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0040
DeficiencyReport
If this form is used to record the resultsof a general inspection, Inspector = “name of person”, Inspection = “type of inspection” (i.e. QC, Sales, Customer).
If this form is used to record “in process issues”, Inspector = “TeamLeader’sName”, Inspection = “Plant #___” or “Department” (i.e. Fab) andDate =date formwas started.
Inspector
_________________________
Inspection
____________________________________________________
Date
____________
Customer
_______________________________________________
Run#:
____________
Unit #:
______________
VIN#:
____________
Repeat deficiencies could indicate theneed for Correctiveor PreventiveAction (CPA)
#1:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#2:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#3:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#4:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#5:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#6:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#7:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#8:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#9:
______________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
#10:
_____________________________________________________________________________________________________________
Action:
_______________________________________________________(
ResolvedBy
_______) (
+1Hour
)
(
Re-inspectedBy
______)
CPA
Send this form toAdministration for data entry. Theoriginal copy is togo to thevehicle file.
