Bieu Mau Tu Van Giam Sat

MC LC BIU MU T VN GIM ST
STT
A
1 2
TN BIU MU
DANH MC
Cc thng s ban u v d n, cng trnh Danh mc h s ti liu hon thnh cng trnh
B
1 2
H S PHP L
Quyt nh thnh lp t TVGS cng trnh Quyt nh thay i cn b TVGS cng trnh
C
1 2 3 4 5 6 7 8
PHN CHUN B THI CNG

Bin bn bn giao mc - v tr - mt bng Phiu ly mu vt liu ngoi hin trng Phiu chp thun mu vt liu & thnh phm xy dng Phiu chp thun thay i mu vt liu & thnh phm xy dng Phiu xc nhn mu vt liu & thnh phm xy dng a vo cng trnh Phiu ly mu b tng Phiu kim tra cao hon thin Phiu kim tra lch trc ca cu kin
D
1 2 3 4 5 6 7
BIN BN KIM TRA & BB X L K THUT

Bin bn kim tra Bin bn x l k thut Bin bn x l vi phm k thut thi cng Bng k nhng thay i so vi thit k c ph duyt Bng k nhng cng vic cha hon thnh Bng k nhng h hng sai st Phiu kim tra cng tc sa cha
E
1 2 3 4 5 6 7 8 9 10 11 12
BIN BN NGHIM THU

Bin bn nghim thu thit k Bin bn nghim thu xy lp (mu chung) Bin bn nghim thu san lp mt bng Bin bn nghim thu o t mng Bin bn nghim thu cc c sn trc khi ng Bin bn nghim thu cc c sn trc khi p Bin bn nghim thu ng cc Bin bn nghim thu p cc Bin bn nghim thu b tng lt Bin bn nghim thu vn khun - ct thp Bin bn nghim thu cht lng b tng Bin bn nghim thu xy tng
STT
13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
TN BIU MU
Bin bn nghim thu gia cng cu kin thp Bin bn nghim thu lp t cu kin thp Bin bn nghim thu cng tc mi Bin bn nghim thu cng tc trt Bin bn nghim thu cng tc trn treo Bin bn nghim thu cng tc p gch Bin bn nghim thu cng tc lng Bin bn nghim thu cng tc lt nn Bin bn nghim thu cng tc sn Bin bn nghim thu cng tc ra Bin bn nghim thu cng tc knh - ca Bin bn nghim thu lp t tnh thit b Bin bn nghim thu hon thnh b phn cng trnh xy dng, giai on thi cng XD Bin bn nghim thu thit b chy th n ng khng ti Bin bn nghim thu thit b chy th lin ng khng ti Bin bn nghim thu thit b chy th lin ng c ti
F
1 2 3 4 5
BIN BN HON THNH CNG TRNH

Bin bn nghim thu hon thnh hng mc hoc cng trnh a vo s dng Bin bn kim tra h s nghim thu Ba bo co TVGS Bo co ca TVGS v cht lng xy dng cng trnh Bo co ca ch u t v cht lng xy dng cng trnh
CC THNG S BAN U V D N, CNG TRNH

TN N V CH QUN CA CH U T:
A CH: Tel: Fax:
CNG TY CP GI XY DNG
TN CH U T:
A CH:
TRUNG TM TIN HC GXD

Tel: 04.35682482 - ng (B): - ng (B): - ng (B): Fax: Chc v: Chc v: Chc v: 04.35682483 Gim c K thut A K thut A
TN N V TH HNG:
A CH: Tel: - ng (B): - ng (B): Fax: Chc v: Chc v:
TN N V CH QUN CA N V T VN THIT K:
A CH: GIY PHP THNH LP CHNG NHN KINH DOANH CHNG CH HNH NGH Tel: Fax:
TN N V T VN THIT K:
Giy php s
- ng (B): - ng (B): - ng (B):
Chc v: Chc v: Chc v:
Gim c Ch tr
KS KTS
XD
TN N V CH QUN CA N V TVGS:
TN N V TRC TIP TVGS:

A CH: GIY PHP THNH LP CHNG NHN KINH DOANH CHNG CH HNH NGH Tel: - ng (B): - ng (B): - ng (B): - ng (B): - ng (B): - ng (B): Fax: Chc v: Chc v: Chc v: Chc v: Chc v: Chc v: Ph Gim c KS gim st T vin T vin T vin KS KS KTS KS IN XD XD
Giy php s
TN N V CH QUN CA DOANH NGHIP XD

TN DOANH NGHIP XY DNG:

A CH:
GIY PHP THNH LP CHNG NHN KINH DOANH CHNG CH HNH NGH Tel: - ng (B): - ng (B): - ng (B): Fax: Chc v: Chc v: Chc v: Gim c Ch huy trng K thut KTS KS KTS XD
TN DOANH NGHIP CUNG CP THIT B:

A CH: GIY PHP THNH LP CHNG NHN KINH DOANH CHNG CH HNH NGH Tel: - ng (B): - ng (B): Fax: Chc v: Chc v:
TN CNG TRNH:
A IM XY DNG CNG TRNH: TNH, THNH PH:
TA NH VN PHNG CNG TY GI XY DNG S 10, NGUYN NGC NI, KHNG MAI, THANH XUN H Ni www.giaxaydung.vn/batdongsan www.giaxaydung.vn/thuvien
GI THU: HNG MC: HNH THC THIT K: A IM GIAO NHN TV, GS, THIT K, THI CNG:
CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc
DANH MC HON THNH CNG TRNH

CNG TRNH: TA NH VN PHNG CNG TY GI XY DNG GI THU: www.giaxaydung.vn/batdongsan HNG MC: www.giaxaydung.vn/thuvien A IM XY DNG:S 10, NGUYN NGC NI, KHNG MAI, THANH XUN CH U T: TRUNG TM TIN HC GXD
STT NI DUNG S VN BN
H S PHP L: A 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Danh mc h s ti liu hon thnh cng trnh xy dng D n u t xy dng cng trnh (bo co nghin cu kh thi) Quyt nh ph duyt d n u t Bo co kho st a cht cng trnh Bn v xin php xy dng Vn bn tha thun v thit k & thit b PCCC Vn bn tha thun kin trc quy hoch cng trnh Vn bn tha thun v mi trng Hp ng kinh t thit k k thut & d ton Bn v thit k D ton thit k thi cng Quyt nh ph duyt TKKT thi cng & d ton Hp ng kinh t thm tra TKKT & d ton Bin bn thanh l hp ng thm tra TKKT & d ton Hp ng t vn qun l d n HS mi thu (iu kin sch, iu kin ring cho thit b, vt liu - nu c, bng tin lng ... ) H s d thu ca . Bin bn m thu Q ph duyt kt qu u thu (hay ch nh thu) Hp ng kinh t giao nhn thu xy lp Lnh khi cng Tin thi cng Danh sch ban qun l cng trnh Danh sch ban ch huy cng trng Hp ng kinh t t vn gim st k thut xy dng Quyt nh c cn b gim st k thut Bin bn xc nh cc mc, cao cng trnh
B H S QUN L CHT LNG:

_____________________________________________________________________________________________________________ \\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office
STT
NI DUNG
S VN BN
I BIN BN LY MU & KT QU TH NGHIM VT T - THIT B I.1 CC BIN BN LY MU VT LIU 1 Xi mng 2 Ct vng 3 1x2 4 Ct thp ln 1 5 Ct thp ln 2 6 Ct thp ln 3 7 Mu b tng mng trc 8 Mu b tng mng trc 9 Mu b tng mng trc 10 Mu b tng king trc 11 Mu b tng king trc 12 Mu b tng king trc 13 Mu b tng king trc 14 Mu b tng ct trc 15 Mu b tng ct trc 16 Mu b tng ct trc 17 Mu b tng ct trc 18 Mu b tng mi sn trc 19 Mu b tng mi sn trc 20 Mu b tng mi sn trc 21 Mu b tng mi sn trc 22 Mu b tng h nc 50m3 I.2 PHIU KT QU TH NGHIM vt liu - CU KIN S DNG CHO CNG TRNH 1 Xi mng 2 Ct vng 3 1x2 4 Ct thp ln 1 5 Ct thp ln 2 6 Ct thp ln 3 7 Mu b tng mng trc 8 Mu b tng mng trc 9 Mu b tng mng trc 10 Mu b tng king trc 11 Mu b tng king trc 12 Mu b tng king trc 13 Mu b tng king trc 14 Mu b tng ct trc 15 Mu b tng ct trc 16 Mu b tng ct trc 17 Mu b tng ct trc
STT
NI DUNG
S VN BN
18 Mu b tng mi sn trc 19 Mu b tng mi sn trc 20 Mu b tng mi sn trc 21 Mu b tng mi sn trc 22 Mu b tng h nc 50m3 II BIN BN BN GIAO - KIM TRA - BIN BN NGHIM THU B PHN - CU KIN II.1 BIN BN BN GIAO - KIM TRA 1 BB bn giao mc v tr cao chun mt bng thi cng 2 BB ly mu xi mng - ct - 3 BB ly mu thp ln 1 4 BB ly mu b tng 5 Phiu chp nhn mu vt liu & thnh phm xy dng 6 Phiu chp nhn thay i mu vt liu & t.phm xy dng Bin bn nghim thu vt liu & thnh phm xy dng chuyn 7 vo cng trng 8 Phiu kim tra cao hon thin 9 Phiu kim tra lch trc ca cu kin 10 BB xc nhn thay i thit k & x l k thut thi cng 11 BB hp giao ban II.2 BIN BN NGHIM THU 1 BBNT san lp mt bng 2 BBNT o mng 3 BBNT o mng 4 BBNT o mng 5 BBNT b tng lt mng 6 BBNT vn khun - ct thp mng trc 7 BBNT vn khun - ct thp mng trc 8 BBNT vn khun - ct thp mng trc 9 BBNT b tng mng trc 10 BBNT b tng mng trc 11 BBNT b tng mng trc 12 BBNT b tng mng trc 13 BBNT vn khun - ct thp king trc 14 BBNT vn khun - ct thp king trc 15 BBNT vn khun - ct thp king trc 16 BBNT vn khun - ct thp king trc 17 BBNT b tng king trc 18 BBNT b tng king trc 19 BBNT b tng king trc 20 BBNT b tng king trc 21 BBNT vn khun - ct thp ct trc 22 BBNT vn khun - ct thp ct trc
STT
NI DUNG
S VN BN
23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64
BBNT vn khun - ct thp ct trc BBNT vn khun - ct thp ct trc BBNT b tng ct trc BBNT b tng ct trc BBNT b tng ct trc BBNT b tng ct trc BBNT vn khun - ct thp mi sn trc BBNT vn khun - ct thp mi sn trc BBNT vn khun - ct thp mi sn trc BBNT vn khun - ct thp mi sn trc BBNT b tng mi sn trc BBNT b tng mi sn trc BBNT b tng mi sn trc BBNT b tng mi sn trc BBNT o t h nc 50m3 BBNT b tng lt y h nc 50m3 BBNT vn khun - ct thp y h nc 50m3 BBNT b tng y h nc 50m3 BBNT vn khun - ct thp thnh h nc 50m3 BBNT b tng thnh h nc 50m3 BBNT vn khun - ct thp np h nc 50m3 BBNT b tng np h nc 50m3 BBNT o t b t hoi BBNT b tng lt y b t hoi BBNT xy tng b t hoi BBNT trt tng b t hoi BBNT ct thp an np b t hoi (khng chu lc) BBNT ct thp an np b t hoi (chu lc) BBNT b tng an np b t hoi BBNT xy tng trc BBNT xy tng trc BBNT xy tng trc BBNT xy tng trc BBNT trt tng trc BBNT trt tng trc BBNT trt tng trc BBNT trt tng trc BBNT cng tc mi trc BBNT cng tc mi trc BBNT cng tc mi trc BBNT cng tc mi trc BBNT cng tc trn treo trc
STT
NI DUNG
S VN BN
65 BBNT cng tc trn treo trc 66 BBNT cng tc trn treo trc 67 BBNT cng tc trn treo trc 68 BBNT cng tc p gch phng trc 69 BBNT cng tc p gch phng trc 70 BBNT cng tc p gch phng trc 71 BBNT cng tc p gch phng trc 72 BBNT cng tc p gch trang tr 73 BBNT cng tc lt nn trc 74 BBNT cng tc lt nn trc 75 BBNT cng tc lt nn trc 76 BBNT cng tc lt nn trc 77 BBNT cng tc lng nn (granit) trc 78 BBNT cng tc lng nn (granit) trc 79 BBNT cng tc lng nn (granit) trc 80 BBNT cng tc lng nn (granit) trc 81 BBNT cng tc lng nn (sn) 82 BBNT cng tc lng mi 83 BBNT cng tc qut vi tng 84 BBNT cng tc ca 85 BBNT gia cng cu kin thp i nc 86 BBNT lp dng cu kin thp i nc 87 BBNT o t mng k 88 BBNT mi dc taluy k 89 BBNT k 90 BBNT cng tc ng ni b 91 BBNT ng ng cp, thot nc sinh hot 92 BBNT lp t thit b nc 93 BBNT lp t ng ng cp nc cha chy 94 BBNT PCCC (lp t thit b - th p lc) 95 BBNT chng st - tip a (o tr khng) 96 BBNT lp t ng dy in, ng lun dy in 97 BBNT lp t thit b in (cng tc, cm ...) 98 BBNT h thng thit b in 99 BBNT ng ch phng x quang II BIN BN HON THNH CNG TRNH 1 BBNT hon thnh giai on hoc cng trnh 2 BB kim tra h s nghim thu 3 Bo co ca TVGS v cht lng xy dng cng trnh 4 Bo co ca ct v cht lng xy dng cng trnh
CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc
NH MC HON THNH CNG TRNH
S 10, NGUYN NGC NI, KHNG MAI, THANH XUN

NGY
NGY
NGHIM vt liu - CU KIN S DNG CHO CNG TRNH
NGY
O - KIM TRA - BIN BN NGHIM THU B PHN - CU KIN
NGY
NGY
CNG TY CP GI XY DNG TRUNG TM TIN HC GXD S: /BBBGMB
CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc H Ni, ngy ... thng ... nm 200
BIN BN BN GIAO MC V TR CAO CHUN - MT BNG THI CNG

CNG TRNH: GI THU: HNG MC: A IM XD: TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/batdongsan www.giaxaydung.vn/thuvien S 10, NGUYN NGC NI, KHNG MAI, THANH XUN
Cn c H s Thit k do: .................................................... thit lp v c duyt. Hm nay ngy //2011 ti: TA NH VN PHNG CNG TY GI XY DNG. Chng ti gm c: I. BN GIAO: Ch u t: TRUNG TM TIN HC GXD - ng (B): Chc v: Gim c - ng (B): Chc v: K thut A T chc TV Thit k: - ng (B): Chc v: Gim c - ng (B): Chc v: Ch tr II. BN NHN: T chc TVGS: - ng (B): Chc v: Ph Gim c - ng (B): Chc v: KS gim st Doanh nghip XD: - ng (B): Chc v: Gim c - ng (B): Chc v: Ch huy trng Cng tin hnh kim tra mt bng cng trnh v thng nht giao nhn: mc, v tr, cao chun v mt bng thi cng n v thi cng tin hnh nh v v thi cng cng trnh, c th: 1. Mc v tr:
2. Cao chun:
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3. Mt bng thi cng: bng phng:
Cao mt t hin hu so vi Thit k (trung bnh):
Kch thc khu t so vi Thit k
* Cc bn tham gia: (K, ghi r h tn v chc v) NH THU GIM ST THI CNG XD Ph Gim c CH U T Gim c
NH THU THIT K XD CNG TRNH Gim c
NH THU THI CNG XD CNG TRNH Gim c
N BN BN GIAO MC V TR CHUN - MT BNG THI CNG
.............................................. thit lp v c duyt.
CH U T Gim c
PHIU LY MU B TNG TI HIN TRNG

CNG TRNH: HNG MC: TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien
1. Thnh phn tham gia chng kin ly mu: T chc T vn Gim st: - ng (B): Doanh nghip Xy dng: - ng (B): 2. B phn ly mu:
Chc v: Chc v:
KS gim st Ch huy trng
3. Mc ch ly mu:
4. Yu cu ly mu: - S mu ca 1 t mu: - Tn sut: ../1 t mu Bng thng k v tr (ng knh), k hiu mu: STT 1 2 3 4 5 6 7 8 5. Kt lun: V TR (NG KNH) K HIU KCH THC MAC BT ST
* Cc bn tham gia ly mu: (K, ghi r h tn v chc v) GIM ST THI CNG XD K THUT THI CNG TRC TIP
PHIU CHP THUN MU VT LIU V THNH PHM XY DNG

CNG TRNH: HNG MC: TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien
1. Thnh phn tham gia: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut T chc T vn Thit k: - ng (B): Chc v: Ch tr - ng (B): Chc v: 2. Cc bn thng nht: Chn mu vt liu/ thnh phm m t di y, ph hp vi Thit k, iu kin sch a vo thi cng. 3. Vt liu /Thnh phm: Loi vt liu /thnh phm:
Quy cch:
M t chi tit:
Nh SX:
Chng ch xut xng (CATALOGUE):
i l cung cp:
K hiu tn mu:
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Phm vi s dng:
S lng cn cung cp:
4. Yu cu: - Nh thu c k hoch nhp s lng cn s dng ng theo mu chn. Trong trng hp khng s lng phi bo ngay cho Ch u t c Quyt nh li. - Mu c lu ti: v c bo qun cn thn c th i chiu khi cn thit. 5. Cc lu khc:
* Cc bn tham gia nghim thu: (K, ghi r h tn v chc v) T VN GIM ST K THUT THI CNG TRC TIP T VN THIT K
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office ChapThuanMau
PHIU CHP THUN THAY I MU VT LIU, THNH PHM XY DNG

