INVESTIA ________________________________________________________

SANTIER _________________________________________________________
OBIECTUL_________________________________________________________

PROCES VERBAL DE PROBE

Nr………….data ……………

Pentru instalatia de __________________________________________________

Lucrarea__________________________________________________________

a fost efectuata proba de:

Dilatare – contractare – circulatie

Presiune

Rezistenta – etanseitate

Spalare

Functionare

Proba a fost efectuata in urmatoarele conditii :

presiune_______________________
temperatura ___________________
durata ________________________
alte conditii ____________________

In urma verificarilor si a lucrarilor executate se constata ca instalatia corespunde

( nu corespunde ) proiectului si normelor tehnice in vigoare , fapt pentru care se
avizeaza ( nu se avizeaza):
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Mentiuni
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
____________________________________
nume premume semnatura

SEF SANTIER _______________ ______________ ________________

R.T.E _______________ ______________ ________________

DIRIGINTE SANTIER_______________ ______________ _______________