CNG HO X HI CH NGHA VIT NAM

c lp - T do - Hnh phc

-------------- 0o0 -------------

Vnh Phc, ngy

thng

nm 2012

BIN BN S: 01/TB/T

NGHIM THU THIT B TRC KHI LP T

1. D n: Xy dng v mua sm H thng X l nc thi cho mt s c s y t cng lp tnh
Vnh Phc
2. Gi thu: Xy dng v mua sm H thng x l nc thi.
3. Cng trnh: Xy dng h thng X l nc thi Phng khm a khoa khu vc o Tr.
4. Thit b c nghim thu:
- H thng x l nc thi hp khi FRP model KAJ-10;
- Cc ph kin i km.
5. Thnh phn trc tip nghim thu:
A / i din Ch u t: S Y t Tnh Vnh Phc.
1. ng ng Quang Thanh

Chc v: Ph gim c

2. ng V c Tin

Chc v: Trng phng K hoch tng hp

3. ng V Hu Ti

Chc v: Cn b phng K hoch tng hp

B / i din T vn gim st: Cng ty C phn T vn u t Y t Thng Long.

1. ng Trnh Ming

Chc v: Gim c

2. ng Nguyn B Qun

Chc v: Gim st thit b

3. ng .

Chc v:

C /i din nh thu: Cng ty C phn Tin b Quc t.

1. ng Nguyn Hng Sn

Chc v: Ph Tng Gim c

2. ng H Xun Ha

Chc v: Ch huy trng cng trnh

3. ng Nguyn Vn Nam

Chc v: K thut thi cng trc tip

6. Thi gian nghim thu:

- Bt u :

.... gi .... pht, ngy...... thng... nm 2012

- Kt thc :
... .gi .... pht, ngy...... thng... nm 2012
- a im nghim thu: Ti Phng khm a khoa khu vc o Tr x o Tr, huyn
Tam o, tnh Vnh Phc.

7. nh gi cng vic nghim thu:

7.1. Ti liu lm cn c nghim thu:
- Phiu yu cu nghim thu ca nh thu;
- Bin bn nghim thu ni b ca nh thu;
- H s thit k bn v thi cng;
- Hp ng s 11/2011/HKT/SYT-AIC ngy 23/12/2011 gia S Y t tnh Vnh Phc v
Cng ty C phn Tin b Quc t, km theo cc Ph lc hp ng;
- Chng ch cht lng sn phm (CO);
- Chng ch xut x sn phm (CQ);
- H s mi thu, H s d thu;
- Chng th kim nh thit b;
- Vn n, t khai hi quan;
7.2. Cc thng s k thut:
STT
tn hng-chng loi
I
H thng x l nc thi ng b
KAJ-10
Bao gm:
B FRP Y12B031
B FRP Y12B006
1
Ni c Tank 600x300
Ni c Tank 450x300
T iu khin
2
No.: 32-0480
My thi kh
Type: HP-150
3
Capacity: 125 W
Serial No.: 111100005H
My bm u vo
Model: 50PU2.4-52
4
H: 6,5m; Q: 0,15m3/h
Motor: 0,4 kW
Serial No.: H-10300573/ H-10300577
Cng tc phao ni
5
Model: RF-5
Cable 6m
Thit b ni nhanh cho bm
8
Model: TOK-4P

S lng
1 h thng

Hng/Nc sn xut

01 b
01 b
02 chic
01 chic
01 chic

Kubota / japan

Nichiei / Japan
Techno takatsuki / Japan

1 chic
02 chic

Tsurumi / Japan

03 chic

Tsurumi / Japan

02 b

Tsurumi / Japan

7.3. Cht lng thit b:

- Cc my, thit b trc khi lp t tnh trng tt, khng c cc du hiu nh xc, gy,
v v mo.
- Cc my, thit b c nghim thu mi 100%, c y cc giy t xc nhn xut x,
cht lng. Cc thng s k thut ng theo h s thit k, hp ng v ph lc hp ng k
kt gia S Y t tnh Vnh Phc v Cng ty C phn Tin b Quc t.
7.4. Cc kin khc: Khng.
8. Kt lun:
- Cc bn tham gia ng nghim thu my, thit b trc lp t v cho php trin khai cc
cng vic tip theo.
I DIN
CH U T

I DIN
T VN GIM ST

I DIN
NH THU THI CNG