Coating sample approval record
Jiashan Techno Coating Co., Ltd.

Project / part number / drawing revision: ____________________

Sample ID and quantity: ____________________

Review date and reviewer: ____________________

Appearance reference and review conditions: ____________________

Critical dimensions / fit / masking checks: ____________________

Agreed tests, methods and acceptance criteria: ____________________

Results and report references (mark pending items): ____________________

Deviations and corrective actions: ____________________

Decision: approved / approved with conditions / not approved: ____________________

Conditions or new sample required: ____________________

Approver and date: ____________________

Linked specification revision: ____________________

Production inspection and change approval arrangements: ____________________

This checklist prepares a discussion or record. It does not create an order, certify compliance or replace the agreed specification.