Format No.
VT/01
SHREE SATYANARAYAN INDUSTRIAL Report
SSIS/VT/
SUPPLIERS PVT. LTD. No.
Date
Page 1 of 1
VISUAL EXAMINATION REPORT
Client: Project No :
Equipment No: Drawing No:
Component : Stage & Extent:
Material: Thk : Procedure No. & Rev.:
Applicable code Edition :
Technique: Direct/ Remote
Surface condition & Temperature:
Surface Preparation:
Lighting Equipment : Light Intensity :
Post Cleaning: Date of Examination:
Sr. Identification of Part Interpretation Evaluation
No. Type Size Location
Map or Record of Indications :
Examined By : Reviewed and Accepted By: TPI / AI :
Name : Name : Name :
Level : Level : Level :
Date : Date : Date :