This section establishes complete traceability for the non-conforming material. Accurate capture of production line data, vendor information, and batch identifiers is critical for root cause analysis and supplier corrective action requests. All fields marked mandatory must be completed to ensure audit compliance.
Production Line Identifier
Specific Work Station or Assembly Cell
Shift During Which Defect Was Discovered
Exact Date and Time of Discovery
Inspector Name and Employee ID
Vendor or Supplier Name
Vendor Batch or Lot Number
Purchase Order (PO) Number
Internal Receiving Document Number
Manufacturing Part Number
Material Description and Grade Specification
Total Quantity Received in This Batch
Quantity Inspected Upon Discovery
Quantity Found Non-Conforming
Is this vendor currently on quality hold or probation status?
Provide details of existing quality hold and reference previous non-conformance reports:
Does this batch represent a critical path component for active customer orders?
List affected customer order numbers and potential delivery impact:
Provide a comprehensive technical description of the material defect. This section quantifies the deviation from specification (the "delta") and classifies the defect type for statistical analysis and corrective action prioritization. Include objective measurements and visual evidence to support the non-conformance determination.
Primary Defect Category
Visual Surface Defect
Dimensional Deviation
Material Property Failure
Contamination or Foreign Material
Incorrect Material Grade
Packaging or Labeling Error
Functional Performance Failure
Other Technical Non-Conformance
Secondary Defect Characteristics (Select all that apply)
Scratches or Abrasions
Dents or Deformations
Corrosion or Oxidation
Coating or Plating Failure
Cracks or Fractures
Porosity or Voids
Color Variation
Texture Irregularity
Warping or Bowing
Edge Burrs or Sharpness
Mixed Parts or Sorting Error
Incomplete Assembly
Electrical Failure
Chemical Residue
Detailed Defect Description and Observed Failure Mode
Specification Requirement (What Should It Be?)
Actual Measured Value or Condition (What Is It?)
Defect Severity Rating (1-10 Scale: 1=Minor Cosmetic, 10=Critical Safety)
Estimated Defect Rate Within Inspected Sample (Rate on scale 1-5)
Has the defect been verified by Quality Lab or Engineering?
Verification Reference Number and Lab Technician Name:
Explain why formal verification was not performed and plan for subsequent validation:
Upload High-Resolution Photographs of Defect (Minimum 3 angles required)
Upload Supporting Documents (Inspection Reports, Test Data, CMM Scans)
Does this defect pattern match any recent supplier quality alerts or industry recalls?
Reference the alert number and describe the similarity:
Document all immediate containment actions taken to prevent further use of non-conforming material. This section tracks physical segregation, inventory holds, and production line stops to ensure defective material does not progress to subsequent operations or reach customers. Complete traceability of affected product is mandatory.
Was the affected batch immediately quarantined upon discovery?
Quarantine Location ID and Physical Area:
Explain why immediate quarantine was not possible and detail alternative control measures implemented:
Was a production line stop or assembly hold initiated?
Production Line Stop Reference Number:
Estimated Quantity of Material Already Consumed in Production
Identification of Work-in-Progress (WIP) and Finished Goods Potentially Affected by This Material
Have potentially affected WIP or finished goods been segregated and quarantined?
Affected Goods Quarantine Location:
Justify why segregation was not performed and detail risk assessment of potential customer impact:
Containment Verification Method and Inspection Criteria Used
Containment Action Completion Timestamp
Has the supplier been notified of the quarantine action?
Supplier Notification Reference Number:
Explain the delay in supplier notification and planned notification schedule:
Calculate the comprehensive financial impact of each potential disposition path. This analysis supports data-driven decision-making by quantifying scrap loss, rework investment, return logistics, and production downtime costs. Include all direct and indirect costs associated with the non-conformance.
Disposition Option Financial Impact Comparison
Disposition Option | Quantity Applicable | Unit Material Cost | Scrap Value (if any) | Labor Rework Cost per Unit | RTV Shipping & Handling per Unit | Production Downtime Cost | Total Impact | ||
|---|---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | H | ||
1 | Scrap All | 47 | $12.50 | $0.75 | $0.00 | $0.00 | $850.00 | $1,402.25 | |
2 | Rework In-House | 30 | $12.50 | $0.00 | $8.25 | $0.00 | $425.00 | $1,047.50 | |
3 | Return to Vendor | 47 | $12.50 | $0.00 | $0.00 | $2.15 | $0.00 | $688.55 | |
4 | $0.00 | ||||||||
5 | $0.00 | ||||||||
6 | $0.00 | ||||||||
7 | $0.00 | ||||||||
8 | $0.00 | ||||||||
9 | $0.00 | ||||||||
10 | $0.00 |
Total Financial Exposure (Sum of All Disposition Impacts)
Has the supplier agreed to issue credit or replacement material for RTV option?
Supplier Credit Authorization Number:
Detail the supplier's response and expected resolution timeline:
Is rework technically feasible and economically justified?
Describe the rework process, required resources, and estimated completion time:
Explain why rework is not viable (technical limitations, cost-prohibitive, skill unavailable):
Estimated Production Units at Risk if Material is Scrapped (Shortage Impact)
Potential Revenue Loss from Production Shortage
Additional Costs Not Captured Above (Expediting, Overtime, Customer Penalties)
Final review and authorization by plant leadership and quality assurance. This section captures formal approval of the disposition decision, validates that all containment actions are complete, and ensures regulatory compliance. Digital signatures are required to proceed with scrap, rework, or RTV execution. Rejected submissions must include detailed feedback for corrective action.
Recommended Disposition Based on Financial Analysis and Technical Assessment
Scrap All Non-Conforming Material
Rework In-House to Specification
Return to Vendor for Credit/Replacement
Engineering Concession (Use-As-Is)
Segregate for Customer Approval
Does the recommended disposition require customer notification or deviation approval?
Customer Deviation Request Number:
Has the Quality Director reviewed all inspection data and containment verification?
Explain the status of Quality Director review and expected completion date:
Plant Manager Review Comments and Operational Risk Assessment
Quality Director Technical Assessment and Compliance Verification
Plant Manager Digital Signature and Approval
Plant Manager Approval Timestamp
Quality Director Digital Signature and Approval
Quality Director Approval Timestamp
Is this non-conformance being escalated to executive leadership or corporate quality?
Escalation Rationale and Executive Summary:
If approval is denied, has a corrective action plan been initiated?
Corrective Action Request (CAR) Number:
Detail the required actions to achieve approval and resubmission timeline:
Final Disposition Execution Tracking Number
To configure an element, select it on the form.