INSPECTION & TEST RECORD - CIVIL

ITR No: C-0102X

SURVEY INSPECTION RECORD
PEC-QU-ITR-X-11083 Rev 2

C-0102X
Sub-Contractor: Target LLC Project: JI20377
Sub System No # NA Tag No #: N/A
Description:
Drawing No: Rev:
RFI #: C-TAR- Date:
Structure/ Member:
Area:

Northing Easting Elevation Remarks

Description As per As per As per
Actual Difference Actual Difference Actual Difference
Drawing Drawing Drawing
1
2
3
4
5
6
7
8
9
10

Notes:

*If RFI has 2 ITR numbers, record number for those ITRs shall be “RFI number/1” and “RFI number/2”. Test reports will have test house identification numbers.
Company Signature: Applicable Not Applicable

Record Acceptance Sub-Contractor Surveyor Petrofac Construction / Surveyor COMPANY

Name:

Signature:

Date:
DRP001-OUF-TAR-RPT-Q-000-002 Page 1 of 1 Ref. ITP No: PEC-QU-ITP-X-11083