XXX公路修复、升级工程
Road Rehabilitation/Upgrading Project from xxx to xxxx
(检查记录表)Record Form of Inspection
承包商:XXX(集团)有限公司
Contractor: XXX Engineering (Group) Company
监理单位:XXX工程监理有限责任公司
Supervising Unit: XXXX Construction Supervising & Consultation Co., Ltd
工程部位project section:工程地点及桩号project location andpile point检查项目inspection item路堑Ⅱ-1型II-Itype cutting K______ +______ —K______+______施工时间:construction time检验时间:inspection timeNO:
检测结果inspection results沟槽开挖trench excavation 合格 qualified 不合格 unqualified基底夯实 合格 qualified 不合格 unqualifiedsubstrate compaction模板支撑formwork support模板几何尺寸geometric size offormwork施工放线setting out断面尺寸section size 合格 qualified 不合格 unqualified 合格 qualified 不合格 unqualified 合格 qualified 不合格 unqualified 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: