UNITATEA ______________________________________________________________________________ANTIER

____________________________________ PUNCT DE LUCRU ____________________________

OBIECTUL_______________________________________________________________________________

PROCES-VERBAL PENTRU VERIFlCAREA CALITII LUCRRILOR CE DEVIN ASCUNSENr._____ Data_____________

Faza din lucrare supus verificrii:__________________________________________________________________________________________ __________________________________________________________________________________________

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

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

Numele

Prenumele

Semntura

CONSTRUCTOR: _________ ____________ ___________________________ _____________ BENEFICIAR _________ ____________ ___________________________ _____________

Atestm refacerea (remedierea) lucrrilor conform prevederilor proiectului. Data ______________ Numele Prenumele Semntura

CONSTRUCTOR: _________ ____________ ___________________________ _____________ BENEFICIAR _________ ____________ ___________________________ _____________