SECCO表格 - 图文(11)

Issued by (Chop) Responsible person (Signature) Date

一致意见Agreement： 建设单位代表 设计单位代表 项目监理机构 Owner’s Representative Designer’s Representative Supervision Organization 签字： 签字： 签字： Signature: Signature: Signature: 日期： 日期： 日期： Date: Date: Date 注：本表由提出单位填报，有关单位会签，并各存一份；涉及设计变更，尚须由有关单位和人员出具书面的设计变更（或指示）文件。Note: This table shall be filled up and submitted by the party who issues it and countersigned by

related parties, all parties shall keep one copy. In case any design changes are involved, related party and person shall issue document of design change (or instruction) in written form.

单项(单元)工程： Work Item (Unit) 上海赛科90万吨乙烯工程 C -- 03

抽 检 记 录 Spot Inspection Record 项目编号： Project No. 编号: No. Shanghai SECCO 900KTPA Ethylene Project

检查项目 Inspection Item 检查部位 Inspection Location 检查数量 Inspection Quantity 被委托单位 Engaged Company 相关承包单位 Related Contractors 检查结果(附示图和检测报告) Inspection results (See attached drawing and inspection report) 检测单位（章）： 技术负责人（签字）： 日期：

Inspected by (Chop) Technical leader (Signature) Date 处置意见Resolution remarks： 委托单位（章） 委托人（签字）： 日期： Owner (Chop) Owner Representative (Signature) Date 注：本表由委托单位填报，有关单位各存一份；相关承包单位应列入交工文件移交。Note: This table

shall be filled up and submitted by the Owner, all parties involved shall keep one copy, related contractors shall list it as one of handover documents.