IR

Work Inspection Request No.

WIR/LUT/

Project Name

Contractor Name
Date Time Category of works to be inspected
Inspection Request submitted on

Work ready for inspection at site on

Drawing
Job Description Location App. Quantity
Ref. No.

Work checked by (on part of contractor)

Submitted By Signature Date

Lodha Engineer's Comments / Consultant’s Comments

Civil Finishing HVAC Electrical Plumbing …………...

Code 1 Code 3
Work may proceed Revise & Resubmit. Work may not proceed
Code 2 Code 4
Conditionally approved. Work may proceed after rectifying the For information and records only.
observation provided above. Work may proceed
Received by (on part of contractor )
Name Signature Date
Project In-
Site Engineer QE Engineer
charge
Signature Signature Signature

Date Date Date

Attach Documents
Method Statement Drawing
QC Cards/ Checklist Other …………………
Consultant Checking Report

Code 1 – Work may proceed Code 3 – Revise & Resubmit. Work may not proceed
Code 2 – Conditionally approved. Work may proceed after rectifying the observation provided above. Code 4 – For information and records only. Work may
Important: Permission to proceed does not relieve contractor from full compliance with contractual obligations
Format No-LUT/QE/DF-001/ Rev-0 Dt: 20/12/17