(SO VI THIT K C DUYT HAY IU KIN SCH) CNG TRNH: HNG MC: TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien
1. Thnh phn tham gia: Ch u t: TRUNG TM TIN HC GXD - CNG TY CP GI XY DNG - ng: Chc v: Gim c - ng: Chc v: K thut A T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut T chc T vn Thit k: - ng (B): Chc v: Ch tr - ng (B): Chc v: 2. Ni dung thay i: Loi vt liu /thnh phm:
Quy cch:
M t chi tit:
Nh SX:
i l cung cp:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office ThayDoiMau
K hiu tn mu:
Phm vi s dng:
S lng cn cung cp:
3. Bn xut thay i vt liu/thnh phm xy dng: 4. Cc bn thng nht chn mu vt liu/thnh phm XD sau y v l do:
5. Yu cu: - Nh thu c k hoch nhp s lng cn s dng ng theo mu chn. Trong trng hp khng s lng phi bo ngay cho Ch u t c Quyt nh li. - Mu c lu ti: v c bo qun cn thn c th i chiu khi cn thit. 6. Cc lu khc:
* Cc bn tham gia nghim thu: (K, ghi r h tn v chc v) T VN GIM ST K THUT THI CNG TRC TIP T VN THIT K
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office ThayDoiMau
BIN BN NGHIM THU VT LIU & THNH PHM XY DNG CHUYN N CNG TRNH
CNG TRNH: HNG MC: 1. Thnh phn tham gia: T chc T vn Gim st: - ng (B): - ng (B): Doanh nghip Xy dng: - ng (B): - ng (B): 2. Tn vt liu /thnh phm: Loi vt liu /thnh phm: TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien
Chc v: Chc v: Chc v: Chc v:
KS gim st T vin Ch huy trng K thut
Quy cch:
Nh SX:
i l cung cp:
K hiu tn mu:
Phm vi s dng:
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3. Kt lun: - Mu vt liu/thnh phm XD m t trn y ph hp vi thit k, ng theo iu kin sch. - ng a mu vt liu/thnh phm xy dng m t trn y vo s dng cho cng trnh. - Mu c lu ti: v c bo qun cn thn c th i chiu khi cn thit. 4. Cc lu khc:
* Cc bn tham gia nghim thu: (K, ghi r h tn v chc v) GIM ST THI CNG XD K THUT THI CNG TRC TIP
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office XacNhanMau
S:
S:
PHIU MU B TNG
- K hiu / S mu: - V tr : - st thc t: - Ngy: / /200 T VN GIM ST mm Gi: h '
PHIU MU B TNG
CNG TRNH: TA NH VN PHNG CNG TY GI XY DNG TRNH: TA NH VN PHNG CNG TY GI XY DNG CNG
K THUT B
K THUT B
S:
S:
PHIU MU B TNG
PHIU MU B TNG
CNG TRNH: TA NH VN PHNG CNG TY GI XY DNG TRNH: TA NH VN PHNG CNG TY GI XY DNG CNG
K THUT B
K THUT B
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BNG K NHNG THAY I SO VI THIT K C PH DUYT

(p dng theo Ph lc 15 Quyt nh s 18/2003/Q-BXD km vi Bin bn nghim thu lp theo Ph lc 4A Ngh nh s 209/2004/N-CP)
CNG TRNH: HNG MC:
TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien

NGI C THM QUYN DUYT S THAY I TN, S, NGY THNG VN BN CHO PHP THAY I
STT
NI DUNG THAY I
NGUYN NHN THAY I
GHI CH
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BKeThayDoi_TKe
STT
NI DUNG THAY I
NGUYN NHN THAY I
NGI C THM QUYN DUYT S THAY I
TN, S, NGY THNG VN BN CHO PHP THAY I
GHI CH
I DIN T CHC T VN THIT K (K, ghi r h tn v chc v, ng du)
H Ni, ngy ... thng ... nm 200 I DIN CH U T (K, ghi r h tn v chc v, ng du)
BIN BN S NGHIM THU THIT K XY DNG CNG TRNH

(p dng theo Ph lc 4A Ngh nh s 209/2004/N-CP)
CNG TRNH: HNG MC: 1. 2.
3. 4. a/.
i tng nghim thu: ghi r bc thit k, i tng thit k xy dng cng trnh Tn cng vic c nghim thu: V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi h s thit k: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-TKe
Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng cng vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD) c/. Cc kin khc (nu c): 5. Kt lun:
- Chp nhn hay khng chp nhn nghim thu thit k xy dng cng trnh; - Yu cu sa cha, b sung h s thit k v cc kin ngh khc nu c.
* Cc bn tham gia nghim thu: GIM ST THI CNG XD
K THUT THI CNG TRC TIP
H s nghim thu cng vic XD gm:

- BBNT cng vic XD v cc ph lc km theo nu c. - Cc ti liu lm cn c nghim thu
BIN BN S M THU THIT K XY DNG CNG TRNH
ghi r bc thit k, i tng thit k xy dng cng trnh
n v thi cng c Ch u t ph duyt v nhng thay i Thit k c
m tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD:
g, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i
vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD)
BIN BN S NGHIM THU CNG VIC XY DNG

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-XL
Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng cng vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD) c/. Cc kin khc (nu c): 5. Kt lun:
(Chp nhn hay khng chp nhn nghim thu, ng cho trin khai cc cng vic XD tip theo) (Yu cu sa cha, hon thin cng vic XD thc hin & cc yu cu khc nu c)

\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-XL

CNG TRNH: HNG MC: 1. 2. 3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: SAN LP MT BNG V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: - Bn v han cng s: Quy chun, tiu chun c p dng: - TCVN 4447 - 1987: Cng tc t. Quy phm thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu.
Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng cng vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD)
STT NI DUNG KIM TRA PHNG PHP KIM TRA KT QU KIMTRA T K. T
1 2 3 4 5
V tr Cao Kch thc Chiu dy mi lp Bc lp hu c
c/. Cc kin khc (nu c): 5. Kt lun: * Cc bn tham gia nghim thu: GIM ST THI CNG XD

CNG TRNH: HNG MC: 1. 2. 3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: O T MNG V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: - Bn v han cng s: Quy chun, tiu chun c p dng: - TCVN 4447 - 1987: Cng tc t. Quy phm thi cng v nghim thu. - TCXD 79 - 1980: Thi cng v nghim thu cc cng tc nn mng. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i
tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng cng vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD)
1 2 3 4
V tr Cao Kch thc Chng

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CC C SN TRC KHI NG V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. - TCXD 190 - 1996: Mng cc tit din nh - Tiu chun thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-CocTruocDong
Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng cng vic XD: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD)
1 2 3 4 5 6 7
Chiu di Tit din thng phng mt Tnh trng b mt (nt, r) u cc ( nghing ca mt phng u cc) Mi cc (x dch u nhn so vi tm)
c/. Cc kin khc (nu c): 5. Kt lun:


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-CocTruocDong

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CC C SN TRC KHI P V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. - TCXD 190 - 1996: Mng cc tit din nh - Tiu chun thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-CocTruocEp
1 2 3 4 5 6 7
Chiu di Tit din thng phng mt Tnh trng b mt (nt, r) u cc ( nghing ca mt phng u cc) Mi cc (x dch u nhn so vi tm)


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-CocTruocEp

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: NG CC V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCXD 190 - 1996: Mng cc tit din nh - Tiu chun thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-DongCoc
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
S hiu cc: Tit din cc: Chiu di cc: Cao u cc: Cao mt t: Loi ba: Trng lng u ba: Ngy c cc: Ngy ng cc: S lng t cc: Sai s nghing cc: chi dng ng: S nht p: Chiu cao ri ba: Chuyn v u cc: Sai s v tr cc:
c/. S liu theo di hin trng:

STT SU S NHT NG CHIU CAO RI BA GHI CH
1 2 3 4 5 6 7 8 9 10 d/. Cc kin khc (nu c): -
5. Kt lun:


3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: P CC V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCXD 190 - 1996: Mng cc tit din nh - Tiu chun thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-EpCoc
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
S hiu cc: Tit din cc: Chiu di cc: Cao u cc: Cao mt t: Thit b p cc: Lc nn ti a: Din tch Piston: Hnh trnh kch: Sai s v tr cc: Sai s nghing cc: Ti trng dng p: p lc dng p: Ngy c cc: Ngy p cc: S lng cc:
c/. S liu theo di hin trng:

STT SU P LC P GHI CH
1 2 3 4 5 6 7 8 9 10 d/. Cc kin khc (nu c): -
5. Kt lun:


CNG TRNH: HNG MC: 1. 2. 3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: B TNG LT 4X6 M100 V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: - Bn v han cng s: Quy chun, tiu chun c p dng: - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu.
1 2 3 4 5 6 7 8
Vt liu Cp phi Phng php trn sch trc khi b tng Chiu dy m nn Lm phng mt Bo dng

CNG TRNH: HNG MC: 1. 2. 3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: VN KHUN - CT THP V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: - Bn v han cng s: Quy chun, tiu chun c p dng: - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu.
VN Kch thc KHUN Cao V tr lch thng ng Chng nhn, kn sch, m Cha l Ch c cao khc CT THP Cng V tr, hnh dng S lng, kch thc Neo Ni buc Ni hn Lp bo v sch

CNG TRNH: HNG MC: 1. 2. 3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CHT LNG B TNG V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: - Bn v han cng s: Quy chun, tiu chun c p dng: - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu.
1 2 3 4 5 6 7
V tr cu kin (sau khi tho cppha) Tit din thng ng vng c chc Tnh trng b mt (nt, r v.v...) Cng th nghim b tng

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: XY TNG V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 4314 - 1986: Va xy dng. Yu cu k thut. - TCVN 1450 - 1986: Gch rng t st nung - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-XayTuong
1 2 3 4 5 6 7 8 9
Vt liu Cp phi va Tim trc, chn tng Lin kt Mch va phng Hnh dng, kch thc V sinh b mt Chi tit cha l, chn sn


- BBNT cng vic XD v cc ph lc km theo nu c.
- Cc ti liu lm cn c nghim thu

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: GIA CNG CU KIN THP V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 170 - 1989: Kt cu thp.Gia cng lp t v nghim thu. Yu cu k thut. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-GiaCongCKT
1 2 3 4 5 6
V tr Ngang bng, thng ng Lin kt hn, bulng Ging vng Sn ph


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-GiaCongCKT

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: LP T CU KIN THP V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LapDatCKT
1 2 3 4 5 6
V tr Ngang bng, thng ng Lin kt hn, bulng Ging vng Sn ph


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LapDatCKT

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CNG TC MI V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Mai
1 2 3 4 5 6 7 8
Vt liu H kt cu mi Hnh dng, kch thc,v tr,cao dc b mt Lin kt kn nc Mi ni Np, p nc


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Mai

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CNG TC TRT V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 4314 - 1986: Va xy dng. Yu cu k thut. - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Trat
1 2 3 4 5 6 7
Vt liu Cp phi V sinh b mt C ghm mc chun phng, vung gc Bong rp Joint, g ch


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Trat

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CNG TC TRN TREO V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Tran
1 2 3 4 5 6 7 8 9 10
Vt liu Khong cch ty treo thng, phng khung trn Khong cch khung xng Mi ni Cao Neo gi tm trn phng trn Gia c v tr c lp t thit b V sinh hon thin b mt


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Tran

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: P GCH V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Op
1 2 3 4 5 6 7 8
Vt liu Cp phi va Cao p phng Sai lch mt phng, vung gc Joint gch Bong rp V sinh


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Op

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: LNG NN V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Lang
1 2 3 4 5 6 7 8
Vt liu Cp phi va V sinh b mt C ghm mc chun phng, dc c chc Joint, g ch Hon thin b mt


