For ANERT office use
1) The submission received on:……………………………………………………………………………………
2) Inspection schedules on:………………………………………………………………………………………..
3) Name of person who conducted the inspection:……………………………………………………………..
4) Remarks after inspection:
Installation is satisfactory / Not satisfactory
Recommended for release of subsidy payment
Signature of the district engineer Date
Name Office seal
White (original)
: Company copy
Yellow (triplicate)
: Representative copy
