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Hashemite Kingdom of Jordan Ministry Of Water and Irrigation

Disi-Mudawarra to Amman Water Conveyance System Project


Disi Water Company Date Report No

Gama Guc Sistemleri Muhendislik ve Taahhut A.S.

COATINGS/ LINING MATERIAL REQUEST FORM

26.06.2012

ICC Subcontractor: ______________________________ 26.06.2012 Date: _______________________________


Item Description 1 2 3 4 5 6. 7. 8. 9. 10. 11.
CANUSA GTS80 /M80 Shrink Sleeve66"

Qty

Warning label attached (Yes/ No)

Expiration Date

CANUSA HBE 95 - Cure CANUSA HBE 95 - Base


Canusa Base Cup 14 oz

120 2 6 500

Roll EA EA pc

Canusa Applicator Pad


CANUSA Weld Seam Strap ( BT65-B25-17 )

Canusa Stir Stick Canusa Gloves Canusa mastic filler bulk roll

648 pc 48 Roll 5 pk 10 pk 1 Roll

Authority Subcontractor Requester: GGS Area Construction Manager: GGS Warehouse Manager:

Name/ Signature

Date

26.06.2012

DISI-QA-FR-G-MS-098 Rev 0

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