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Lang

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: LT NN V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Lat
1 2 3 4 5 6 7
Vt liu Cp phi va Cao phng, dc Joint gch Bong rp V sinh b mt


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Lat

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CNG TC SN V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Son
1 2 3 4 5 6 7
Vt liu V sinh b mt B mastit hon thin b mt Sn lt Sn hon thin (s lp) bm dnh ng mu


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Son

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: TRT RA V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-DaRua
1 2 3 4 5 6 7 8 9
Vt liu Cp phi va V sinh b mt C ghm mc chun phng, vung gc Bong rp Joint, np, g ch ng mu B mt hon thin


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-DaRua

3. 4. a/.
i tng nghim thu: Tn cng vic c nghim thu: CNG TC KNH, CA V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k:
Quy chun, tiu chun c p dng: - TCVN 192 - 1996: Ca g, ca i, ca s. Yu cu k thut chung. - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-KinhCua
1 2 3 4 5 6 7 8 9
Vt liu Hnh dng V tr Kch thc Lin kt thng ng Cong vnh Chn, Joint, np, ch V sinh


\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-KinhCua
BIN BN S NGHIM THU LP T TNH THIT B

(p dng theo Ph lc 4B Ngh nh s 209/2004/N-CP)
3. 4. a/.
Thit b/Cm Thit b c nghim thu: Tn Thit b/Cm Thit b: V tr lp t trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng vic xy dng thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LDTinhTB
Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng lp t thit b: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh) - Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. c/. Cc kin khc (nu c): 5. Kt lun:
H s nghim thu lp t tnh thit b gm:

- BBNT lp t tnh thit b v cc ph lc km theo nu c. - Cc ti liu lm cn c nghim thu
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LDTinhTB
BIN BN S NGHIM THU HON THNH B PHN CNG TRNH XY DNG GIAI ON THI CNG XY DNG
3. 4. a/.
i tng nghim thu: Tn b phn cng trnh XD (hay giai on thi cng XD) c nghim thu: V tr xy dng trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi b phn cng trnh xy dng (hay giai on thi cng xy dng) thc hin: Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: - TCVN 4447 - 1987: Cng tc t. Quy phm thi cng v nghim thu. - TCXD 79 - 1980: Thi cng v nghim thu cc cng tc nn mng. - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu. - TCXD 190 - 1996: Mng cc tit din nh - Tiu chun thi cng v nghim thu. - TCVN 4314 - 1986: Va xy dng. Yu cu k thut. - TCVN 1450 - 1986: Gch rng t st nung - TCVN 5674 - 1992: Cng tc hon thin trong xy dng. Thi cng v nghim thu.
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Bophan_GdoanXD
- TCVN 170 - 1989: Kt cu thp.Gia cng lp t v nghim thu. Yu cu k thut. - TCVN 4519 - 1998: H thng cp thot nc bn trong nh v cng trnh. Quy phm thi cng v nghim thu. - QCXDVN II: H thng cp thot nc bn trong v bn ngoi nh. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: - Xi mng - Ct vng - 1x2 - 4x6 - Cng thp 6 - Cng thp 8 - Cng thp 10 - Cng thp 12 - Cng thp 14 - Cng thp 16 - Cng thp 18 - Cng BT Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. BBNT cc cng vic thuc b phn CTXD (hay giai on thi cng XD) c nghim thu: - BBNT san lp. - BBNT o t mng. - BBNT cc c sn trc khi ng. - BBNT cc c sn trc khi p. - BBNT cc c sn trc khi p. - BBNT ng cc. - BBNT p cc. - BBNT btng lt. - BBNT vn khun - ct thp. - BBNT cht lng btng. - BBNT xy tng. - BBNT gia cng cu kin thp. - BBNT lp t cu kin thp. - BBNT cng tc mi. - BBNT cng tc trt. - BBNT cng tc trn treo. - BBNT p gch. - BBNT lng nn. - BBNT lt nn. - BBNT cng tc sn.
- BBNT trt ra. - BBNT cng tc knh, ca. - BBNT cng tc lp t ng dy in, ng lun dy in. - BBNT cng tc lp t thit b in (cng tc, cm, bng n, CB ....) - BBNT cng tc lp t ng ng cp, thot nc sinh hot. - BBNT cng tc lp t thit b nc. - BBNT cng tc lp t ng ng thot nc ngoi nh. - BBNT lp t ng ng cp nc PCCC. - BBNT lp t thit b - th p lc PCCC. - BBNT lp t chng st - tip a. Bn v hon cng b phn cng trnh: BBNT b phn cng trnh XD (hay giai on thi cng XD) hon thnh ca ni b Nh thu thi cng XD: Cng tc chun b cc cng vic trin khai giai on thi cng XD tip theo: b/. Kim tra ti hin trng:
STT NI DUNG KIM TRA KT QU T K.T GHI CH
1 2 3 4 5
Hnh dng V tr Kch thc thng ng Cao
c/. Cht lng XD b phn cng trnh (hay giai on thi cng XD): (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD) - Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. d/. Cc kin khc (nu c): \\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-Bophan_GdoanXD
5. Kt lun:
H s nghim thu b phn CTXD (hay giai on thi cng XD) gm:
- BBNT hon thnh b phn trnh (hay giai on thi cng XD) v cc ph lc km theo. - Cc ti liu lm cn c nghim thu
BIN BN S NGHIM THU THIT B CHY TH N NG KHNG TI

(p dng theo Ph lc 5B Ngh nh s 209/2004/N-CP)
3. 4. a/.
Thit b/Cm Thit b c nghim thu: Tn Thit b/Cm Thit b: V tr lp t trn cng trnh: Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN nh gi cng tc chy th thit b n ng khng ti thc hin: Cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: -
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-DonDong_KhongTai
Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng chy th thit b n ng khng ti: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh). - Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. c/. Cc kin khc (nu c): 5. Kt lun:

- BBNT thit b chy th n ng khng ti. - Cc ti liu lm cn c nghim thu
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-DonDong_KhongTai
BIN BN S NGHIM THU THIT B CHY TH LIN NG KHNG TI

