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1 <br />1 <br />1 <br />1 <br />1 <br />'~,~ CORE LABOF~ATORIES <br />Western Atlas <br />International <br />..e..o.~ ce.P. <br />ITLE <br />SOP N0. <br />ANALYTICAL CHEMISTRY DIVISION QUALITY ASSURANCE MANUAL <br />REVISION N0. EFFECTIVE GATE PAGE <br />Figure 14-2 Non-Conformance Report Form <br />NON-CONFORMANCE REPORT lNCRI Page _~ of <br />NCR No.: Reference No. (iP applicable): <br />i <br />Location: Issued By: <br />Date Issued: Position: <br />i <br />I. AREAS AFFECTED <br />Laboratory Section: <br />Parmeters/Matrices: <br />Sample Nos.: _ _ _ _ i <br />Other: <br />II. DESCRIPTION AND IMPACT OF NON-CONFORMANCE: <br />IZI. ACTION REQUIRED: <br />Personnel Assigned <br />Responsibility: <br />ZV. ACTION TAKEN AND RESOLUTION: <br />Completed 8y: <br />V. DISTRIBUTION: <br />Laboratory Manager/Supervisor <br />Laboratory Section Supervisor <br />QA/QC Coordinator <br />Time Schedule <br />for Action: <br />Date: <br />Client/Protect File <br />Staff Members ~ <br />Division/Regional Manager/QA Director <br />