Shore Based Manager/Lead Master Non-Conformance/Corrective Action Report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

1. Shore-based Manager - Proposed Action

• For Corrective/Preventative Actions, please indicate:

• Root Cause of Problem:

• Proposed Corrective/Preventative Action:

• Proposed Completion Date

  Date

• Date Action Requested:

  Date

• Shore-Based Manager's Name/Signature:

  Sign

• Date:

  Date

• IF THERE IS A NON-CONFORMITY, REPORT IT TO THIRD PARTY ORGANIZATION

• Notice to Proceed Granted by TPO?

  Yes

  No

  N/A

• SEND BACK TO MASTER/GREG BANGERT FOR QUALITY ASSURANCE FOLLOW UP