6-16
ALRE QUALITY ASSURANCE INSPECTOR RECOMMENDATION/DESIGNATION
CANDIDATE NAME
I. WORK CENTER SUPERVISOR RECOMMENDATION
In accordance with OPNAVINST 4790.15 the above named person is recommended for:
QAI
CDQAI
CDI
RATE
FOR: (SYSTEM/SUBSYSTEM, ETC.)
W/C SUPERVISOR
SIGNATURE
II. QUALITY ASSURANCE ENDORSEMENT
The candidate has been examined in accordance with OPNAVINST 4790.15 and has passed all requirements
satisfactorily. Recommended approval.
DATE
QA SUPERVISOR TYPED NAME AND RANK
SIGNATURE
DATE
III. ALRE MAINTENANCE OFFICER ENDORSEMENT
APPROVAL
DISAPPROVAL
RECOMMENDED
MAINTENANCE OFFICER TYPED NAME AND RANK SIGNATURE
DATE
IV. V-2 DIVISION OFFICER ENDORSEMENT
APPROVAL
DISAPPROVAL
RECOMMENDED
V-2 OFFICER TYPED NAME AND RANK
SIGNATURE
DATE
V. AIR OFFICER ENDORSEMENT/ACTION
APPROVAL
DISAPPROVAL
DESIGNATED
NOT DESIGNATED
AIR OFFICER TYPED NAME AND RANK
SIGNATURE
DATE
VI. COMMANDING OFFICER ACTION
DESIGNATED
NOT DESIGNATED
COMMANDING OFFICER TYPED NAME AND RANK
SIGNATURE
DATE
VII. DESIGNEE RESPONSIBILITY
I understand my responsibility as set forth herein:
"When performing inspections, I am considered to be the direct representative of the Commanding Officer for ensuring
operational safety of the item concerned. I will not permit factors, such as operational desires, maintenance
consideration, personal relations or the approach of liberty to modify my judgement. By signing an inspection report, I
am certifying upon my own individual responsibility that the work involved has been personally inspected by me; that it
has been properly completed and is in accordance with current instructions and directives; that it is satisfactory; that any
related parts or components which may have been removed by the work are properly replaced and all parts are secure;
and that the work has been performed in such a manner that the item is completely safe for use."
CANDIDATE TYPED NAME
SIGNATURE
DATE
Original to: Quality Assurance
Copy to: Branch Officer
OPNAVINST 4790.15B
1 FEBRUARY 1995
ABEf608
Figure 6-8.—ALRE Quality Assurance Inspector Recommendation/Designation form.
