MSS Form

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MATERIALS SUBMISSION SAMPLES APPROVAL REQUEST

MSS NO. Rev. Date: Discipline: Activity :


CLIENT
ENGINEER
MAIN CONTRACTOR
SUB CONTRACTOR

Material Detail
List of Enclosures
Item Description
(Tick the Related Box)

Spec./BOQ/Drwg. Vendor's Technical

Manufacturer Specified Test Results


Product name
Compliance Statement
Area of Application Data Specification

Manufacturer / Local Samples


distributor
List of Previous Projects
Country of Orgin Done

Others (Specification)

Remarks

Consultant
Procurement Manager: Tech. Manager: Received by:

QA/QC Manager:

Project Manager: Date: Date:


Response required by :
FOR THE USE OF CONSULTANT / ENGINEER
Consultant Comments : Engineer Comments:

Consultant:
Reviewed By Date:

Action:
A - No Objection B - Proceed With Comments C - Revise and Resubmit D - Rejected

Engineer
Reviewed By Date:

Received By :
Date:

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