Title Page

  • Number

  • Prepared by

  • Date

Material infomation

  • Product

  • Origin

  • If On Site which reclaim unit or ancillary equipment (Automation)

  • Item (e.g. POL0021N,LCORE765)

  • Lot or Batch Number

  • Weight (if Wrap, Reclaim or Scrap) Number (Any other item)

  • Has rejected items been taken to QA Area

Reject Detail

  • Department raising reject

  • Reason for Rejection

  • Product (item) being affected (e.g. SBLB40S-A)

  • Which line is it being manufactured on

  • Additional information - Must include Photo

  • Route Cause and Corrective Action at Time of Production

QA Comments

  • Supplier

  • Outcome

  • Additional Infomation

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