NON CONFORMANCE / EQUIPMENT TROUBLE REPORT

Date

MM

DD

YYYY

Person Filing Report

First Name

Last Name

Customer / Location

NCR Cause

Lost Time

How many hours of lost time occurred?

Lost Revenue / Unexpected Costs / Repair Costs

$

NCR Description

Describe the reported issue in detail.

Corrective Action

How was / could this issue be resolved in the future?

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