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["天津顺港建设工程质量检测有限公司",{"$nulls":17},"TJSG-JS-001"]
["               送 （抽） 样 委 托 单",{"$nulls":16},"委托日期：    年  月  日"]
["工程编号",null,null,"工程名称",{"$nulls":7},"委托单位",{"$nulls":4},"收样人",null,"登录人"]
["种类名称","委托编号",null,"检验编号",null,"规格/型号/取土样尺寸（mm）",null,"标号/等级/设计要求",null,"牌号/    焊接方法","接头形式/水采样  地点","质量证书号/炉号/   焊条型号","出厂日期/成型日期","进场日期/试压日期","代表批量","取样数量","厂家/产地/操作人/养护条件",null,"使用部位"]
[]
[]
[]
["砼（砂浆）配合比（kg/m³）",{"$nulls":8},"样品状态描述：",null,null,"见证单位盖章",{"$nulls":5},"抽样人签字"]
["配合比编号","水泥","砂","石","水","白灰膏","掺合料","外加剂",{"$nulls":4},"总监理工程师签字",{"$nulls":5},"联系电话"]
[{"$nulls":12},"受委托单位",null,"天津顺港建设工程质量检测有限公司",{"$nulls":3},"联系电话","88811388    88811989"]
["请委托单位选择以下检测标准及参数",{"$nulls":8},"  □低压流体输送用焊接钢管GB/T3091-2015",{"$nulls":8},"取样位置草图/备注"]
["一、建筑材料类：",{"$nulls":8},"▲参数：□拉伸试验 □弯曲试验 □反向弯曲 □化学成分 □屈强比 □尺寸、重量偏差 □压扁"]
["●水泥标准：□硅酸盐通用水泥GB175-2007",{"$nulls":8},"●焊接标准：□钢筋焊接JGJ18-2012 □钢结构焊接GB50661-2011"]
["●预拌砂浆标准：□GB/T25181-2010  □DB/T 29-130-2015",{"$nulls":8},"●钢筋机械连接：□JGJ107-2016 "]
["●聚合物水泥防水砂浆标准：□JC/T984-2011",{"$nulls":8},"▲参数：□抗拉强度 □弯曲试验 □残余变形",{"$nulls":7},"注：GB/T25181-2019（2020.7.1）"]
["▲参数：□安定性 □凝结时间 □强度 □细度 □保水率",{"$nulls":8},"●高强螺栓：□螺栓技术条件GB/T1231-2006□钢结构工程施工验收规范GB50205-2001"]
["  □含水率 □2h稠度损失 □拉伸粘接强度 □抗渗压力",{"$nulls":8},"           □钢结构用扭剪型高强螺栓连接副GB/T3632-2008"]
["●砂、石标准：□砂JGJ52-2006   □砂GB/T14684-2011",{"$nulls":8},"▲参数：□扭矩系数 □抗滑移系数 □连接副紧固轴力"]
["             □石子JGJ52-2006 □石子GB/T14685-2011",{"$nulls":8},"五、混凝土砂浆 ："]
["▲参数：□颗料级配 □含泥量 □泥块含量 □针（片）状颗粒含量",{"$nulls":8},"●□砼配比标准:JGJ55-2011      □砂浆配合比：JGJ/T98-2010"]
["  □表观密度 □含水率 □堆积密度和紧密密度 □压碎指标值",{"$nulls":8},"●□砼力学标准：GB/T50081-2019 □砂浆力学标准：JGJ/T70-2009"]
["二、砌体材料类：",{"$nulls":8},"●□砼抗渗标准：GB/T50082-2009 □混凝土：GB50080-2016"]
["●□烧结普通砖GB/T5101-2017 □烧结多孔砖和多孔砌块GB/T13544-2011",{"$nulls":8},"▲参数：□抗压强度 □抗渗等级 □抗折强度 □稠度 □凝结时间 □配合比设计"]
["  □烧结空心砖和空心砌块GB/T13545-2014 ",{"$nulls":8},"六、防水材料类："]
