NMR Form
Document text
Text extracted from the attached file. Refer to the original document for the authoritative version.
Section 1
NONCONFORMING MATERIAL REPORT FORM
Page 1 Revision Date: 09/30/2021
Note: Enter “N/A” into unused fields.
To:
CC:
From:
Date:
☐ Draft ☐ Open ☐ Closed
Check one of the following:
☐ Receiving PA-identified issue
☐ Shipping PA-identified issue
Fill in as much of the following information as possible (fields will expand as necessary) to identify the
impacted product. Keep information protection in mind when deciding to include the weapon system on this
report. If associating the part number with the weapon system will make this report classified at level higher
than OUO, then do not include the weapon system in this report:
Weapon System:
Part Number:
Nomenclature:
Manufacturer Code: Date Code:
Serial Number:
Lot Number: Quantity:
Other:
Specifications or criteria used to determine the discrepant condition:
Description of the discrepant conditions:
Pertinent circumstances of discovery:
Production impact and priority level and description:
wqa@nnsa.doe.gov; na-122workflow@nnsa.doe.gov; dl-na-125nmr@nnsa.doe.gov;
NMR #: Revision #
NONCONFORMING MATERIAL REPORT FORM
Page 2 Revision Date: 09/30/2021
Material disposition:
(If applicable list EA number and summary here):
Discrepant category: Check all that apply:
☐ 1. Records Examination: Any accompanying quality records with missing or incorrect entries (e.g.,
incorrect record of assembly (ROA), wrong part number or serial/lot number, or incorrect testing
data)
☐ 2. Part Marking: Manufacturing identification does not comply with specification requirements
(e.g., wrong suffix on part/package)
☐ 3. Surface Condition and Foreign Material: Physical damage or contamination not allowed per
specification requirements (e.g., dents/scratches in critical sealing surfaces, coatings outside of
allowed boundaries, surface discoloration)
☐ 4. Assembly: Part does not assemble, has incorrect components installed, incorrect material or process
used, missing components or mispackaged for shipment (e.g., missing washer, wrong suffix of
component, missing packaging material, packaged upside down)
☐ 5. Functional: The part/assembly fails to mechanically operate as intended or incorrect mechanical test
performed (e.g., rotating part does not rotate, leak test not performed)
☐ 6. Dimensional: Part does not meet dimensional drawing requirements (e.g., radius too small, stem
height wrong)
☐ 7. Electrical: Failure to meet electrical tests (e.g., resistance test failed)
☐ 8. Other: Describe the nonconformance that does not fit the other categories:
Check the highest grade that applies (Grade can be determined any time up to the point of the NMR being closed):
☐ Grade 1 – Failure to meet product definition requirement(s) and cannot be utilized for its intended use.
A corrective action response is required to prevent the recurrence of this nonconformance.
☐ Grade 2 – Failure to meet product definition requirement(s), but material can be used for its intended
use. Corrective action response is required, to prevent the recurrence of this nonconformance, at the
discretion of the responsible Field Office.
☐ Grade 3 – Product definition requirements are met, but there are issues with other quality requirements
that can be corrected without impact to product (for example, shipping documents are incorrect).
Corrective action response is required, to prevent the recurrence of this nonconformance, at the
discretion of the responsible Field Office. Note: The Grade 3 NMRs are documented for record purposes
only and product segregation is not necessary.
Section 2
Remarks:
Signature: (Click to enter Digital Signature; alternately, form may be printed and signed)
* Note: Only the original signer of the pdf can remove his/her signature and
re-sign the form.
To:
From:
Manufacturer Code:
Date Code:
Serial Number:
Lot Number:
Other:
Quantity:
Material disposition:
Priority Level: [null]
Material Disposition: [null]
1 Records: Off
2 Part Marking: Off
3 Surface condition and foreign material: Off
4 Assembly: Off
5 Functional: Off
6 Dimensional: Off
7 Electrical: Off
8 Other: Off
Other - Description:
Grade: Off
Submit:
Remarks:
Draft/Open/Closed: Off
Nomenclature:
Shipping/Recieving PA: Off
Weapon System:
Part Number:
Production impact Priority Level and description:
Pertinent circumstances of discovery:
Description of the discrepant conditions:
Specifications or criteria used to determine the discrepant condition:
NMR Date_af_date:
CC:
NMR Number:
Revision Number:
Revise: