Title Page
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Site conducted
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Type of Report
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Location
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Document Number
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Prepared by
QUALITY ASSURANCE OBSERVATIONS
- Quality Assurance Item Under Inspection
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Definable Feature of Work
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Type of Inspection
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Inspection Details
Contractor Line Item Under Inspection
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Project Area
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Description of Work
GENERAL OBSERVATIONS/DISCUSSIONS
- Observation/Discussion/General Note
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Item of Interest
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Description of Interest
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Is project Safety within Compliance of Federal and State Regulations?
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Is Project Cleanliness Properly Maintained in all Work and Public Areas?
CONTRACTOR'S WORK FORCE
- Company and Personnel on Site
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Contractor
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Personnel Count
REPORT ATTACHMENTS AND SIGNATURE
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QA Progress Photos
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Approved Outage Request
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Incident Report
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Non-Conformance Report
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Additional Items to Include
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QA Manager Signature
