JRB COMPANY INC. NON-CONFORMANCE/CORRECTIVE ACTION REPORT NCR Cust: External Origin Cust Claim: JRB Warranty Claim: Other Cust P.O: JRB Code: Supplier/Other Supp Ref: JRB P.O. Internal Origin W.C. Tag# JRB Product Description: RGA # Other Ser# Cntr# Job# Dwg# Rev. Non-Conformance Part# Qty. See back for further details List all details related to problem. Disposition Signed: Immediate action to be taken. Date: See back for further details/or rework Eng. Date: Pur. Date: QA. Date: Specific steps to prevent reoccurrence. Corrective Action See back for further details Signed: Date: Corrective actions are in place as of effective date. Review and Approval Mfg. Sign._________________________ Date: _____________ Eng. Sign._________________________ Date: _____________ Q.A. Sign._________________________ Date: _____________ Pur. Sign.__________________________ Date: _____________ EFF. Date: Sales Sign. Date: 204822581.doc Page 1 of 2
Non-Conformance Contd NCR# - TAG# Int. Date: Disposition Contd Eng. Date: Int. Date: QA. Date: W C Part # Description of Rework or Repair Sign. Date QA. Corrective Action Contd Int. Date: 204822581.doc Page 2 of 2
