Non-Conformance Report Form

• NCR No. (please check last recorded NCR for next number)

• Department / Business Function

  Select Operations Projects Operations Network Support People/HR HSEQ Marketing Sales & Tendering IT Support IT Development

  • Operations Projects
  • Operations Network Support
  • People/HR
  • HSEQ
  • Marketing
  • Sales & Tendering
  • IT Support
  • IT Development
• Location
  Address

• Name of person reporting the Non Conformance

Details of Non-Conformance

• Priority (if the Non Conformance is safety related the default selection must be high or critical)

  Low

  Medium

  High

  Critical

• Source

  Select Internal - Employee External - Client External - Supplier External - Customer

  • Internal - Employee
  • External - Client
  • External - Supplier
  • External - Customer

• Process

  Select Groundworks Feeder Pillar Installation Electrical Connection Commissioning Charge Point Unit Charge Point Component Junction Box Component Delivery Operational Fault/Defect Waste Management Tools & Equipment Procedure/Process Other (please specify)

  • Groundworks
  • Feeder Pillar Installation
  • Electrical Connection
  • Commissioning
  • Charge Point Unit
  • Charge Point Component
  • Junction Box Component
  • Delivery
  • Operational Fault/Defect
  • Waste Management
  • Tools & Equipment
  • Procedure/Process
  • Other (please specify)

• Detailed description of Non Conformance [Note: After providing details of the Non Conformance , click "Media" to add photo's from your camera or library]

• Name and Signature of Staff who raised the issue

  Sign

• Date the NCR was endorsed to the Manager

  Date

Improvement Actions

• Type

  Select Corrective Action Preventive Action Opportunity for Improvement/Suggestion

  • Corrective Action
  • Preventive Action
  • Opportunity for Improvement/Suggestion

• Improvement actions to be implemented [Note: After providing all corrective or preventive actions, click "Action" to create your action plan/s]

Item Closed Out

• Result

  Pass

  Fail

• Additional Notes

• NCR effectiveness verified by (Name and Signature of Manager)

  Sign