a-11((检验批)分项工程质量报验申请表)(模块一).docVIP

上海赛科90万吨乙烯工程 Shanghai SECCO 900KTPA Ethylene ProjectA—11 单项(单元)工程： （检验批）分项工程质量报验申请表 (Inspection atch) Work Item Quality Inspection Application 项目编号： Project No.: 编号：No.： 致（监理单位）To (Supervision Company)： 我方已完成了 （检验批）分项工程，经我方检验符合设计、规范要求，请予以验收。 We’ve completed single item of work (inspection batch) of , which has been inspected by us and proven to be in accordance with design and code requirements, please inspect and accept it. 附Attachment： 名称Description 页数Page 编号No. 1、□ 设备、材料、构配件质量证明文件 页 PageEquipment, Material and Components Quality Certificate Document 2、□ 隐蔽工程检查记录表Concealed Work Inspection Record 页 Page 3、□ 予检工程检查记录表Pre-inspected Work Inspection Record 页 Page 4、□ 施工记录Construction Record 1 页 Page5、□ 施工试验记录 Construction Test Record, 页 Page6、□ 工序质量控制点查验认可文件 页 PageWork Procedure Quality Control Point Inspection and Approval Document 7、□ 分项工程质量检验评定记录 2 页 Page Individual Item of Work Quality Inspection and Evaluation Record 8、□ 页 Page 专业质量工程师(检查员）（签字）： 日期 Quality Engineer (Inspector) (Signature Date 承包单位（章）： 技术负责人（签字）： 日期 Construction Contractor (Chop) Technical leader (Signature) Date 审查意见： Review Remarks: 审查结论Review conclusion： □合格Qualified □不合格Unqualified 项目监理机构（章）： 专业监理工程师（签字） 日期 Supervison Com. (Chop) Discipline supervision engineer (signature) Date 本表由承包单位填报，一式三份，经监理单位审批后，业主单位、监理单位、承包单位各存一份。 This table shall be filled up and submitted by the contractor in three copies, once it being reviewed and approved by the supervision company, the Owner, Supervision Company and Contractor sh