GLOBAL SUPPLIER QUALITY MANUAL - Sloan Valve Company

Deviation Approval Request
Date:
Quality Champion:
Deviation Number Part Number Revision Number All Parts Effected
Engineering Drawing # Department Code Defect Code Deviation Quantity
Use-As-Is Receiving Inspection Supplier Parts Life of Tool Alternate Bill
Deviation Nonconformance Not Available Deviation of Materials
Fill in the following blanks, as applicable.
RMR Number Supplier Name Supplier Location RIR Number Tool ID Number
Complete the Inspection Summary, including the Drawing Number and the dimensions to deviate.
Print Dimensions and Tolerances Sample 1 Measurements Sample 2 Measurements Sample 3 Measurements
Dimension 1
Dimension 2
Dimension 3
Inspected By:
Inspection Date:
Description of Nonconformance:
Reason or Cause of Deviation:
Corrective Action:
Date Corrective Action Implemented:
Deviation Action Plan:
Corrective Action Audit Date:
Deviation Closeout Plan:
Deviation Expiration/Closeout Date:
Order Quantity:
Deviation Requested By:
Quality Assurance Approval Date Comments :
Material Manager Approval Date Comments :
Design Engineering Approval Date Comments :
Interchangeability Affected? Yes No
Fit / Form / Function Affected? Yes No
Sales / Marketing Approval (As Required) Date Comments :
Customer Concession Required? Yes No
Technical Support Services Approval (As Required) Date Comments :
Manufacturing Engineering Approval or Purchasing (As
Required)
Date
Comments :