Contract No.

  • Contract No.

Contract Title.

  • Title

  • Date Of Inspection

Preparatory Phase

  • Was Preparatory Phase Work Performed Today?

  • Definable Feature Of Work

Initial Phase

  • Was Initial Phase Work Performed Today?

  • Definable Feature Of Work

Follow-up Phase

  • Work Complies With Contract As Approved During Inital Phase

  • Work Complies With Safety Requirement

  • Description Of Work

  • Definable Feature Of Work

Photos Of Job Site

  • Photos Of Conduit For Gas Meter If Installed.

  • Photos Of Gas Meter If Installed.

  • Photos Of Conduit For Water Meter If Installed.

  • Photos Of Water Meter If Installed.

  • Photos Of Conduit For Comms If Installed.

  • Photos Of E-Meter If Installed.

Rework Items Identified Today (Not Corrected By Close Of Business)

  • Description

  • Photos Of Rework Items Today.

  • Site Supervisor

Rework Items Corrected Today (From Rework Items List)

  • Description

  • Photos Of Rework Items Corrected Today.

Remarks (Also Explain Any Follow-up Phase Checklist Item From Above That Was Answered "NO"). Manuf. Rep On-Site, ect.

  • Description

  • Authorized QC Manager At Site

Government Quality Assurance Report

  • Description

  • Government Quality Assurance Manager

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