QASP Exhibit 4 Customer Complaint Form by cln12100

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									Guidebook                                                                              5/10/2006
                          Exhibit C.2-4: Customer Complaint Form

                             PART A – To be completed by Customer
DATE:                       CUSTOMER: (Include Name, Organization, and phone number)


NATURE OF COMPLAINT:




STAFF CONTACTED REGARDING COMPLAINT: (Check if yes)

Staff Member       QC       Supervisor/Manager         Project Officer

DESCRIPTION OF INTERACTIONS TO DATE:




                          PART B – To be completed by Quality Assurance
QAE NAME:                                                                 DATE:

PWS REFERENCE #:                                 PWS REQUIREMENT:


                                      VALIDATION BY QA
NOTES:




                                         SP INFORMED
NAME:                                                                     DATE:

TITLE:                                                                    TIME:

ACTION TAKEN BY SP:




                                   CUSTOMER NOTIFICATION

COMPLAINT VALID:    Yes       No                 DATE CONTACTED:




                                             C.2-4-1

								
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