Inspection Release Form Properties



|Company Name |

|INSPECTION RELEASE FORM |

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|Fabricator: | |Date: | |

|Work Order Number: | | | |

|Fabricator Work Order Number: | | | |

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|Description of Equipment Released |Deficiencies |

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| | | |The item (s) Listed above is / are accepted without deficiencies |

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| | | |The item (s) listed above is / are accepted with deficiencies as noted above |

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|I, the undersigned, have inspected the component (s) listed above, and state that, to the best of my knowledge, the Manufacture has constructed this |

|component (s) in accordance with the applicable Codes, Regulations, Acts or Specifications in effect at this time. |

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|By signing this document, the inspector does not relieve the Manufacturer from meeting contractual requirements |

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|Signature of Quality Control Inspector | |Signature of Fabricator Representative |

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|Company Representing | |Fabricator |

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