Form No.

REPUBLIC OF THE PHILIPPINES

PROVINCE OF CAMARINES NORTE
PROVINCIAL ENGINEER'S OFFICE
Non Conformity Report (NCR)
Name of Project
Project Location:
Contractor: Date Prepared:
NCR Report No.

Issued to Item Description

Reference Pay
Signature
Item No.
Name Location
Title Proprietor (Contractor)
Date Received: Product
Time Received: Quantity

Description of Non-Conformity
Requirement Reference Error Code

Ref. IRF No.

Ref. QA/ QC Report No.
Ref. Test Result
Ref. Survey Result

Initiated by Issued by
Signature Signature
Name Name
Title PROJECT INSPECTOR Title CONSTRUCTION DIVISION, CHIEF
Date Date

Contractor's Proposed Disposition

Waiver Rework Replace Scrap Other

1
2
3

Proposed by: Disposition Approved by:

Signature Signature
Name Name
Title PROPRIETOR (Contractor) Title PROJECT INSPECTOR
Date Date

Disposition Verified and Recommended for Close-out: NCR Close-out Approved by

Signature Signature
Name Name
Title CONSTRUCTION DIVISION, CHIEF Title PROVINCIAL ENGINEER
Date Date
Corrective Action Request Needed
Yes No
Corrective Action Requested by
Remarks:
Signature
Name
Title CONSTRUCTION DIVISION, CHIEF
Date
Form Filling-in Instructions:
1 In the header the Project Inspector shall fill in the name of the Contractor, the ID Number as per LGU's number series, and the
NCR number. The NCR number shall be in the series of Proj ID-NCR-A-XXX, where A corresponds to Area of
Discipline(A=Architectural,C=Civil Works,E=Electrical,M=Mechanical,S=Structural, P=Sanitary and Plumbing) and the last three
digits is the ordinal number series of the NCR.
2 The "Issued to" box contains the Contractor's Project Manager (or that equivalent to the Managerial level) name, signature
and date/ time received.
3 The "Item Description box" contains the pay item per Contract BOQ referred to in the NCR subject item, and other descriptive
data such as location, product or material, and the involved quantity.
4 The "Description of Non-conformity" box defines the reason or cause why the NCR is issued. The "Requirement Reference"
identifies the provision in the specification or accepted engineering standard that has been violated or not complied with. The
"Error Code" defines the type of non-conformity as tabulated below. Reference QA/QC activities' numbers (IRF, Test/Survey,
QC inspection, QA/QC inspection leading to the issuance of the NCR), as applicable shall be indicated.

5 The Inspectorate Team and/or Project Inspector, who initiates the issuance of the NCR fills in his/her name and signature
and the date the NCR was prepared in the "Initiated by" box.
6 The Construction Chief, after due review and approval, fills in his/her name and signature and the date the NCR is issued in the
"Issued by" box, after which forwards it to the Contractor.
7 The "Contractor's Proposed Disposition" shall be filled in by the Contractor indicating the remedial action it intends to undertake
to resolve the NCR. Tick boxes for common dispositions are provided to facilitate filling out, other details also have to be
described in the space provided.
8 The Contractor's Project Manager (or that equivalent to the Managerial level), who proposes the disposition fills in his/her
name and signature and the date the disposition was submitted to the PPMIU Head in the "Proposed by" box. The disposition
must be submitted to the PPMIU Head not later than three (3) days after the NCR is issued.

9 The Project Inspector or his designate, after due review and approval, fills in his/her name and signature and the date the
disposition is approved in the "Approved by" box, after which forwards it to the Contractor for implementation of the disposition.

10 Inspectorate Team may conduct verification and inspection to determine the acceptability conforming to the approved
disposition and witnessing that the NCR is resolved, fills in his/her name and signature and the date the disposition is verified in
the "Disposition Verified" box. If found acceptable, the Inspectorate Teams will recommends for close-out, otherwise the
inspectorate teams disapproves the Inspection Request (IRF).
11 The Provincial Engineer, after due review and approval, fills in his/her name and signature and the date the NCR Close-out is
approved in the "NCR Close-out Approved by" box.
12 If similar type of Non-conformity occurs three (3) times, then a request for a Corrective Action (CAR) shall be initiated by the
PLGU to correct concerned QA/QC procedures and/or construction methodology to prevent future occurrences of the non-
conformity.
Error Code
Administration Concrete
01 No Shop drawings submitted 30 No Concrete Mix Design and Trial Mix Result
02 No materials test report 31 Retempering of freshly mixed concrete
03 No inspection request 32 Batching of concrete not in accordance with
04 No work request the approved mix design
05 No inspection and test plan and MMTR Master Plan 33 Inadequate compressive strength
06 No supervision 34 Inadequate flexural strength
07 No Detour/Rerouting 35 No test sample prepared
08 No Care of water 36 Bulging
09 No pre-construction/joint survey 37 Honeycomb
10 Others 38 Cold joint
Materials 39 No slump test carried out/inadequate slump
11 Incorrect materials 40 Cracks
12 Defective and damaged materials 41 Spalling
13 No materials testing and source approvals 42 Scaling
14 No submittal of material test certificate and 43 No proper curing
Manufacturer's certificate of compliance 44 Sealing of joints
16 Size/Dimension is not as per plan 45 Others
17 Test frequency not followed
18 Installation of disapproved materials Workmanship
19 Others 45 Installation/work not as per drawings
46 Vertical and horizontal misalignment
Embankment/Subbase/Base course 47 Surface preparation inadequate
20 Contaminated w/ unsuitable and oversized materials 48 Architectural finishing aesthetically
21 Insufficient number of FDT not acceptable
22 Laying of Embankment on section w/ failed FDT results 49 Wrong procedure / Construction Methodology
23 Laying of Embankment w/o reconditioning 50 Defective installation / work
compacting subgrade level 51 Concrete covering
24 Layering not respected 52 No upkeep to harmful debris at work site
25 Series of Lifts without FDT results 53 No safety measures
26 Proctor test result not representative to the in-situ materials 54 Unacceptable formworks
27 FDT was conducted without MLGU representative 55 Others
28 In place Materials is not from approved source
29 Others