SUTHERLAND SHIRE COUNCIL PROJECT SERVICES

• Document No.

• Audit Title

• Conducted on

  Date

Quality Non-conformance Report

• Project:

• Project Number:

• Date:

  Date

• Inspector

• Description of Non Conforming Work:

• Chainage ?

• Lot Number ?

• Photos of Non Conformity

  Media

• The Non-conformance could have been avoided by:

  Select Better Planning Better Training Better Instruction Better Supervision Change/update work Procedure Better Communication

  • Better Planning
  • Better Training
  • Better Instruction
  • Better Supervision
  • Change/update work Procedure
  • Better Communication

• Rectification Proposed by Contractor

  Select Rework/Redo Minor Rectification Remove and Replace Accept below standard other

  • Rework/Redo
  • Minor Rectification
  • Remove and Replace
  • Accept below standard
  • other

• Detail of Proposed Rectification

• Superintendent's Representative Approval of Proposed Rectification

  Sign

• Date of Contractor advice that rectification complete.

  Date

• Has the Non-conformance been re-inspected and found rectified?

  Yes

  No

  N/A

• Superintendent's Representative Signoff of rectification.

  Sign