吊装作业安全技术方案报审表

1、吊装作业安全技术方案报审表洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )监理附表 supervision sheet丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECT单项 ( 单元 )工 程：Work Item (Unit):施工质量规则附表目录 (一 ) PR-00-CIJ-QU-0002 Construction Quality Rules Annexed Table Index (I)项目编号：Project No.:表号

2、 Table No.表格名称 Table Title备注 Remarks-A01a工程开工报审表Review Request on Commencement of Work-A01b工程复工报审表Review Request for Resume of Work-A02施工组织总设计报审表 Review Request on Overall Construction Organization Design-A02a工程技术管理文件报审表 Review Request on Engineering Technical Management Document-A03分包单位资格报审 表 Revie

3、w Request on Qualification of Subcontractors-A03a( ) 资质报审表 Review Request on Qualification-A04质量控制点核报审表Review Request on QualityControl Point Inspection-A05工程款支付申请表Application for Project Payment-A06监理工程师通知回复单 Supervision Engineer Notice Response-A07工程临时延期申请表 Application for Temporarily Postponement

4、 of Project洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany （LPECSC ）-A08费用索赔申请表 Application For Claim on Cost-A09材料/构配件/设备报审表Material/Component/Equipment Review Request-A10工程交工报验单 Construction Takeover Inspection Request-A11质量控制点检验通知Quality Control Point Inspect

5、ion Notice-A12主要施工设备进场报审表-B01监理工程师通知单 Supervision Engineer Notice-B02工程暂停令 Work Suspension Order-B03工程款支付证书 Project Payment Certificate-B04工程临时延期审批表 Approval for Postponement of Project Temporarily-B05工程最终 延期审批 表 Approval for Final Postponement of Project-B06费用索赔审批表 Approval For Claim on Cost-B07会 议

6、 纪 要（一） Minutes of Meeting （I）-C01监理工作联系单Supervision Correspondence-C02工程变更单 Variation Order-C03工程承包单位及承包内容 Construction Contractor Info. And Scope of Contract丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECTA 01a单项 （单元 ） 工 程：Work Item （Unit）单位工程开工报审表 Review Request on Commencement of Work Unit项目编号：Project No.:

7、编号： No.洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )致（监理单位）To(Supervision Company)工程，已完成了开工前的各项准备工作， 计划于 年 月 日开工，请审批。We contracted work of and completed items of preparation work prior to commencement. We planned to commence the work at (Day) (Month)

8、 (Year), please review and approve.附： Attachment:1.图纸会审、设计交底Design countercheck and clarification records2.审批文件3.4.5.施工组织设计 （方案） 员及特殊工种资格证明） review and approval document （including qualification certificate） 施工机具与检测试验设备检查 inspection & testing equipment inspected. 工序质量控制点报审 request.施工测量放线含主要管理人Constr

9、uctionmain managementWork proceduremanagement design (proposal)personnel and special tradeConstruction machinery andquality control point reviewConstruction surveying and setting out work completed6.主要人员、 材料、 设备进场 Major personnel, material and equipment mobilized7.施工现场道路、水、 电、通讯等已达到开工条件Access road,

10、site for commencing the work.water, power and communications etc for construction are ready on8. 承包单位（盖章）字）：Construction Contractor（Chop）日期：Project manager (Signature)项目经理（签Date洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )审查意见 Review remarks专业监 理工程 师

11、（ 签字）：Date日期：Discipline supervision engineer (Signature)审批结论 Review conclusionApprove不同意 Not approve项目监理机构（章）： 字）： Supervision Com. （Chop日期：总监理工程师 （签Chief supervision engineer (SignatureDate本表由承包单位填报， 一式三份，经监理单位审批后， 业主单位、监理单位、承包单位各存一份。 This table shall be filledup and submitted by the contractor in

12、three copies, once it being reviewed and approved by the supervision company, each of the Owner, Supervision Company and Contractor shall hold one copy.洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany （LPECSC ）丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECTA 01b单项 （单元 ） 工

13、程：Work Item （Unit）:工程复工报审表 Review Request for Resume of Work项目编号：Project No.:编号： No.洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )致（监理单位）To (Supervision Company我方承担的 工程，由总监理工程 师签发的第 号工程暂停令指出的原 因已清除，经检查已具备了复工条件，请予 以审核并批准复工。The reason resulting in Work

14、Suspension Order No.issued by the chief supervisionengineer for the work contracted by us has been eliminated, it psr oven that the conditions for resumption of work has been made ready. Please review and approve.Attachment: Detail statement of reasons for附：具备复工条件的详细说明resuming the work 。承包单位（盖章）： 项目