(p dng theo Ph lc 5C Ngh nh s 209/2004/N-CP)
CNG TRNH: HNG MC:
1. H thng thit b c nghim thu: Tn h thng thit b: Thi gian chy th: - Bt u: h ngy thng nm 200 - Kt thc: h ngy thng nm 200 V tr lp t trn cng trnh: 2. Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut 3. Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN 4. nh gi cng tc chy th thit b lin ng khng ti thc hin: a/. Cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu - iu kin k thut ring:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LienDong_KhongTai
trang
Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng chy th thit b lin ng khng ti: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh). - Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. c/. Cc kin khc (nu c): 5. Kt lun:

- BBNT chy th lin ng khng ti v cc ph lc km theo nu c. - Cc ti liu lm cn c nghim thu
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LienDong_KhongTai
BIN BN S NGHIM THU THIT B CHY TH LIN NG KHNG TI

(p dng theo Ph lc 5C Ngh nh s 209/2004/N-CP)
CNG TRNH: HNG MC:
1. H thng thit b c nghim thu: Tn h thng thit b: Thi gian chy th: - Bt u: h ngy thng nm 200 - Kt thc: h ngy thng nm 200 V tr lp t trn cng trnh: 2. Thnh phn trc tip nghim thu: T chc T vn Gim st: - ng (B): Chc v: KS gim st - ng (B): Chc v: T vin Doanh nghip Xy dng: - ng (B): Chc v: Ch huy trng - ng (B): Chc v: K thut 3. Thi gian nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN 4. nh gi cng tc chy th thit b lin ng khng ti thc hin: a/. Cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu - iu kin k thut ring:
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LienDong_CoTai
trang
Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. Bin bn nghim thu ni b cng vic xy dng ca nh thu thi cng xy dng: b/. Cht lng chy th thit b lin ng khng ti: (i chiu vi TK, TCXD & yu cu k thut ca cng trnh). - Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. c/. Cc kin khc (nu c): 5. Kt lun:

- BBNT chy th lin ng khng ti v cc ph lc km theo nu c. - Cc ti liu lm cn c nghim thu
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-LienDong_CoTai
CNG TY CP GI XY DNG TRUNG TM TIN HC GXD S: /BBBGMB
BIN BN NGHIM THU HON THNH HNG MC CNG TRNH HOC CNG TRNH A VO S DNG
(p dng theo Ph lc 7 Ngh nh s 209/2004/N-CP)
CNG TRNH: GI THU: HNG MC: A IM XD:
TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/batdongsan www.giaxaydung.vn/thuvien S 10, NGUYN NGC NI, KHNG MAI, THANH XUN
1. Thnh phn tham gia nghim thu: Ch u t: TRUNG TM TIN HC GXD - CNG TY CP GI XY DNG - ng (B): Chc v: Gim c - ng (B): Chc v: K thut A T chc TVGS: - ng (B): Chc v: Ph Gim c - ng (B): Chc v: KS gim st Doanh nghip XD: - ng (B): Chc v: Gim c - ng (B): Chc v: Ch huy trng T chc TV Thit k: - ng (B): Chc v: Gim c - ng (B): Chc v: Ch tr 2. Thi gian tin hnh nghim thu: Bt u: h ngy thng nm 200 Kt thc: h ngy thng nm 200 Ti: S 10, NGUYN NGC NI, KHNG MAI, THANH XUN 3. nh gi hng mc cng trnh, cng trnh xy dng: a/. Ti liu lm cn c nghim thu: Phiu yu cu nghim thu ca nh thu. H s thit k bn v thi cng c Ch u t ph duyt v nhng thay i Thit k c chp nhn: - Bn v thi cng s: - Bin bn thay i Thit k: Quy chun, tiu chun c p dng: - TCVN 4447 - 1987: Cng tc t. Quy phm thi cng v nghim thu. - TCXD 79 - 1980: Thi cng v nghim thu cc cng tc nn mng. - TCVN 4453 - 1995: Kt cu BTCT ton khi. Quy phm thi cng v nghim thu.
\\vboxsrv\conversion_tmp\scratch10604\97669079.xlsx.ms_office BBNT-HoanThanh
Mng cc tit din nh - Tiu chun thi cng v nghim thu. Va xy dng. Yu cu k thut. Gch rng t st nung Cng tc hon thin trong xy dng. Thi cng v nghim thu. Kt cu thp.Gia cng lp t v nghim thu. Yu cu k thut. H thng cp thot nc bn trong nh v cng trnh. Quy phm thi cng v nghim thu. - QCXDVN II: H thng cp thot nc bn trong v bn ngoi nh. - TCVN 2103 - 94: Dy in bc nha. - TCXD25 - 1991: t ng dy dn trong nh v cng trnh cng cng. - TCXD7 - 1991: t thit b in trong nh v cng trnh cng cng. - 20 TCN 46 - 84: Chng st cho cng trnh. - QCXDVN II: Phng chng chy. Ti liu ch dn k thut km theo Hp ng XD. - iu kin k thut thi cng: Mc iu trang - iu kin k thut ring: Cc kt qu kim tra, th nghim cht lng VL, thit b c thc hin trong qu trnh XD: - Xi mng - Ct vng - 1x2 - 4x6 - Cng thp 6 - Cng thp 8 - Cng thp 10 - Cng thp 12 - Cng thp 14 - Cng thp 16 - Cng thp 18 - Cng BT Nht k thi cng, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i tng nghim thu. - TCXD 190 - 1996: - TCVN 4314 - 1986: - TCVN 1450 - 1986: - TCVN 5674 - 1992: - TCVN 170 - 1989: - TCVN 4519 - 1998: BBNT cc cng vic thuc b phn CTXD (hay giai on thi cng XD) c nghim thu: - BBNT san lp. - BBNT o t mng. - BBNT cc c sn trc khi ng. - BBNT cc c sn trc khi p. - BBNT cc c sn trc khi p. - BBNT ng cc. - BBNT p cc. - BBNT btng lt. - BBNT vn khun - ct thp. - BBNT cht lng btng. - BBNT xy tng.
- BBNT gia cng cu kin thp. - BBNT lp t cu kin thp. - BBNT cng tc mi. - BBNT cng tc trt. - BBNT cng tc trn treo. - BBNT p gch. - BBNT lng nn. - BBNT lt nn. - BBNT cng tc sn. - BBNT trt ra. - BBNT cng tc knh, ca. - BBNT cng tc lp t ng dy in, ng lun dy in. - BBNT cng tc lp t thit b in (cng tc, cm, bng n, CB ....) - BBNT cng tc lp t ng ng cp, thot nc sinh hot. - BBNT cng tc lp t thit b nc. - BBNT cng tc lp t ng ng thot nc ngoi nh. - BBNT lp t ng ng cp nc PCCC. - BBNT lp t thit b - th p lc PCCC. - BBNT lp t chng st - tip a. Bn v hon cng b phn cng trnh: BBNT b phn cng trnh XD (hay giai on thi cng XD) hon thnh ca ni b Nh thu thi cng XD: Cng tc chun b cc cng vic trin khai giai on thi cng XD tip theo: b/. Kim tra ti hin trng:
STT NI DUNG KIM TRA KT QU T K.T GHI CH
1 2 3 4 5
Hnh dng V tr Kch thc thng ng Cao
c/. Cht lng XD b phn cng trnh (hay giai on thi cng XD): (i chiu vi TK, TCXD & yu cu k thut ca cng trnh XD)
- Thi cng ng bn v thit k c duyt, t yu cu v k thut, m thut. - Cng tc thi cng ng quy trnh, quy phm hin hnh ca Nh nc ban hnh. - Cng tc thi cng ng tin c lp. - Chng loi vt t thi cng ng theo iu kin sch ca cng trnh. d/. Cc kin khc (nu c): 4. Kt lun:
(Chp nhn nghim thu hon thnh hng mc cng trnh hoc cng trnh XD a vo s dng) (Yu cu sa cha, hon thin b sung cc kin khc nu c)
Cc bn trc tip nghim thu chu trch nhim trc Php lut v quyt nh nghim thu ny. NH THU GIM ST THI CNG XD Ph Gim c CH U T Gim c
NH THU THIT K XD CNG TRNH Gim c
H s nghim thu gm:

- BBNT hon thnh XD cng trnh hoc hng mc cng trnh v cc ph lc km theo bin bn ny nu c. - Cc ti liu lm cn c nghim thu

Bieu Mau Tu Van Giam Sat

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Bieu Mau Tu Van Giam Sat

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MC LC BIU MU T VN GIM ST

PHN CHUN B THI CNG

BIN BN KIM TRA & BB X L K THUT

BIN BN NGHIM THU

BIN BN HON THNH CNG TRNH

CC THNG S BAN U V D N, CNG TRNH

TRUNG TM TIN HC GXD

- ng (B): - ng (B): - ng (B):

Chc v: Chc v: Chc v:

TN N V TRC TIP TVGS:

TN N V CH QUN CA DOANH NGHIP XD

TN DOANH NGHIP XY DNG:

TN DOANH NGHIP CUNG CP THIT B:

CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc

DANH MC HON THNH CNG TRNH

B H S QUN L CHT LNG:

CNG HA X HI CH NGHA VIT NAM c lp - T do - Hnh phc

NH MC HON THNH CNG TRNH

S 10, NGUYN NGC NI, KHNG MAI, THANH XUN

NGHIM vt liu - CU KIN S DNG CHO CNG TRNH

O - KIM TRA - BIN BN NGHIM THU B PHN - CU KIN

CNG TY CP GI XY DNG TRUNG TM TIN HC GXD S: /BBBGMB

BIN BN BN GIAO MC V TR CAO CHUN - MT BNG THI CNG

3. Mt bng thi cng: bng phng:

Cao mt t hin hu so vi Thit k (trung bnh):

Kch thc khu t so vi Thit k

NH THU THIT K XD CNG TRNH Gim c

NH THU THI CNG XD CNG TRNH Gim c

N BN BN GIAO MC V TR CHUN - MT BNG THI CNG

.............................................. thit lp v c duyt.

NH THU THI CNG XD CNG TRNH Gim c

PHIU LY MU B TNG TI HIN TRNG

KS gim st Ch huy trng

PHIU CHP THUN MU VT LIU V THNH PHM XY DNG

Chng ch xut xng (CATALOGUE):

S lng cn cung cp:

PHIU CHP THUN THAY I MU VT LIU, THNH PHM XY DNG

Chng ch xut xng (CATALOGUE):

S lng cn cung cp:

Chc v: Chc v: Chc v: Chc v:

KS gim st T vin Ch huy trng K thut

Chng ch xut xng (CATALOGUE):

BNG K NHNG THAY I SO VI THIT K C PH DUYT

CNG TRNH: HNG MC:

TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien

NGUYN NHN THAY I

NGUYN NHN THAY I

NGI C THM QUYN DUYT S THAY I

TN, S, NGY THNG VN BN CHO PHP THAY I

I DIN T CHC T VN THIT K (K, ghi r h tn v chc v, ng du)

BIN BN S NGHIM THU THIT K XY DNG CNG TRNH

CNG TRNH: HNG MC: 1. 2.

TA NH VN PHNG CNG TY GI XY DNG www.giaxaydung.vn/thuvien

* Cc bn tham gia nghim thu: GIM ST THI CNG XD

K THUT THI CNG TRC TIP

H s nghim thu cng vic XD gm:

BIN BN S M THU THIT K XY DNG CNG TRNH

(p dng theo Ph lc 4A Ngh nh s 209/2004/N-CP)

ghi r bc thit k, i tng thit k xy dng cng trnh

n v thi cng c Ch u t ph duyt v nhng thay i Thit k c

g, nht k gim st ca Ch u t v cc vn bn khc c lin quan n i

K THUT THI CNG TRC TIP

BIN BN S NGHIM THU CNG VIC XY DNG

CNG TRNH: HNG MC: 1. 2.