INSPECTION REPORT FORM

Date: ...........................Time:.............................
Reader.........................................................................................................
Specification Reference.........................................................................................................
Specification Author.........................................................................................................
Code Reference.........................................................................................................
Code Author.........................................................................................................
Reviewers.........................................................................................................

DETAILS OF REWORK
Re-work Index Change Spec. or Code?
Rework Required
 Edit. Or Tech Rework

Initials

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D/line