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Lot Inspection Report

TED-FD-11-108
Report #
Date
Page
1 of 2
INTERNAL COPY
Inspection Type
Part & Lot Information
Item #
Description
Rev
Drawing / Spec Reference
Lot #
Date Received (Receiving Only)
Customer
Customer PO #
Sales Order / Work Order #
Purchase Order #
Vendor
Vendor Lot #
On Hand / Lot Qty
Sample Size
AQL / Sampling Plan
Inspector
Date Inspected
Receiving & Compliance Verification (Receiving Only)
Dimensional & Attribute Inspection
# Characteristic Specification / Requirement Actual / Observed P / F / N/A
1
2
3
4
5
6
7
8
9
10
Equipment / Instruments Used
Calibration ID / Due Date
Overall Inspection Result
Status:
Results Summary / Comments
Inspector Signature:
Initials:
Date:
TED-FD-11-108

Lot Inspection Report

TED-FD-11-108
Report #
Date
Page
2 of 2
INTERNAL COPY
Prepared By (Inspector)
Title
Date Prepared
▸ Complete this page when lot is REJECTED or ACCEPTED WITH DEVIATION. Attach to Page 1.
Rejection / Nonconformity Details
NCR #
SCAR #
Description of Nonconformity
Qty Accepted
Qty Rejected
Qty On Hold / Segregated
Attachments
Disposition of Nonconforming Material
Disposition
Disposition Summary
Disposition Instructions (Internal Only)
MRB (Material Review Board) Required?
Vendor Corrective Action Required
Corrective Action Required
SCAR Due Date
RMA # (If Applicable)
Vendor Action Required / Notes
Deviation Justification (If Accepted with Deviation)
Justification / Rationale
Approved By:
Title:
Date:
QA Review & Closure (Internal Only)
QA Reviewed By
Date:
Disposition Approved?
Title:
Comments
Final Status
Closure Date:
Closed By
Date:
TED-FD-11-108