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Location :
Citation
Engineer Inspection
Value
Item
Design Actual Accepted Not Accepted
Lav
(Cd/mm2)
Ti
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Memo :
SAMPLE FORMAT
Signature
Name
Date
The Construction of Kanchpur, Meghna, Gumti 2nd Bridges and
Rehabilitation of Existing Bridges (Package No. PW-01)
Appendix “A” – Inspection Report for Dimension and Levelling on Anchor Bolt
Inspection Date Inspection Date
Internal The Engineer
A
B
C
D
E
F
G
H
I
J
Name
Date
Appendix “A” – Inspection Report for Dimension and Levelling on Anchor Bolt
Inspection Date Inspection Date
Internal The Engineer
A
B
C
D
E
F
G
H
I
J
Contractor The Engineer
QC Engineer QA/QC Manager
Signature
Name
Date