Information
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Location
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Subcontractor/Activity
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Conducted on
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Completed Work
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Yes
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No
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Report No.
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Inspection Checklist, Specification, Or Drawing Used As Referance
RESULTS
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Follow up Required
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Satisfactory
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Description Of Item/Work Inspection/Observed
Observations/Deficiency:
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Surveillance Personnel
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Select date
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Project Quality Lead
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Select date
Person Notified Of Deficiency
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Name
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Title
Recommended Corrective Action
Corrective Actions Implemented/Accepted
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Surveillance Personnel
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Select date
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Project Quality Lead
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Select date