The Construction of Kanchpur, Meghan, Gumti 2nd Bridges

and Rehabilitation of Existing Bridges( Package No.PW-01)

OSJI Joint Venture

VISUAL INSPECTION FOR REPAIRING GALVANIZED COATING OF SCREW HOLES

OF CONNECTION BRACKET FOR LIGHTING POLE

(SAMPLE FORMAT)
location of Inspection: RFI No.:
Inspection Item: Date of Inspection:
Total Quantity:

Sketch:

Cleaning Screw Holes Application of Anti-oil Application of Sealing Material

No. Item Quantity
Accepted Not Accepted Accepted Not Accepted Accepted Not Accepted
1 UB-LP-S01 1
2 UB-LP-S02 1
3 UB-LP-S03 1
4 UB-LP-S04 1
5 UB-LP-S05 1
6 UB-LP-S06 1
7 UB-LP-S07 1
8 UB-LP-S08 1
9 UB-LP-S09 1
10 UB-LP-S10 1
11 UB-LP-S11 1
12 UB-LP-S12 1
13 UB-LP-S13 1
14 UB-LP-S14 1
15 UB-LP-S15 1
16 UB-LP-S16 1
17 UB-LP-S17 1
18 UB-LP-S18 1
19 UB-LP-S19 1
20 UB-LP-S20 1
21 UB-LP-S21 1
22 UB-LP-S22 1
23 UB-LP-S23 1
24 UB-LP-S24 1

THE CONTRACTOR THE ENGINEER

Person -in-chrage QA/QC Manager Inspector, Site Material Engine Senior Engineer
Signature:

Name:
Date:
The Construction of Kanchpur, Meghan, Gumti 2nd Bridges
 and Rehabilitation of Existing Bridges( Package No.PW-01)
OSJI Joint Venture

VISUAL INSPECTION FOR REPAIRING GALVANIZED COATING OF SCREW HOLES

OF CONNECTION BRACKET FOR LIGHTING POLE

(SAMPLE FORMAT)
location of Inspection: RFI No.:
Inspection Item: Date of Inspection:
Total Quantity:

Sketch:

Cleaning Screw Holes Application of Anti-oil Application of Sealing Material

No. Item Quantity
Accepted Not Accepted Accepted Not Accepted Accepted Not Accepted
1 UB-LP-S25 1
2 UB-LP-S26 1
3 UB-LP-S27 1
4 UB-LP-S28 1
5 UB-LP-S29 1
6 UB-LP-S30 1
7 UB-LP-S31 1
8 UB-LP-S32 1
9 UB-LP-S33 1
10 UB-LP-S34 1
11 UB-LP-S35 1
12 UB-LP-S36 1
13 UB-LP-S37 1
14 UB-LP-S38 1
15 UB-LP-S39 1
16 UB-LP-S40 1
17 UB-LP-S41 1
18 UB-LP-S42 1
19 UB-LP-S43 1
20 UB-LP-S44 1
21 UB-LP-S45 1
22 UB-LP-S46 1
23 UB-LP-S47 1

THE CONTRACTOR THE ENGINEER

Person -in-chrage QA/QC Manager Inspector, Site Material Engine Senior Engineer
Signature:

Name:
Date: