Cod Document : A 3 - 06

Unitatea: ______________________

Obiectul: ______________________

Lucrarea: _____________________

PROCES VERBAL
DE TRASARE A LUCRARILOR

incheiat astazi ______________

Denumirea obiectului (lucrarea)

________________________________________________________

Trasarea a fost efectuata pe baza planselor Nr. _________ din proiectul ________________

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Elementul de reper si verificare este: (borna, constructia invecinata etc.) ________________

__________________________________________________________________________

__________________________________________________________________________

avind coordonatele x ____________________

y ____________________

z ____________________

Cote
__________________________________________________________________________

Executat trasarea Verificat

Numele si prenumele: ______________________ ______________________

Functia: ______________________ ______________________

Semnatura: ______________________ ______________________