15、经理（签 字）： 日期：Contractor (Chop )Project manager (Signature)Date洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )审批意见 Review/approval remarks审批结论：Review/approval conclusion具备复工条件，同意复工 。 Conditions for resuming work are ready and agree to resume work.不具备复工条件

16、， 暂不同意复工 。Conditions for resuming work are not ready and not agree to resume work now.总监理工程项目监理机构(章) 师(签字)： Project supervision company (Chop) 本表由承包单位填报， 一式三份，经监理单位审批后，日期：Chief supervision engineer (Signature)DateThis table shall be业主单位、监理单位、承包单位各存一份。 filled up and submitted by the contractor in thr

17、ee copies, once it being reviewed by the supervision company , each of the Owner s Representative, Supervision Company and Contractor shall hold one copy.A02丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECT单项（单元 ）工程： 公用工程项目编号： LDA03/7S04/812041Project No.:WorkItem施工组织设计 /施工方案 报审表 Review Request on Overall Const

18、ruction Organization Design/ Construction Project编号 :No.(Unit) : UTILITY洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )致（监理单位 ） To （Supervision Company） ： 洛阳石化工程建 设监理公司我方已根据施工合同的有关规定完成了 丽东 芳烃项目 UT 区 FLARE 区安装工程吊装作业安全技术方案 的编 审查批准，请予以审 We ve completed ov

19、erall constructi as per related requirements as spec approved by competent technical leader in o制，并经我单位上级技术负责人 查。n organization design / Construction Project for works of ified in the Construction Contract, which has been reviewed and ur company, we hereby submit it for your review.附 Attachment ： UT

20、 区FLARE 区安装工程吊装作业安全技术方案承包单位 （章 ）： 湖南大和设备安装有限公司 项目经理(签字)： 日期：Contractor(Chop) Project manager(Signature): Date:总监理工程师审查意见： Review remarks of Chief Supervision Engineer:审查结论 Review conclusion ：同意 Approve修改后再报 To be resubmitted after revision重新编制 To be compiled again项目监理机构(章) ： 总监理工 程师(签字)： 日期：Project

21、supervision company(Chop):Chief supervision engineer (Signature):Date:洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )业主项目经理审批意见Review remarks of the Owner s project manager审查结论 Review conclusion同意 Approve修改后再报 To be resubmitted after revision重新编制 To be

22、 compiled again业主管理机构（章）：表）：Owner s management level （chop）:日期：Project manager (Representative):项目经理（代Date:注：施工组织总设计 /方案审批意见中，特指的重大施工方案须经业主审批。Note: Major construction method especially specified in review and approval remarks on overallconstruction organization design/ Construction Project shall be

23、also reviewed and approved by theOwner.本表由承包单位填报，一式三份，经监理单位审查，业主代表批准后，业主单位、监理单位、承包单位各存一份。This table shall be filled up and submitted by the contractor in three copies, once it being reviewed by the supervision company and approved by the Owner s representative, each of the Owner s Representative, Su

24、pervision Company and Contractor shall hold one copy.丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECTA 02a单项 (单元 ) 工 程： 公用工程Work Item (Unit): Utility工程技术管理文件报审表 Review Request on Engineering Technical Management Document项目编号： LDA03/7S04/812041Project No.:编号： No.洛阳石化工程建设监理公司Louyang P etrochemical E ngineering a

25、nd Construction Supervision C ompany (LPECSC )致（监理单位） To （Supervision Co 监理公司mpany) ：洛阳石化工程建设UT 区、 FLARE 术管理文件，请ereby submitted for review and现报上关于 丽东芳烃项目 区安装工程施工组织设计 工程技 予以审定。The technical management document of works of is h approval.序 号 No.类别Category编制 人Prepared by:册数Volume(s):页数Page(s)1单位工程施工组织设

26、 计Construction Organization Design of SingleUnit of Work2施工方案 Construction Method34编制单位(章)： 技术负责人(签字) ： 申报人(签字)：Prepared by(chop):Technical leader (Signature):Submitted by (Signature):承包单位意见 Contractor s remark：有 Yes / 无 No 附页 Annexed pages承包单位(章)： 技术负责人 (签 字) ： 日期：Contractor (chop) :Technical leade

27、r (Signature):Date:洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )监理机构审核意见修改后再报专业监理工程师签字）Review and approval remarks of the Supervision Company审定结论 Review conclusion同意 ApproveTo be resubmitted after revision重新编制 To be compiled again日期：Discipline superv

28、ision engineer (Signature): 项目监理机构(章) 程师(签字)： Project Supervision Com.(Chop):日期：Chief supervision engineer (Signature):Date:总监理工Date:业主项目经理审批意见Review remarks of the Owner s project manager项目经理（代业主管理机构(章)：表)：Owner s management level (chop): 本表由承包单位填报，一式三份，经监理单位审查，业主代表批准后，业主单位、监理单位、承包单位各存一份。日期：Project

29、 manager (Representative):Date:This table shall be filled up and submitted by the contractor in three copies, once it being reviewed by the supervision company and approved by the Owners representative, each of the Owners Representative,Supervision Company and Contractor shall hold one copy.洛阳石化工程建设

30、监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )丽东芳烃项目A03LIDONG AROMATIC COMPLEX PROJECT单项 （单元 ） 工分包单位资格报审表项目编号：Project No.:程：编号： No.Review Request on Qualificationof SubcontractorsWork Item (Unit):致(监理单位) To (Supervision Company)经考察我方认为拟选择的分包单位）具有承担下列工程的施工资质和施

31、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，我方仍然承担总承包单位的全部责任。请予以审查和批准。has constructionAfter investigation, we believe the selected Subcontractor,qualification and construction capability required for following work and can ensure to completeconstruction of the project as per contract requirements. Upon subcontracti

32、ng the work, we will still bearall responsibility as a General Contractor. Please review and approve.附件 Attachment1、分包单位资质材料Qualification information of theSubcontractor ；2、分包单位业绩材料Achievement information of theSubcontractor分包工程名称（部位）Subcontracted workdescription (Location)工程数Work amount(Total)拟分包工程

33、合同额Proposedsubcontract value分包工程占全部工程Subcontracted amountwork amount/Total洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )承包单位（章）：项目经理（签字）：日期：Contractor (Chop):Project manager (Signature):Date:专业监理工程师审查意见Review remarks of discipline supervision engineer

34、专业监理工程师（签字）Date:日期：Discipline supervision engineer (signature):总监理工程师审核意见 Review remarks of the chief supervision engineer项目监理机构（章）总监理工程师签字）：日期：Project Supervision Company (chop)Chief supervision engineer (Signature)Date本表由承包单位填报， 一式三份， 经监理单位审批后， 业主单位、 监理单位、 承包单位各存一份。 This table shall be filled up a

35、nd submitted by the contractor in three copies, once it being reviewed by the supervision company, each of the Owner s Representative, Supervision Company and Contractor shall hold one copy.丽东芳烃项目LIDONG AROMATIC COMPLEX PROJECT单项 （ 单元 ）工( 湖南大和公司 )资质报审表 Review Request on QualificationA03a项目编号： 7S04Pr

36、oject No.洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )程： 公用工程Work Item (Unit )Utility编号:No.致（监理单位） To （Supervision Company） ： 洛阳石化工程建设监理公司 事由 Subject:现将我公司资质证书等资料报予贵公司，请审核。内容 Content: ：1、资质证书一份。2、营业执照一份。3、企业法人营业执照一份。4、组织机构代码证一份。5、压力管道安装许可证资料一份。提出单位（章

37、）：湖南大和设备安装有限公司表人（签字）：日期：Issued by(Chop)Representative(Signature)Date洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )Review remarks of discipline supervision engineerDate:专业监理工程师（签字） ： 日期：Discipline supervision engineer (signature):Review remarks of the

38、chief supervision engineer项目监理机构（章）： 总监理工程师 （签字）： 日期：Project Supervision Company (chop)Chief supervision engineer (Signature)Date本表由承包单位填报， 一式三份，经监理单位审批后， 业主单位、监理单位、承包单位各存一份。 This table shall be filled up and submitted by the contractor in three copies, once it being reviewed by the supervision comp

39、any, each of the Owner s Representative, Supervision Company and Contractor shall hold one copy.丽东芳烃项目A04LIDONG AROMATIC COMPLEX PROJECT洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany （LPECSC ）单项(单元) 工程： 公用工程 Work Item (Unit) UTILITY（检验批）分项工程质量报验申请表 （Inspection

40、Batch） Work Item Quality Inspection Application项目编号： LDA03/7S04/812041Project No.:编号：No.致（监理单位） To （Supervision Company） ：洛阳石化工程建设监理公司我方已完成了 公用工程消防水管道安装 （检验批）分项工程，经我方检验符合设计、规范要求，请予以验收。 Weve completed single item of work （inspection batch） of, which has been inspected by us andproven to be in accorda

41、nce with design and code requirements, please inspect and accept it.附Attachment ： 名称Description 页数Page 编号 No.1、 设备、材料、构配件质量证明文件页 PageEquipment, Material and Components Quality Certificate Document2、 隐蔽工程检查记录表 Concealed Work Inspection Record 页 Page3、 予检工程检查记录表 Pre-inspected Work Inspection Record页 P

42、age4、 施工记录 Construction Record页 Page5、 施工试验记录 Construction Test Record, 页 Page6、 工序质量控制点查验认可文件页 PageWork Procedure Quality Control Point Inspection and Approval Document7、 分项工程质量检验评定记录页 PageIndividual Item of Work Quality Inspection and Evaluation Record专业质量工程师 （检查员）（签字）：日期Discipline Quality Enginee

43、r （Inspector） （SignatureDate承包单位（章）：湖南大和设备安装公司 （DC） 技术负责人（签字） ： 日期：Construction Contractor （Chop）Technical leader （Signature）Date审查意见：Review Remarks:审查结论 Review conclusion ：合格 Qualified不合格Unqualified洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )项目监理机构

44、（章）专业监理工程师（签字）日期Supervision Com. (Chop)Discipline supervision engineer (signature)Date本表由承包单位填报，一式三份，经监理单位审批后，业主单位、监理单位、承包单位各存一份。This table shall be filled up and submitted by the contractor in three copies, once it being reviewed and approved by the supervision company, the Owner, Supervision Compa

45、ny and Contractor shall hold one copy.丽东芳烃项目LIDONG AROMATICS COMPLEX PROJECTA 05单项 (单元 ) 工 程：Work Item (Unit):工程款支付申请表 Application for Project Payment项目编号： Project No.:编号： No.:洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany （LPECSC ）致 To ： （监理单位 Supervision Comp

46、any ） 我方已完成了 工作，按施工合 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） 现报上 工程款申请表请予以审查并开具 工程款支付证书。We ve finished work of . According to the rules of the Construction Contract, owner should pay this project payment total （amount in words） （amount in ordinary figures） before . Now we submit application for project

47、payment. Please check up and write out project payment certificate.附件 Attchment ：1. 工程量清单 ;Quantity Bill2. 计算方法 . count method洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )承包单位（章）：项目经理（签字）：日期：Contractor(Seal)Project Manager (Sign)Date本表由承包单位填报， 一式三份，经

48、监理单位审批后， 业主单位、监理单位、承包单位各存一份。 This table shall be filled up and submitted by the construction contractor in three copies. Once it being reviewed and approved by the supervision company , each of the Owner, supervision company and construction contractor shall hold one copy.丽东芳烃项目LIDONG AROMATIC COMPL

49、EX PROJECTA 06单项 （ 单元 ）项目编号：Project No.:监理工程师通知回复单工程：Supervision Engineer Notice Response编号：Work Item (Unit):No.:洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )致（监理单位）To (Supervision Company)的监理工程师通知后，已按要求完成了工作，现报上，请予复查。Upon receiving notice No.which i

50、s issued by the supervisionas required. We, hereby ,engineer, we vec ompleted workof submit it for your inspection.详细内容： Detail content:承包单位（章）：项目经理（签字）：日期：Construction Contractor (Chop)Project Manager (Signature)Date:洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C omp

51、any （LPECSC ）复查意见Inspection remarks项目监理机构（章）总/专业监理工程师（签字）： 日期：Project supervision company （Chop） Chief/discipline supervision engineer （Signature） Date本表由承包单位填报，一式三份，经监理单位审批后， 业主单位、 监理单位、 承包单位各存一份。 This table shall be filled up and submitted by the contractor in three copies, once it being reviewed

52、by the supervision company, each of the Owner s Representative, Supervision Company and Contractor shall hold one copy.丽东芳烃项目LIDONG AROMATICS COMPLEX PROJECTA 07单项 （单元 ） 工 程：Work Item （Unit）:工程临时延期申请表Application for Temporarily Postponement of Project项目编号： Project No.:编号： No.:洛阳石化工程建设监理公司Louyang P e

53、trochemical E ngineering and Construction Supervision C ompany （LPECSC ）致 To ： （监 理单位 Supervision Company ） 根据施工合同条款 条的规定，由于 原因，我方申请工程延期，请予以批准。According to the rules of item of construction contract, our side apply project to be postponed, because of 。 Please grant our application.附件 Attchment ：1.工程

54、延期的依据及工期计算Basis of project to be postponed and count to the time limit for a project合同完工日期 contract complete time洛阳石化工程建设监理公司Louyang P etrochemical E ngineering and Construction Supervision C ompany (LPECSC )承包单位（章）：项目经理（签字）：日期：Ccontractor (Seal)Project Manager (Sign)Date本表由承包单位填报， 一式三份，经监理单位审批后， 业主单位、监理单位、承包单位各存一份。 This table shall be filled up and submitted by the construction contractor in three copies. Once it being reviewed and approved by the supervision company , each