Michigan Department of Transportation QA NCR#
0560 (10/20) QUALITY ASSURANCE
NONCONFORMANCEREPORT To be completed by a QAI, combined with other supporting
documentation and submitted to the Structural Fabrication Unit. Naming Convention: 0560 MOOT ID-JN Fabricator QA NCR# REV#.pdf
GENERAL INFORMATION
INSPECTION AGENCY INSPECTOR MOOT ID
FABRICATOR LOCATION JOB NUMBER
JOB DESCRIPTION
ELEMENT MARK DATE I
NONCONFORMANCE DESCRIPTION
• Combine this document with all relevant QC reports, photos, repair plans, WPS, etc. into one PDF document prior to
submitting to the Structural Fabrication Unit.
mailto:[email protected]
QANCR NUMBER: QANCR INSPECTION AGENCY: QANCR INSPECTOR: QANCR FABRICATOR: QANCR LOCATION: QANCR JOB DESCRIPTION: QANCR ELEMENT MARK: QANCR JOB NUMBER: QANCR DATE: QANCR DESCRIPTION: Clear Form button: MDOT ID: