Invoice No. Invoice Date
Customer Supplier
Order No. Inspector
Item No. Cust. Item No.
Description
Order Qty Vessel
Shipping Qty (lot size) Customs Closing
Inspected Qty (sample size) ETD
CARTON NUMBERS/QTY INSPECTED
CTN NO.
QTY
GENERAL INSPECTION (Describe nature of performance test and results)
COMPARISON TO APPROVAL SAMPLES (Any variation in detail)
RECOMMENDATION OF INSPECTION: Pass Reject Sus