OVERAGE, SHORTAGE AND DAMAGE REPORT
MRR REPORT No.: OS&D No.: DATE:
RECEIVED FROM: WAREHOUSE RECORD No.:
P.O. No.: PACKING SLIP No.:
RECEIVED AT: TRAILER TRUCK No:
FREIGHT BILL No.:
THE ABOVE SHIPMENT RECEIVED IN THE FOLLOWING CONDITION:
OVERAGE: SHORTAGE: DAMAGED:
DISCIPLINE: HVAC PIPING ELECTRICAL ROTATING EQUIPMENT
INSTRUMENTATION STRUCTURAL OTHER (SPECIFY)________________________________
DETAILS OF OVERAGE, SHORTAGE OR DAMAGE ITEMS
QUANTITY QUANTITY
ITEM No. DESCRIPTION OF EXCEPTION OR REJECTED MATERIAL
ORDERED DELIVERED
QC REPRESENTATIVE NOTIFIED: YES NO DATE:
QC HOLD TAG ISSUED: YES NO NCR ISSUED: YES NO NCR No.:
RECEIVER: DATE: CLIENT: DATE:
CEDA QC REP.: DATE: SHIPPER: DATE:
FM-QA-CSP-043 Form Revision Date: 08-Aug-2014