Incident of Non-Conformance (INC)
QMS
Date
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Month
-
Day
Year
Date
State
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Project Name
*
Project Number
*
Who discovered the non-conformance?
*
First Name
Last Name
Who performed the non-conforming work or supplied the non-conforming material?
Email
*
example@example.com
Non-Conformance Details
What was the non-conformance?
Describe clearly and factually- what went wrong?
Where was the non-conformance found?
Location: shop, field, supplier, warehouse, etc.
What should have happened (according to requirements)?
Reference procedure, spec, drawing, standard.
What actually happened?
Factual description of the deviation.
Has this type of non-conformance occurred before?
If yes, where and when?
What is the impact of the non-conformance?
Impact
On the product/service quality?
On customer satisfaction?
On project cost or schedule?
On regulatory or contract compliance?
Is the non-conforming item repairable or must it be scrapped/replaced?
Repairable
Replaced
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Does this failure require a RCA?
Yes
No
Lead Investigator
Fishbone Categories
People (Human Factors)
People– Contributing Factors (Select all that apply)
Insufficient training or onboarding
Misunderstanding of specifications or drawings
Lack of attention to detail
Fatigue or stress
Language or communication barriers
Overreliance on tribal knowledge
Inadequate staffing levels
Cultural or behavioral issues
Lack of accountability or ownership
Inconsistent work practices between shifts
Equipment (Machines & Tools)
Equipment (Machines & Tools)- Contributing Factors (Select all that apply)
Worn-out or damaged equipment
Uncalibrated tools
Inadequate maintenance schedule
Obsolete or inappropriate equipment
Setup errors or adjustments not documented
Poor user interface (confusing settings, displays)
Lack of error-proofing (poka-yoke)
Inconsistent machine performance
Improper tool storage or access
Limited spare parts availability
Materials (Inputs & Consumables)- Contributing Factors (Select all that apply)
Materials (Inputs & Consumables)-
Material out of spec or contaminated
Incorrect part or batch used
Damaged during storage or handling
Supplier variability
Lack of traceability
Improper material substitutions
Expired or shelf-life sensitive items
Incorrect labeling or packaging
Mixing of different material grades
Environment (Workplace Conditions)
Environment (Workplace Conditions)- Contributing Factors (Select all that apply)
Temperature or humidity variations
Dust, moisture, or other contaminants
Poor lighting or visibility
Excessive noise or vibration
Inadequate workspace layout
Safety hazards affecting quality focus
Poor air quality or ventilation
Workplace distractions or interruptions
Cluttered or unorganized areas
Measurement (Inspection & Data)- Contributing Factors (Select all that apply)
Measurement (Inspection & Data)
Out-of-tolerance measuring devices
Inconsistent measurement techniques
Poor sample selection
Incorrect interpretation of tolerances
Missing or incomplete inspection records
Measurement data not analyzed
SPC limits not monitored
Inadequate training for inspectors
Bias or inconsistency in subjective inspections
Root Cause Statement
Summarize the most likely root cause(s) based on contributing factors
What Immediate Corrections Were Made?
What Preventive Actions Are Recommended?
Note who owns each Preventative Action and the Date is must be completed by!
Who Closed This Incident Report?
first/last name
Date Closed
-
Month
-
Day
Year
Date
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