Issued Date:
___________________________________Rev:__________
No.
___________________________________Rev:__________
Item
Category
FINAL CLEARANCE
Contractor
Company
Notes:
1)
Indicate
Indicate
Indicate
Indicate
:A
:B
:C
:D
Construction
Name
Sign
Date
QCI
Company
Date
Issued Date:
___________________________________Rev:__________
No.
___________________________________Rev:__________
Item
Category
FINAL CLEARANCE
Contractor
Company
Notes:
1)
Indicate
Indicate
Indicate
Indicate
:A
:B
:C
:D
Construction
Name
Sign
Date
QCI
Company
Date