(Supervision form) Gui Jianan Supervision AD-12

Construction project safety hazard rectification review application and approval letter

Project name: No.:

: (Supervision agency)

This project has been rectified according to the "Notice on Rectification of Safety Hazards in Construction Projects" (No.: ) issued by your unit, and the safety hazards have been eliminated. Please review and approve Return to use/construction.

The rectification situation is as follows:

Signature of the project leader of the construction unit:

Signature of the project chief supervisory engineer: Signature of the supervising agency receiver:

Issuance date: Year Month Day Signing Date: Year Month Day

Approval comments:

Supervisor signature: Construction unit receiver signature:

(After signing for receipt Submit one copy to the construction and supervision units respectively)

Official seal of the supervision agency:

Issue date: year month day Signing date: year month day

Note: 1 , This document must be made in quadruplicate, with one copy filed by the supervision agency and one copy each by the construction, supervision, and construction units.

2. The numbering rules for the application approval letter: the number of the rectification notice + the word "reply". If the rectification notice number is 450001 2005 0001, the corresponding application approval number is: 450001 2005 0001 reply.