XXX 至 XXX N6公路修复、升级工程
Road Rehabilitation/Upgrading Project from XXX to XXX
(检查记录表)Record Form of Inspection
承包商:XXX(集团)有限公司
Contractor: XXXXX (Group) Company
NO:
监理单位:XXX 工程监理有限责任公司
Supervising Unit: XXXXX Construction Supervising & Consultation Co., Ltd纵向与横向裂缝维修施工时间:工程部位maintainance of longitudinal andconstruction timeproject section:horizontal crack工程地点及桩号project location andpile point检查项目inspection item K______ +______ —K______+______检验时间:inspection time检测结果inspection results裂缝清理crack clearance 合格 qualified 不合格 unqualified裂缝灌缝crack grouting 合格 qualified 不合格 unqualified承包商自检意见review of contractor self-inspection: 签字signature: 日期date:现场监理意见review of site supervisor: 可以Yes 不可以 No 签字signature: 日期date: