ISM Non-Conformity and Corrective Action Record
Vessel / Department:
Date:
Report No.:
Reported By:
Non-Conformity Details
Description of Non-Conformity:
Reference (procedures / regulations):
Immediate Action Taken:
Date Immediate Action Completed:
Root Cause Analysis
Analysis Details:
Corrective / Preventive Action Plan
Action(s) Required
Person Responsible
Target Date
Date Completed
Effectiveness of Corrective Action Verified by:
Date of Verification:
Remarks: