UNITATEA : ________________________________________________________________

SANTIER : _______________________ PUNCT DE LUCRU : _______________________

OBIECTUL : ________________________________________________________________

PROCES-VERBAL PENTRU VERIFICAREA CALITATII

LUCRARILOR CE DEVIN ASCUNSE

Nr.________Data________

Faza din lucrare supusa verificarii:

______________________________________________________________________________

Elementele de identificare (sector, portiune, ax, cota etc.):

___________________________________________________________________________________
_________________________________________________________________________

Verificarile s-au facut pe baza prevederilor proiectului nr_____________plansele nr. _____________

____________________________________________________sau a dispozitiei de santier
nr.____________din data de ___________

Concluzii:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
____________________

Numele Prenumele Semnatura

CONSTRUCTOR:___________________ ________________ _______________
BENEFICIAR: ___________________ ________________ _______________
PROIECTANT: _______________ _________________ _______________
R.T.E ________________ ________________ _______________

Atestarea refacerea (remedierea) lucrarilor, conform prevederilor proiectului.

Data ________________

Numele Prenumele Semnatura

CONSTRUCTOR: _______________ _________________ ________________
BENEFICIAR: _______________ _________________ ________________
PROIECTANT: _______________ _________________ _______________
R.T.E ________________ ________________ _______________
Cod F-8.2.4-01-04 Rev. 1 Pagina 1/1