ŞANTIER __________________________

PUNCT DE LUCRU___________________
OBIECTIVUL________________________

PROCES – VERBAL
DE RECEPŢIE CALITATIVĂ

Nr._______Data____________

Cu ocazia verificării efectuate la:

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Au stat la baza verificărilor următoarele elemente:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Din verificările efectuate pe teren şi examinarea documentelor au rezultat următoarele:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Menţiuni speciale:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Numele Prenumele Semnătura

BENEFICIAR: ________________ ____________ ______________

PROIECTANT: ________________
EXECUTANT: ________________ ____________ ______________

Formular cod FO10–05 rev.0