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·1·2009年版湖北省建筑工程施工统一用表（上册）湖北省建设工程质量安全监督总站二○○九年三月·2·目录前言5建筑工程施工统一用表··························································································15.1工程管理文件（A类）····················································································15.2工程技术文件（B类）···················································································145.3工程测量记录（C类）···················································································205.4工程施工记录（D类）···················································································265.5工程试验检验记录（E类）·············································································715.6工程物资文件（F类）·················································································1495.7施工质量验收文件（G类）····································································中、下册5.8工程竣工验收文件······················································································下册·1·5建筑工程施工统一用表5.1工程管理文件（A类）1、工程概况表（表A1）·························································································22、施工现场质量管理检查记录（表A2）····································································33、工程开工报告（表A3）······················································································44、工程竣工报告（表A4）······················································································55、工程停工报告（表A5）······················································································66、工程复工报告（表A6）······················································································77、施工进度计划分析（表A7）················································································88、项目大事记（表A8）·························································································99、施工日志（表A9）···························································································1010、不合格项处置记录（表A10）············································································1111、建设工程质量事故调（勘）查记录（表A11-1）·····················································1212、建设工程质量事故报告书（表A11-2）·································································13·2·工程概况表表A1编号：一般情况工程名称建设单位建设用途设计单位建设地点监理单位总建筑面积施工单位开工日期年月日竣工日期年月日结构类型基础类型层数建筑檐高地上面积地下室面积人防等级抗震等级载客（货）电梯扶梯、自动人行道构造特征地基与基础柱、内外墙梁、板、楼盖外墙装饰内墙装饰楼地面装饰屋面防水防火设备建筑节能建筑给排水、采暖、电气、通风与空调、电梯安装及智能建筑系统简要描述其它本表由施工单位填写，建设单位、施工单位、城建档案馆各保存一份。·3·施工现场质量管理检查记录表A2开工日期：编号：工程名称施工许可证（开工证）建设单位项目负责人设计单位项目负责人监理单位总监理工程师施工单位项目经理项目技术负责人序号项目内容1现场质量管理制度2质量责任制3主要专业工种操作上岗证书4分包方资质与对分包单位的管理制度5施工图审查情况6地质勘察资料7施工组织设计、施工方案及审批8施工技术标准9工程质量检验制度10搅拌站及计量设置11现场材料、设备存放与管理12检查结论：总监理工程师（建设单位项目负责人）年月日本表由施工单位填写，建设单位、施工单位、城建档案馆各保存一份。·4·工程开工报告表A3编号：工程名称湖北省鄂东监狱市政管网工程施工单位长青建设集团有限公司工程地点路口花园建设单位鄂东监狱筹建处致：湖北中南工程建设监理公司根据合同的约定，我承担的鄂东监狱市政管网工程合同项目工程，已完成各项准备工作，具备开工条件，计划于2011年4月28日开工，请审批。已完成报审的条件有：□建设工程规划许可证（复印件）□施工组织设计（含主要管理人员和特殊工种资格证明）□施工测量放线□主要人员、材料、设备进场□施工现场道路、水、电、通讯等已到达开工条件□其他项目负责人（签字）：施工单位：长青建设集团有限公司2011年4月28日审批意见：审批结论：□同意□不同意总监理工程师（签字）：年月日·5·本表由施工单位填报，经监理单位审批后，建设单位、监理单位、施工单位、城建档案馆各存一份。工程竣工报告表A4编号：工程名称施工单位工程结构类型建筑面积层数工程开工日期年月日计划竣工日期年月日致监理单位：根据合同约定，我方已完成合同规定的全部工作内容，工完场清，具备竣工验收条件。特此报告，请批复。项目负责人（签字）：施工单位（章）：年月日审批意见：审批结论：□同意□不同意总监理工程师（签字）：年月日·6·本表由施工单位填报，经监理单位审批后，建设单位、监理单位、施工单位、城建档案馆各存一份。工程停工报告表A5编号：工程名称施工单位停工日期预计停工天数致监理单位：工程于年月日开工。目前由于以下方面的原因，现要求停止施工，特此报告，请批复。停工原因：项目负责人（签字）：施工单位（章）：年月日审批意见：审批结论：□同意□不同意总监理工程师（签字）：年月日·7·本表由施工单位填报，经监理单位审批后，建设单位、监理单位、施工单位、城建档案馆各存一份。工程复工报告表A6编号：工程名称施工单位复工日期实际停工天数致监理单位：工程于年月日开始停工。目前具备复工条件，特此报告，请批复。复工具备的条件：项目负责人（签字）：施工单位（章）：年月日审批意见：审批结论：□同意□不同意总监理工程师（签字）：年月日·8·本表由施工单位填报，经监理单位审批后，建设单位、监理单位、施工单位、城建档案馆各存一份。施工进度计划分析表A7编号：工程名称共页第页序号分部分项工程单位数量计划开始时间计划结束时间备注实际开始时间实际结束时间说明：汇总人审核人填报日期年月日·9·本表由施工单位填写，建设单位、监理单位、施工单位、城建档案馆各保存一份。项目大事记表A8编号：工程名称共页第页序号时间内容项目负责人整理人本表由施工单位填写，建设单位、施工单位、城建档案馆各保存一份。·10·施工日志表A9编号：日期年月日施工部位天气状况风力最高/最低温度突发事件生产情况记录：（施工项目内容、机械作业、班组工作、生产存在问题）技术质量安全工作记录：（技术质量安全活动、技术质量安全问题、检查验收情况等）项目负责人记录人本表由施工单位填写，建设单位、施工单位、城建档案馆各保存一份。·11·不合格项处置记录表A10编号：工程名称发生/发现日期年月日不合格项发生部位与原因：致：由于以下情况的发生，使你单位在发生严重□/一般□不合格项，请及时采取措施予以整改。具体情况：□自行整改□整改后报我方验收签发人：签发日期：年月日不合格项改正措施：整改期限：整改责任人：不合格项整改结果：致：根据您方指示，我方已完成整改，请予以验收。整改结论：□同意隐蔽□继续整改□返工重做□其它验收人：日期：年月日本表由下达方填写，整改方填报整改结果，双方、建设单位、监理单位、施工单位、城建档案馆各保存一份。·12·建设工程质量事故调（勘）查记录表A11-1编号：工程名称发生/发现日期年月日调（勘）查时间年月日时分至时分调（勘）查地点参加人员单位姓名性别年龄职务电话等其他被调查人陪同调（勘）查人员调（勘）查笔录：现场物证照片□有□无共张共页事故证据资料□有□无共张共页被调查人签字调（勘）查人本表由调查人员填写，各有关单位均保存一份。·13·建设工程质量事故报告书表A11-2编号：工程名称建设地点建设单位设计单位施工单位建筑面积（m²）工程造价（元）结构类型事故发生时间年月日上报时间年月日经济损失（元）事故经过、后果与原因分析：事故发生后采取的措施：事故发生责任单位、责任人及处理意见：负责人报告人日期年月日本表由报告人填写，各有关单位均保存一份。·14·5.2工程技术文件（B类）1、工程技术文件报审表（表B1）············································································152、技术交底记录（表B2）·····················································································163、图纸会审记录（表B3-1）···················································································174、设计交底记录（表B3-2）···················································································185、设计变更、洽商记录（表B3-3）··········································································19·15·工程技术文件报审表表B1编号：工程名称日期年月日现报上关于（）工程的技术管理文件，请予以审定。类别编制人册数页数□施工组织设计□施工方案□□施工单位名称：技术负责人：申报人：总