Executant: SC ___________________ SRL

ȘANTIER: _______________________
Obiectivul: ____________________________________________________________

PROCES-VERBAL PENTRU VERIFlCARE A CALITĂŢII

LUCRĂRILOR DE SĂPĂTURĂ
Nr. _______ Data ________________

Faza din lucrare supusă verificării:

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Elementele de identificare (sector,porțiune,ax,cotă,etc.):

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Verificările s-au făcut pe baza prevederilor proiectului nr.________ , planşele nr.________ sau a
dispoziției de șantier nr. ____________ din data de ___________ elaborat de ___________________
__________________________________________________________________________________

Concluzii:
___________________________________________________________________________________
___________________________________________________________________________________
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Numele Prenumele Semnatura

CONSTRUCTOR: ______________ ________________ __________________

BENEFICIAR: ___________________ ________________ ___________________

RTE: ___________________ __________________ ___________________

GEOLOG: ___________________ __________________ ___________________

EXECUTANT: ___________________ __________________ ____________________