["  □砼普通砖和装饰砖NY/T671-2003 □蒸压粉煤灰砖JC/T239-2014",{"$nulls":8},"●□弹性体改性沥青防水卷材GB18242-2008□塑性体改性沥青防水卷材GB18243-2008"]
["  □轻集料砼小型空心砌块GB/T15229-2011",{"$nulls":8},"　□自粘聚合物改性沥青防水卷材GB23441-2009  □预铺防水卷材GB/T23457-2017",{"$nulls":7},"  检测项目在资质范围内：",null,"□是，  □否；"]
["  □混凝土实心砖GB/T21144-2007",{"$nulls":8},"  □种植屋面用耐根穿刺防水卷材JC/T1075-2008 □湿铺防水卷材GB/T35467-2017",{"$nulls":7},"  样品符合检测要求：   ",null,"□是，  □否；"]
["  □普通砼小型空心砌块GB/T8239-2014",{"$nulls":8},"▲参数：□拉力 □延伸率 □不透水性 □低温柔性 □耐热性",{"$nulls":7},"  收费标准达成一致：  ",null,"□是，  □否；"]
["  □蒸压加气砼砌块GB/T11968-2006",{"$nulls":8},"●□高分子防水材料 第1部分:片材GB/T18173.1-2012",{"$nulls":7},"  检测周期客户认可：    ",null,"□是，  □否；"]
["  □蒸压砂加气砼砌块DB/T29-128-2015",{"$nulls":8},"▲参数：□拉伸强度 □拉断伸长率 □不透水性 □低温弯折",{"$nulls":7},"  客户要求明确：       ",null,"□是，  □否；"]
["▲参数：□抗压强度□密度□含水率□导热系数□干燥收缩值",{"$nulls":8},"●□水泥基渗透结晶型防水材料GB18445-2012",{"$nulls":7},"  客户对样品真实性负责：",null,"□是，  □否；"]
["三、混凝土掺合料及外加剂：●粉煤灰GB/T1596-2017",{"$nulls":8},"▲参数：□抗压强度□抗折强度□湿基面粘结强度□砂浆抗渗性能□混凝土抗渗性能",{"$nulls":7},"  样品处置方式：       □取回，□废弃；"]
["▲参数：□细度 □含水量 □需水量比 □烧失量",{"$nulls":8},"七、土工类：●□土、石硝GB/T50123-2019 ",{"$nulls":7},"  检测结果复议期为：     天。"]
["四、钢筋及钢结构类：",{"$nulls":8},"▲参数：□干密度 □土工击实 □压实度 □液塑限 □含水率"]
["●钢筋标准：□热轧带肋GB/T1499.2-2018□热轧光圆GB/T1499.1-2017  ",{"$nulls":8},"八、安全类：●□安全帽GB2811-2007 □安全带GB6095-2009 □安全网GB5725-2009"]
["           □冷轧带肋GB/T13788-2017□热轧圆盘条GB/T701-2008",{"$nulls":8},"▲参数：□佩戴高度□垂直间距□冲击吸收性能□耐穿刺性能□下颏带强度□侧向刚性□阻燃性能"]
["●钢结构标准：□低合金高强度结构钢GB/T1591-2018",{"$nulls":8},"        □整体静态负荷 □整体动态负荷"]
[" □碳素结构钢GB/T700-2006□优质碳素结构钢GB/T699-2015             ",{"$nulls":8},"        □耐冲击性能 □阻燃性能 □耐贯穿性能 □网目密度"]
[" □热轧钢板和钢带GB/T3274-2017□热轧钢带GB/T3524-2015",{"$nulls":8},"●脚手架扣件：□钢管脚手架扣件GB15831-2006□脚手架安全技术规范JGJ130-2011"]
["●钢管标准：□结构用无缝钢管GB/T8162-2018",{"$nulls":8},"▲参数：□抗滑 □抗破坏 □扭转刚度 □抗拉 □抗压 "]
["           □输送流体用无缝钢管GB/T8163-2018",{"$nulls":17},"委托人签字确认："]

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