INSPECTION REPORT BG/QA/FRM- 04/13 Rev:00

IR-No
Project : Date

Client :
Consultant :
Contractor :
Sub Contractor :

Attn: (Clients/Consultants) Project Manager

Item or Work to be tested / inspected ( Please put tick mark in the box )

_________ __________________ _______________ ___________ ___________

_________ __________________ _______________ ___________ ___________

_________ __________________ _______________ ___________ ___________

Location : Date:
Section : ___________________________ Time:

Electrical FA FF Mechanical
Others __________________________________________

Drawing No :

Comments: .

Attachments:
Enclosed Not enclosed
Electrical Fire Fighting Mechanical ELV Others

Name : (QA/QC Engineer ) Position: Engineer Signature / Date (Date)

Name : (Project Manager) Position: Manager Signature / Date (Date)

Consultant Comments

Consultant Status Description Signature

Name: Signature / Date:

A- Approved B- Approved with comment C- Not Approved