Ordin nr. 1316/C din 29 martie 2012

Triplicat: rămâne nedetaşat în carnet
PROCES-VERBAL DE REPARAŢIE

(Primire, Predare, Recepţie)

PENTRU AUTOVEHICULE
I. DATELE UTILAJULUI (AUTOVEHICUL, APARAT)
1. Felul autovehiculului _________________________________________

2. Marca __________ tipul ____________ anul de fabricaţie ________

3. Nr. de circulaţie ___________ seria şasiu _________ serie motor ______________ .

4. Unitatea deţinătoare __________________________________________.

II. CONSTATĂRI LA PRIMIREA ÎN ATELIER:
5. Data primirii în atelier ______________________________________

6. Gradul profesional, numele şi prenumele predătorului __________

7. Felul reparaţiei necesare _____________________________________

8. Starea tehnică şi gradul reparaţiei necesare:

______________________________________________________________________________

|Nr. | Elemente componente | Starea tehnică | Reparaţii necesare |

|crt.| (agregate, sisteme, |____________________|______________________________|

| | subansamble) |Bun |Degradat |Uzat |Mijlocie |Generală |Înlocuire |

|____|_____________________|____|_________|_____|_________|_________|__________|

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|____|_____________________|____|_________|_____|_________|_________|__________|
9. Reglaje necesare ______________________________________________

__________________________________________________________________

__________________________________________________________________

11. Lipsuri şi degradări constatate la predare ___________________

__________________________________________________________________

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12. Lipsuri şi degradări constatate după demontare _______________

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PREDĂTOR, PRIMITOR,
ANEXA 27

la Normativul privind asigurarea tehnică de autovehicule a Administraţiei Naţionale a Penitenciarelor şi unităţilor subordonate