Government Quality Assurance (QA) Report

• DATE

  Date

• CONTRACT NO

• TITLE AND LOCATION

• REPORT NO

STATUS

• WORKING?

  YES

  NO

• WEATHER CONDITIONS

CHECK POINTS

• SUPERINTENDENT ON SITE

  Yes

  No

  N/A

• QC MANAGER ON SITE

  Yes

  No

  N/A

• QC REPORTS CURRENT

  Yes

  No

  N/A

• AS-BUILTS CURRENT

  Yes

  No

  N/A

• SUBMITTALS APPROVED FOR ONGOING WORK

  Yes

  No

  N/A

• DEFICIENCY LIST REVIEWED

  Yes

  No

  N/A

WORK OBSERVED/DEFICIENCIES NOTED/SAFETY ISSUES DISCUSSED/QA TESTS AND REULTS

OBSERVATION

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  Media

MEETING CONFERENCE NOTES (INCLUDING PARTICIPANTS)

NOTE

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  Media

INSTRUCTIONS GIVEN OR RECEIVED/CONTROVERSIES PENDING

INSTRUCTION

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  Media

• QA REPRESENTATIVE

  Sign