Memoriu tehnic al obiectivului _______________________________

DATE GENERALE
- denumirea completă a unităţii
________________________________________________________________________
________________________________________________________________________
- adresa exactă_____________________________________________________
________________________________________________________________________
- numele persoanei fizice sau juridice destinatoare (nume administrator/
director)
________________________________________________________________________
- forul ierarhic superior (nume societate/ AF/ PF) _______________________
________________________________________________________________________
ELEMENTE TEHNICO – FUNCŢIONALE
OBIECTUL DE ACTIVITATE_____________________________________
- Unităţi funcţionale,compartimente, spaţii, dotări
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
- Alimentare cu apă rece şi caldă (menajeră)____________________________

-Canalizare _______________________________________________________
- Instalaţii sanitare____________________stare de funcţionare____________
________________________________________________________________________
- Iluminat : natural ____________________artificial_____________________
- Ventilaţie : naturală _________________artificială _____________________
Încălzire__________________________________________________________
DOTARE TEHNICÂ:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
___________________
ANEXE SANITARE:
- vestiar _______________________ duşuri ____________________________
- WC pentru personal ______________________________________________
- WC pentru public ________________________________________________
DEZINFECŢIE
- dotare cu materiale de dezinfecţie __________________________________
COLECTAREA REZIDUURILOR SOLIDE
-colectate în ______________________________________________________
NUMĂR PERSONAL___________________analize medicale___________________
________________________________________________________________________

DATA SEMNĂTURA