NATIONAL WATER COMPANY ‫ﺷرﻛــﺔ اﻟﻣﯾـــــﺎه اﻟوطﻧﯾـــــــﺔ‬

Project Name\.............................................................................. ....................................... / ‫اﻟﻣﺷـروع‬

Consultant\ .............................................................................
Contractor Consultant
......................................... /‫اﻻﺳﺗﺷﺎري‬
Contractor \.........................................................................
Logo Logo................................................ / ‫اﻟﻣﻘـــــﺎول‬

S. No.: .........................

Ground Level Record ‫ﺳﺟل ﻟﻣﻧﺎﺳﯾب اﻷرض اﻟطﺑﯾﻌﯾﺔ‬

LINE ……………………………………………. PAGE …………………………………..…………
STATION B.S I.S F.S H.I ELEVATION REMARKS

The Consultant: :‫اﻻﺳﺗﺷﺎري‬ The Contractor: :‫اﻟﻣﻘﺎول‬

Name : ..........................................................................: ‫اﻻﺳـــم‬ Name : .................................................................. : ‫اﻻﺳــم‬
Signature : ....................................................... ........:‫اﻟﺗوﻗﯾﻊ‬ Signature: ........................................................... : ‫اﻟﺗوﻗﯾﻊ‬
Date : …………………………………….………………….…………………..: ‫اﻟﺗﺎرﯾﺦ‬ Date : ................................................................... : ‫اﻟﺗﺎرﯾﺦ‬