Nr.

________ din _______________

PROCES - VERBAL DE CONSTATARE

Subsemnaii_________________________________________________________________
_________________________________________________________________________________
din cadrul Primriei comunei Srata, mputernicii prin Hotrrea Consiliului Local Srata nr.39 din
22.07.2016,

ne-am

deplasat

data

de

______________

la

domiciliul

numitului

______________________________________________________________________________ din
________________________________________________________________________________,
identificat cu _______ seria ______ numrul_____________ eliberat de _________________, la
data de ______________, C.N.P._________________________, avnd calitatea de uitlizator al
sistemului de ap i canalizare din comuna Srata, n vederea verificrii sistemului de ap i
canalizare precum i a respectrii de ctre utilizator a obligaiilor prevzute de lege i a celor asumate
prin contract.
Cu ocazia efecturii controlului, au fost constatate urmtoarele: ________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
________________________________________________________________________________,
drept pentru care dispunem luarea urmtoarelor msuri ____________________________________
_________________________________________________________________________________
_________________________________________________________________________________
________________________________________________________________________________.
Meniuni speciale___________________________________________________________________
________________________________________________________________________________.
Fa de cele artate, utilizatorul a fcut urmtoarele obieciuni_______________________________
_________________________________________________________________________________
________________________________________________________________________________.
ntocmit astzi __________________, n 2 exemplare originale din care unul a fost nmnat
utilizatorului.
ntocmit
1. ___________________________
2. ___________________________
3. ___________________________
4. ___________________________
5. ___________________________

Utilizator
______________________________