Project :

JKR SARAWAK
Contract No. :

APPROVAL CHIT CHIT NO. :

(EARTH WORKS / PAVEMENT WORKS / DRAINAGE WORKS / BRIDGE WORKS / OTHER WORKS)*

PART A : (To be filled by Contractor)

From : PROJECT MANAGER / CONSTRUCTION MANAGER / SITE AGENT * (Contractor)

To : SUPERINTENDANT OFFICER'S REPRESENTATIVE

We request for inspection and permission to proceed with the following work;

Submitted by :- Signature : Checked by :- Signature :

( ) Project Manager/Construction Manager/Site Agent*

Time : Date : / /

PART B : (To be filled by Superintendant Officer's Rep)*

Received by:- Signature : Time : Date : / /

Name :

1) Certification/Approval of materials : 2) Inspection/Measurement of Prior Work/Platform : 3) Testing of Prior Work :

Type Type Type
Pass/Fail Pass/Fail Pass/Fail
Pass/Fail Pass/Fail Pass/Fail
Pass/Fail Pass/Fail Pass/Fail

Comments (where relevant) :- Signature :

SO Representative
Date:

PART C : (To be filled by Engineer / Quality Assurance Engineer)*

From : SUPERINTENDANT OFFICER (SO) REPRESENTATIVE *

To : PROJECT MANAGER / CONSTRUCTION MANAGER / SITE AGENT * (Contractor)

Your request to proceed with the above mentioned work IS APPROVED

*
IS NOT APPROVED

Remarks :

Received for Contractor ; Signature :

PM/RE/ARE/QAE *

Time : Date : / /
Signature :
Project Manager/Construction Manager/Site Agent*
Neither the endorsement of this Form nor anything written on it is intended to convey final approval for
Time : Date : / / any part of the Works, nor does it relieves the Contractor of his responsibility to comply with the quality
requirements of the Works.

* select as appropriate

Format Rev. No. : 0

Computer ref.: C:/A-c-2/ISO/QA Forms/QA-03 Appr. Chit Minsar/QA/03