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Location : IR No.

:
Structure: Date :
Ref. Drg. No.: Report No.:
EASTING NORTHING EASTING NORTHING
List of Attachments (if any):
Remarks :
Client : Ministry of Electricity and Water
Signature
Serial No Validity Date
Date
Name
Designation
SURVEY SURVEY REPORT
Instrument calibration status
REF.PT
ACTUAL
ELEVATION
REQUIRED
ELEVATION
REMARKS
Type
DIF. IN
ELEVATION
ACTUAL COORDINATES REQUIRED COORDINATES
]