKA CONSULTTIM SUPERVISI KONSTRUKSI( ........Diisi Nama PROJECT......)(............Alamat........)

ATTACHMENTNCR No. : .................

Issued Date : ...............