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UNITATEA ______________________________________________________________________________

ANTIER

____________________________________ PUNCT DE LUCRU ____________________________

OBIECTUL_______________________________________________________________________________

PROCES-VERBAL PENTRU VERIFlCAREA CALITII


LUCRRILOR CE DEVIN ASCUNSE
Nr._____ Data_____________

Faza din lucrare supus verificrii:


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Elementele de identificare (sector, poriune, ax, cot, etc.):


_________________________________________________________________________________________
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Verificrile s-au fcut pe baza prevederilor proiectului nr. _____________, planele nr. ________________ sau a
dispoziiei de antier nr.______________ din data de ________________________ .
Concluzii:
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Numele

Prenumele

Semntura

CONSTRUCTOR: _________ ____________ ___________________________ _____________


BENEFICIAR

_________ ____________ ___________________________ _____________

Atestm refacerea (remedierea) lucrrilor conform prevederilor proiectului.


Data ______________
Numele

Prenumele

Semntura

CONSTRUCTOR: _________ ____________ ___________________________ _____________


BENEFICIAR

_________ ____________ ___________________________ _____________