1、濮阳中油工程管理有限公司 监理资料107采 油 六 厂 工 程 建 设 项 目工程报审报验监 理 表 格（石油化工建设工程项目监理规范 SH/T 3903-2004）濮阳中油工程管理有限公司工 程 管 理 六 站ST/T 3903-2004SH/T 3903-A.1工程开工/复工报审表Works Commencement/Resumption Approval Request工程名称 Works Title：编号 Item No：致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我单位承担的 采油六厂马厂联合站防洪排涝 工程，已完成了以下各项工作，具备了开工/复工条件，特此申请施工
2、，请核查并签发 开工/ 复工指令。We have fulfilled the following activities for the work contracted by us, the works commencement/ works resumption conditions are available, therefore the construction is applied hereby, please review and issue works commencement/ works resumption orders.附 Attached：1 开工报告 commenceme
3、nt Report；2 证明文件 Supporting documents。项目经理Project Manager承包单位（章） 日 期Contractor(Chop) Date审查意见 Review Comments：总监理工程师Chief Supervision Engineer项目监理机构：工程管理六站 日 期CS/CMC DateST/T 3903-2004SH/T 3903-A.2施工组织设计（方案）报审表Construction Organization Design Approval Request工程名称 Works Title：编号 Item No：致 濮阳中油工程管理有限公
4、司（监理单位）To （CS/CMC）我方已根据施工承包合同的有关规定完成了采油六厂马厂联合站防洪排涝工程施工组织设计（方案）的编制，并经我单位技术负责人审查批准，请予以审查。According to the regulations of the construction contract, we have completed the preparation of the construction organization design ,and it has been reviewed and approved by the technical responsible people of ou
5、r company, please review it.附 Attached施工组织设计/施工方案。Construction Organization Design/ Construction Plan项目经理Project Manager承包单位（章） 日 期Contractor(Chop) Date专业监理工程师审查意见 专业监理工程师Discipline Supervision Engineer日 期Date总监理工程师审核意见 Review comments from chief supervision engineer：总监理工程师Chief Supervision Engineer
6、项目监理机构：工程管理六站 日 期CS/CMC DateST/T 3903-2004SH/T 3903-A.3 分包单位资格报审表Subcontractor Qualification Approval Request工程名称 Works Title：编号 Item No：致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）经考察，我方认为拟选定的 菏泽方明集团有限公司 （分包单位）具有承担下列工程的施工资质和施工能力，可以保证本工程项目按合同的规定进行施工。分包后，我方仍承担承包合同的全部责任。请予以审查和批准。After investigation, we think the p
7、roposed (subcontractor) has the qualification and capability for contracting the fallowing works, and can assure that this woks will be constructed as per the contract regulations. After subcontracting this works, we still hold the whole responsibilities of the lump sum contractor. Please review and
8、 approve it.附 Attached1 分包单位资质材料 Subcontractor Qualification Documents；2 分包单位业绩材料 Subcontractor Performance Documents。分包工程名称（部位）Subcontracted works(location)工程数量Works Quantity拟分包工程合同额Contract Price of proposed subcontracted works分包工程占全部工程Percentage of subcontracted works合 计 Totals项目经理Project Manager
9、承包单位（章） 日 期Contractor(Chop) Date专业监理工程师审查意见 专业监理工程师Discipline Supervision Engineer日 期Date总监理工程师审核意见 Review comments from chief supervision engineer：总监理工程师Chief Supervision Engineer项目监理机构：工程管理六站 日 期ST/T 3903-2004CS/CMC DateSH/T 3903-A.4隐蔽记录 报验申请表Inspection Request工程名称 Works Title：采油六厂马厂联合站防洪排涝工程编号 It
10、em No：致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我已完成了采油六厂马厂联合站防洪排涝工程之电缆的隐蔽工作，经自检合格，先报上该工程报验申请表，请予以审查。We have completed the works, after self inspection, the works is on spec, now we submit the inspection request for this works, please inspect and accept.附 Attached：项目经理Project Manager承包单位（章） 日 期Contractor(Chop)
11、 DateST/T 3903-2004审查意见 Review Comments：总/专业监理工程师Chief /discipline supervision engineer项目监理机构：工程管理六站 日 期CS/CMC DateSH/T 3903-A.5 工程款支付申请表Works payment Request工程名称 Works Title：编号 Item No：ST/T 3903-2004致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我方已完成了采油六厂马厂联合站防洪排涝工程 工作，按施工承包合同的规定，建设单位应在 年 月 日前支付该项工程款共（大写）（小写 ） ，现
12、报上工程付款申请表，请予以审查并开具工程款支付证书。We have completed the Works,according to the contract regulations, the owner should make the payment of total of (amount in works),(say ) fort his works before . Now we submit the Works Payment Request, please review and issue the works payment certificate.附件 Attached：1 工程量
13、清单 Quantity List；2 计算方法 Calculation Methods：项目经理Project Manager承包单位（章） 日 期Contractor(Chop) DateST/T 3903-2004SH/T 3903-A.9工程材料/构配件/设备报审表Works Materials/Components/Equipment Inspection Request工程名称 Works Title：采油六厂马厂联合站防洪排涝工程编号 Item No：致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我方于 年 月 日进场的工程材料/构配件/设备数量如下（见附件） 。现
14、将质量证明文件及自检结果报上，拟用于下述部位：采油六厂马厂联合站防洪排涝工程集水池的施工请予以审核。We have mobilized the following materials/components/equipment for the works on Its quantity is listed below(see the attachments)Now, we submit the quality documents and our self inspection results, The proposed locations for use as follows：Please re
15、view it.附件 Attached：1 数量清单 Quantity List；2 质量证明文件 Quality Documents；3 自检结果 Self Inspection Results。项目经理Project Manager承包单位（章） 日 期Contractor(Chop) Date审查意见 Review Comments：经检查上述工程材料/构配件/设备，符合/不符合设计文件和规范的要求，准许/不准许进场，同意/不同意适用于拟定部位。After the inspection, the abovematerials/components/equipment, meet do n
16、ot meet the requirements of the design documents and specifications. site mobilization is allowed/site mobilization is not allowed. use for the proposed locations is allowed/not allowed.总/专业监理工程师Chief /discipline supervision engineer项目监理机构：工程管理六站 日 期ST/T 3903-2004CS/CMC DateSH/T 3903-A.10 工程竣工报验单Wor
17、ks Completion Inspection Request工程名称 Works Title：编号 Item No：致 濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我方已合同要求完成了 工程，经自检合格，请予以检查和验收。We have completed the works according to the requirements of the contract, after the self check, it is on spec, please inspect and accept.附 Attached：项目经理Project Manager承包单位（章） 日 期C
18、ontractor(Chop) DateST/T 3903-2004审查意见 Review Comments：经初步验收，该工程：After the preliminary inspection and acceptance, this works：1 符合/不符合我国现行法律、法规要求；meet/not meet the requirements of the current state laws and regulations；2 符合/不符合我国现行工程建设标准；meet/not meet the requirements of the current national standard
19、s；3 符合/不符合设计文件要求；meet/not meet the requirements of the design documents；4 符合/不符合施工合同要求。 meet/not meet the requirements of the construction contract.综上所述，该工程初步验收合格/不合格， 可以/ 不可以组织正式验收。Based on the above points, the preliminary inspection and acceptance of this works is on spec/off spec, formal inspection and acceptance can be/ can not be organized.总监理工程师Chief Supervision Engineer项目监理机构：工程管理六站 日 期CS/CMC DateSH/T 3903-A.11 施工进度计划报审表Construction Schedule Approval Request工程名称 Works Title：编号 Item No：
