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CONSTRUCTION INSPECTION REPORT

CONSTRUCTION INSPECTION REPORT . DIVISION REPORT LAST INSPECTION DATE OF State Job No. County NO. REPORT . Fed. No. INSPECTION MADE BY QUALITY OF WORK PROGRESS OF WORK TIME ELAPSED WORK COMPLETED. Unsatisfactory Unsatisfactory % %. Satisfactory Satisfactory IN COMPANY WITH. (Name, Title). (Check appropriate box). Process Review / Product Evaluation Phase ( INSPECTION -in-Depth) Project Final LOCATION: (fill in the blank). PROJECT DESCRIPTION/WORK TYPE: (fill in the blank). PROJECT INFORMATION: (Acquire a copy of Contract Award Summary once at the beginning of the project). CONTRACTOR (Name). (Address). (City). (Phone). CONTRACT AMOUNT ($XXXX).

X = Unacceptable NA = Not Relevant (Use check box to indicate if documentation attached) Explanations of minor deviations or unacceptable ratings for items reviewed are attached. The symbol and signature indicate the OE Inspection Performance as witnessed by the TxDOT observer. Signature of TxDOT Observer Observation Date Construction MD X NA

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