• Maatvoering:

  • Ontkist na:

  • Dilataties waterdicht:

  • Uiterlijk strakke lijnen:

  • Scheuren:

  • Grindnesten:

  • Beschadigingen:

  • Luchtbellen in zicht:

  • Aansluiting stortnaden:

  • Afwijking in oppervlaktestructuur:

  • Afwijking in oppervlaktebehandeling:

  • Vlakheid (zichtwerk):

  • Eindsterkte:


  • Afwijkingsrapporten opgesteld?


  • Bijzonderheden:

  • Bijlage(n):


  • Keuring uitgevoerd op:

  • Handtekening 1e-lijnskeurder:

  • Ondersteuning akkoord:

  • Handtekening voor ondersteuning akkoord uitvoerder:

  • Indien van toepassing:

  • Datum 2e-lijnskeuring:

  • Handtekening 2e-lijnskeurder:

  • Gezien directie:

  • Handtekening directie:

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