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Initial Sample Inspection Report

General Information

Part Name & Number

Order Quantity

Delivery Quantity

Inspection Type

Reason for inspection during serial production

Reason for inspection before serial production

Specify

Scope and Extent of Inspection

Specify

Inspection Results
Released
Released with stipulations (waiver required)
Rejected (re-sampling required)

Overall Disposition

Completion

Additional Comments

Name & Signature of Quality Inspector
Name & Signature of Customer Representative

Initial Sample Inspection Report Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 35

Use this Initial Sample Inspection Report Form to easily specify the part name and number, order quantity, and delivery quantity, and identify the scope and extent of the inspection. Indicate inspection results as released, released with stipulations, or rejected, and capture the digital signature of the customer representative as an agreement to the overall disposition of the intial sample inspection report.

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Initial Sample Inspection Report

General Information

Part Name & Number

Order Quantity

Delivery Quantity

Inspection Type

Reason for inspection during serial production

Reason for inspection before serial production

Specify

Scope and Extent of Inspection

Specify

Inspection Results
Released
Released with stipulations (waiver required)
Rejected (re-sampling required)

Overall Disposition

Completion

Additional Comments

Name & Signature of Quality Inspector
Name & Signature of Customer Representative