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t••• CGL-4AMNS
AM/NS
INDIA

TITLE FOUNDATION RELEASE NOTE FOR EQUIPMENT & STRUCTURE ERECTION

REPORT NO. 'DATE: I 1-O<a- 2. 2..
Area/Location : Ut1lt½t Bwl&l61 f\
Drawing No. & Rev. No: AM DEC. I12-1 o;q ( 2-+l I lo f c...v-5t.{?:;
Equipment / Structure Details:
A-9 . .,,
Checked Remarks
SR.No • -Activity/ Jtem to be'~hecked ( Yes/No/NA)
"
-. -
- -~
•·
'
Foundation co-ordinates, level and dimensions are within
I pennissible deviation (Post concreting as built sketch y~ (01c..
attached)
Anchor bolts position, spacing and projection are
2 confirmed with drawing (Post concreting as built sketch YQJ, z,
attached) / Cleanness of bolt.
(? M c.:t--= ,=,I oK
3
Pocket size and spacing are confirmed with drawing (Post
concreting as built sketch attached) / Cleanness of pocket
y4J,
C.,e,c,l d t'• 1@ t-111
4
Setting outline and datum level are detennined and visible
for installation\ erection purpose
'{~ -6t~ ¢~M:::b~ t.. ,

5
Foundation top surface are scrabbled/hacked and cleaned
of all dirt, laitance, oil & grease etc.
y~ Ntf~ ~ of<-
Remarks :

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.·•,. · -, ' (CJvii)-,-_\'-_.) ... , ·.: · \/.,:': .·.
. ,
. .· ; . , ~;

-'. IJISP.(Execution) . •, .. PSP (QA/QC) . '.· - :AMNS(Execution)·'· ., ; 'AMNs (QA/QC) ·.

Signature !'-pi} (;)\~

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Name !'-I.0 , eQ_vi 5,~,f-
-
K L\~CI ~1'½
Date 11 lo R"I ?-'l.- . . ,.·:r' ~· -. ,.
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- (Mechanical) ..
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AMNS (Execu~on) . · . AMNS' (QA/QC) - '
CONTRACTOR
.·:.. -•· ~' ' . ' /'"'\:

Signature /Mr- .
Name LY Aai.~ :1 .. . u
'11

Date
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