现场检查(勘验)笔录

 现场检查(勘验)笔录

                                                                                                  

检查(勘验)时间:                     分至      

检查(勘验)地点:                                             

被检查(勘验)人名称:                             法定代表人(负责人):       

被检查(勘验)人姓名:            性别:    民族:     身份证号码:            

工作单位:                             职务或职业:           电话:           

   址:                                           邮编:                        

现场负责人:           职务:      身份证号              本案关系:          

其他见证人:                     单位或住址:                                  

检查(勘验)人及执法证号码:                                记录人:                                     

工作单位:                                                                           

告知事项:                                                                     

现场情况:                                                                               

                                                                                                              

                                                                                           

                                                                                               

                                                                                         

                                                                                                              

                                                                                       

    (以下是检查笔录尾页)                                                                               

应注明:“检查(勘验)笔录上述内容,记录属实。”                                 

被检查(勘验)人或现场负责人签字:                             

见证人签字:                                                             

检查(勘验)人签字:                            记录人签字:                 

                                                                                 页共  

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