Vessel and Equipment Non-Conformance Report

• Vessel/Equipment Serial Number:

• Date

  Date

• Prepared by

Non-Conformance Categorisation

• Please select the non-conformance category - add as many as required; touch the plus sign or 'Add Category' to begin and add more.

Category

• Nature of fault:

  Select Leak tight Labelling Painting Missing components Bracketing Mechanical damage Incompatible components Non-Standard parts used Rust Poor vacuum Electrical - non-functioning (e.g. polarity reversed) Process parameters not met Safety Quality Availability Idea for improvement Other

  • Leak tight
  • Labelling
  • Painting
  • Missing components
  • Bracketing
  • Mechanical damage
  • Incompatible components
  • Non-Standard parts used
  • Rust
  • Poor vacuum
  • Electrical - non-functioning (e.g. polarity reversed)
  • Process parameters not met
  • Safety
  • Quality
  • Availability
  • Idea for improvement
  • Other

• Comments

• Photos

  Media

• Please describe:

• Photos

  Media

General Information

• Work order/job number:

• State/New Zealand:

  Select Western Australia South Australia Northern Territory Queensland Victoria Tasmania New South Wales New Zealand

  • Western Australia
  • South Australia
  • Northern Territory
  • Queensland
  • Victoria
  • Tasmania
  • New South Wales
  • New Zealand

• Customer:

• Supplier/Source:

• Equipment Type:

  Select Bulk vessel Cryospeed vessel Gasmatic Vapourisor Panel Telemetry Other

  • Bulk vessel
  • Cryospeed vessel
  • Gasmatic
  • Vapourisor
  • Panel
  • Telemetry
  • Other

• Equipment Type:

• Make/Manufacture:

• Size (if appropriate):

• Service:

  Select LIN LOX Med LOX LAR CO2 LNG Other

  • LIN
  • LOX
  • Med LOX
  • LAR
  • CO2
  • LNG
  • Other

• Service:

  Select 702 - LIN Scientific 712 - LIN Laser 719 - LIN Industrial 723 - LIN Hospitality 731 - LAR Welding 734 - LAR Scientific 740 - LCO2 Welding 738 - LCO2 Dry Ice 755 - LCO2 Hospitality 673 - LOX Laser 686 - LOX Industrial 687 - LOX Hospitality 684 - LOX Medical Minilox Other

  • 702 - LIN Scientific
  • 712 - LIN Laser
  • 719 - LIN Industrial
  • 723 - LIN Hospitality
  • 731 - LAR Welding
  • 734 - LAR Scientific
  • 740 - LCO2 Welding
  • 738 - LCO2 Dry Ice
  • 755 - LCO2 Hospitality
  • 673 - LOX Laser
  • 686 - LOX Industrial
  • 687 - LOX Hospitality
  • 684 - LOX Medical Minilox
  • Other

• Vessel Size:

• Size (if appropriate):

• Make/Manufacture

• Pressure:

  High Pressure

  Low Pressure

  N/A

• Action taken to rectify:

  Yes

  No

  N/A

• Please describe

• Contact person: (who to contact for further information)

• Purpose: (What were you trying to do with this equipment?)

• Cost: (Please add any relevant comments)

Identification

• Equipment Identification Number:

  ZZ Number

  Equipment Number

  Non-stock item

• ZZ Number:

• Yes

  No

  N/A

• Supplier:

• Store:

• Equipment Number:

• Serial Number:

• Model

• Item:

• Supplier:

• Part Number:

• Age of Equipment

  New

  0-6 Months

  6-12 Months

  1 Year +

• Does it meet current safety standards?

  Yes

  No

  N/A