QSM QR0602

Non-Conforming Material Report

Revision G

By Rta Approval by RM Date 03/07/18

IDENTIFICATION

1. Originator Name AT 2. Date 10/15/2019

3. Supplier / Machine S.C PA 4. PO / SO Number N/A

5. Part Number 01-0108 6. Quantity on hold 264K

7. Part description Piston 10-0602 8. Part Lot # 9288

9. Process detected:  Incoming control  In process control  Other

10. Description of nonconformance (use reverse side if necessary)

Flash on top of the lip

11. Action taken to prevent misuse (use reverse side if necessary)

All box made on 9/18/2019 are on quarantine area
9/24/2019
9/25/2019
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 QSM QR0602
Non-Conforming Material Report
Revision G

By Rta Approval by RM Date 03/07/18

DISPOSITION

 Return to supplier Reject/Regrind  Rework  Repair

12.  Use-as-is
 Non-critical NC  Critical NC

Responsible Name AT Date 10/15/2019

13. Approval of return to supplier, reject, rework, repair

QC Supervisor Name YB Date 10/15/2019

CORRECTIVE/PREVENTIVE ACTION

14. Description of proposed action (use reverse side if necessary)

Return to supplier

15. Approval of corrective/preventive action

QC Supervisor Name YB Date 10/15/2019

CLOSING THE NONCONFORMANCE

16. Planned disposition has been completed and corrective/preventive action has been implemented

Quality Manager Name Date

PRODUCTED DATE TIME DEFECTS

9/18/2019 02:06PM Flash

9/18/2019 2:06PM Flash

9/24/2019 02:48PM Flash

9/25/2019 02:50PM Flash

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