FOLDAY / PHYSICAL SAMPLE REVIEW RECORD
BLANK WORKSHEET — NOT A TEST REPORT

Sample ID and revision:
Concept:
Actual upper / lining / bottom references:
Reviewer and review date:
Review conditions:
Observed junction or issue:
Observation (describe only what was seen):
Proposed change and owner:
Evidence still needed:
Next sample revision:
Approval responsibility (not provided here):

Do not infer general performance from a prototype observation.