UNITATEA: …………………………………………………………………………………………..

SANTIERUL: …………………………………………………………………………………………
OBIECTUL……………………………………………………………………………………………

PROCES-VERBAL PENTRU VERIFICAREA CALITĂŢII

LUCRĂRILOR CE DEVIN ASCUNSE
Nr. _____ / ______________

Faza din lucrări supusă verificării:

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Elementele de identificare (sector, porţiune, ax, cotă, etc.):
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Verificările s-au făcut pe baza prevederilor proiectului nr. ________________________________

planşele nr. ______________________________ sau a dispoziţiei de şantier nr.________________
din data de __________________.

Concluzii:
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CONSTRUCTOR, BENEFICIAR,
Numele ___________________ ___________________
Prenumele ___________________ ___________________
Semnătura ___________________ ___________________

Atestăm refacerea (remedierea) lucrărilor conform prevederilor proiectului.

Data _________________

CONSTRUCTOR, BENEFICIAR,
Numele ___________________ ___________________
Prenumele ___________________ ___________________
Semnătura ___________________ ___________________