附录A SH／T 3503-2017 (交工技术文件通用表英文版)

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Project Quality Supervision Station/Team Leader:

(Official Seal)

Date:

Related Organizations

(Official Seal)

Representative:

Date:

(Official Seal)

Representative:

Date:

(Official Seal)

Representative:

Date:

260

SH/T

3503

—

2017

工程名称：

Project Name:

单位工程名称：

Unit Name:

SH/T 3503

—

J110

工程设计变更一览表

List of Design Changes

Discipline

S/N

Change Order No.

Cause (s)

Drawing No. and Main Points of Change

of Change

Status of

Implementation

Note: Fill “Design

Cause

” or “Non

-design Cause

” in

the column of

“

Cause

(s) of Change”.

Owner

Discipline Engineer:

Date:

Supervision Contractor

Discipline Engineer:

Date:

Construction Contractor

Prepared by:

Reviewed by:

Date:

217

SH/T

3503

—

2017

工程名称：

Project Name:

单位工程名称：

Unit Name:

SH/T 3503

—

J111

工程联络单一览表

List of Liaison Sheets

Discipline

S/N

Sheet No.

Cause(s)

General Contractor

Discipline Engineer:

Date:

Status of

Implementation

Construction Contractor

Prepared by:

Reviewed by:

Date:

Owner/Supervision Contractor

Discipline Engineer:

Date:

260

SH/T

3503

—

2017

工程名称：

隐蔽工程验收记录

Concealed Work Acceptance

单位工程名称：

Inspection Record

Construction

Drawing No.

SH/T 3503

—

J112

Concealed

Item

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Owner/Supervision Contractor

Discipline Engineer:

Date:

General Contractor

Discipline Engineer:

Date:

Construction Contractor

Foreman:

Quality Inspector:

Discipline Engineer:

Date:

217

SH/T

3503

—

2017

工程名称：

Project Name:

单位工程名称：

Unit Name:

Item No.

SH/T 3503

—

J113

垫

铁

隐

蔽

记

录

Shim Embedding Record

Equipment/Structure

Description

Shim Layout:

Description on Shim Conditions:

Flat Shim Size (

L

*

W

*

< br>H

):

Wedge Size (

L

*

W

*

H

Gradient:

Shim Set Formation:

Piece Number:

Shim Set Height:

Installation Requirement

Data in conformance with the requirements of

Equipment Alignment

the specifications.

In conformance with the requirements of the

Shim Size

method statement.

In conformance with the requirements of the

Shim Arrangement

specifications.

In conformance with the requirements of the

Number of Shims Per Set

specifications.

In conformance with the requirements of the

Height of Shims Per Set

design documents and specifications.

In conformance with the requirements of the

Wedge Overlapping Length

specifications.

In conformance with the requirements of the

Fixing of Shims by Tack Welding

specifications.

Inspection Item

Inspection Result

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

□

Conforming

□

Nonconforming

Conclusion:

Shims are verified by inspection as

□

Nonconforming

□

Conforming to design and specification requirements

□

Unacceptable for embedment

□

Acceptable for embedment

Owner/Supervision Contractor

General Contractor

Construction Contractor

Discipline Engineer:

Date:

260

Discipline Engineer:

Date:

Foreman:

Quality Inspector:

Discipline Engineer:

Date:

SH/T

3503

—

2017

工程名称：

Project Name:

单位工程名称：

Unit Name:

SH/T 3503

—

J114

工程联络单

Liaison Sheet

Addressed to

Sheet No.

Cause(s):

Contents:

Handled by:

Raised by (Seal of Project Organization)

Reviewed by:

Date:

Receiving Organization

’s Disposition

Comments:

Handled by:

Reviewed by

（

Seal of Project Organization

）

Date:

Date:

Countersignature Comments:

Representative:

Signed for and on behalf of:

(Seal of Project Organization)

Date:

Countersignature Comments:

Representative:

Signed for and on behalf of:

(Seal of Project Organization)

Date:

Countersignature Comments:

Representative:

Signed for and on behalf of:

(Seal of Project Organization)

Date:

217

SH/T

3503

—

2017

工程名称：

Project Name:

SH/T 3503

—

J115

合格焊工登记表

Register of Qualified Welders

Certificate No.

General Contractor

Discipline Engineer:

Date:

Code of Qualified Item

Validity Period

Construction Contractor

Discipline Engineer:

Date:

S/N

Name

Stamp No.

Owner/Supervision Contractor

Discipline Engineer:

Date:

260

SH/T

3503

—

2017

工程名称：

Project Name:

S/N

Name

Certificate No.

Code of Qualified Item

General Contractor

Discipline Engineer:

Date:

217

SH/T 3503

—

J116

无损检测人员登记表

Register of NDE Personnel

Level

Validity Period

Owner/Supervision Contractor

Discipline Engineer:

Date:

Inspection Agency

Discipline Engineer:

Prepared by:

Date: