| OFFICE USE ONLY |
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| SECTION 1****************************************************************************************** |
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| Job Name |
Job # |
Date |
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| Caller Name |
Title/Co. |
Phone |
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| Relation To Customer |
E-mail |
Fax |
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| Customer Name |
Contact |
Phone |
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| Note |
E-mail |
Fax |
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| Address |
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| Details of Call or Report |
Received By |
Date |
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| SECTION 2 (To Be Completed By QA/QC)****************************************************************************************** |
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| Immediate Response |
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| Further Response to Customer Required? What? |
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| Action Taken OFFICE USE ONLY |
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| Action By Date Complete Notes |
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| Copies To : On Date President Operations Manager Project Mgr |
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