Quality Inspection Report 1/1: Job Number Project Page of

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Job Number Project Page of

Quality Inspection Report 1/1

CONTRACTOR: _____________________________________________ REPORT NUMBER: ________________

TYPE OF INSPECTION: Preparatory Inspection. Initial Inspection. Follow-up Inspection. Completion Inspection.

DESCRIPTION/INTENT OF INSPECTION: _____________________________________________________________

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COMPONENTS/MATERIALS REVIEWED: ____________________________________________________________

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CONTRACTOR PERSONNEL CONTACTED: __________________________________________________________

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APPLICABLE CONTRACTOR PROCEDURES, CHECK LISTS, INSTRUCTIONS: ____________________________

__________________________________________________________________________________________________

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RESULTS OF INSPECTION: _________________________________________________________________________

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__________________________________________________________________________________________________

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DEFICIENCIES NOTED: ____________________________________________________________________________

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RECOMMENDED CORRECTIVE ACTION: ____________________________________________________________

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NON-CONFORMANCES: ___________________________________________________________________________

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QA Inspector Signature: Date:

D-2

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