SAMPLE TRIAL REPORT

CUSTOMER NO

ITEM NO DATE

ITEM NAME QTY

DETAILS OF MOD /RECT /PROTOTYPE :

ANALYSIS RESULT :

REMARK :

PREPARED BY APPROVED BY
ESP:QA 54 REV:01 DATE:10.08.2018
 SAMPLE TRIAL REPORT

SUPPLIER DATE

PART NO. QTY

PART NAME
DETAILS OF MOD /RECT /PROTOTYPE :

ANALYSIS RESULT (For Terminal) :

Height Width Pull Out Force Required Observed
Terminal to
Required
Connector

Terminal to
COPPER
Connector
Terminal to
PVC
Cable

IQC: Accepted: YES No

Name: Sign: Dt:

Production/Assembly: Accepted: YES No

Name: Sign: Dt:

QA: Accepted: YES No

Name: Sign: Dt:

Development Dept: Accepted: YES No

Name: Sign: Dt:

QAHEAD PLANT HEAD

Accepted Yes Accepted Yes No

Sign: Sign:

ESP:QA 54 REV:02 DATE: 29.12.2021