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["抽  样  单",{"$nulls":7},"第一联\n\n抽样单位留存"]
["CTCSZ/DWT040-1/2                                                    №:"]
["任务类别",null,null,"□抽样     □行业抽检     □年检     □认定抽样     □其他："]
["委托单位",null,null,"□同受检单位    □其他："]
["受检单位",null,null,"□中文名称：\n□英文名称："]
[{"$nulls":3},"地址：                                                     邮政编码："]
[{"$nulls":3},"法人代表",null,"联系人"]
[{"$nulls":3},"电话号码",null,"传真号码"]
["生产单位",null,null,"□同受检单位    □其他，详细信息如下"]
[{"$nulls":3},"□中文名称：\n□英文名称："]
[{"$nulls":3},"地址：                                                     邮政编码："]
[{"$nulls":3},"法人代表",null,"联系人"]
[{"$nulls":3},"电话号码",null,"传真号码"]
["受\n \n检\n\n产\n\n品\n\n信\n\n息","样品名称",{"$nulls":3},"规格类型"]
[null,"生产日期/批号",{"$nulls":3},"商标"]
[null,"执行标准/技术文件",{"$nulls":3},"抽样地点","□企业成品仓库  □其他："]
[{"$nulls":5},"抽样方式","系统随机"]
[null,"样品数量",{"$nulls":3},"其中\n备样量","            ，备样同时寄送抽样单位"]
[null,"抽样基数",{"$nulls":3},"批量"]
[null,"抽样日期",null," 年     月     日",null,"封样状态","   封条完好"]
["抽样程序",null,null,"□同执行标准/技术文件    □其他：",null,"检验依据","□同执行标准/技术文件   □其他："]
["报告出具抬头",null,null,"R 中国建材检验认证集团苏州有限公司（必选）\n□ 国家防水与节水材料产品质量检验检测中心\n□ 国家建筑材料工业建筑防水材料产品质量监督检验测试中心\n注：以上中心可任选或全选",null,"报告类型","□电子报告（默认） \n□纸质报告（50元/份）"]
[{"$nulls":5},"报告真伪查询显示信息","□首页信息（默认）  \n□完整报告  □基本信息 \n  "]
["□无附页       另附：□营业执照   □生产许可证   □其他："]
["寄送\n样至",null,"名  称","中国建材检验认证集团苏州有限公司",null,null,"联 系 人"]
[null,null,"地  址                                      ","苏州市工业园区娄葑和顺路1号2#楼     邮编：215122",null,null,"联系方式","0512-65332019,65332034 "]
["注：受检单位/生产单位应对封样样品进行包装，保证样品无损坏、封条无破坏，并使用合法的快递公司寄送样品，保证样品自抽样之日起7天内到达抽样单位。"]
["备注："]
["受检/生产单位对上述内容无异议\n代表签名/盖章（公章）：\n\n                               年    月    日                                                                                                                                                           ",{"$nulls":4},"抽样单位盖章（公章）：\n抽样人签名：\n           \n                   年年    月    日  "]
["帐号：1102020429000673980",{"$nulls":3},"开户名称：中国建材检验认证集团苏州有限公司",null,"开户银行：工商银行苏州平江支行"]
["电话：0512-65572034 65332019",{"$nulls":3},"   邮箱：65332019@163.com"]
["注意事项：请您在汇完款后将汇款底单传真至本中心，并注明委托单位和发票开票单位。"]

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[]
["CTCSZ/DWT040-1/0 "]
["抽样附表"]
["样品\n序号","样品编号","样品名称",null,null,"规格类型、配合比","样品状态","生产日期\n/批号","抽样数量","抽样\n基数","批量","抽样程序/判定依据","检验项目及检测依据","备注"]
[1,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[2,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[3,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[4,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[5,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[6,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[7,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[8,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
[9,{"$nulls":6},"        /\n         ",{"$nulls":4},"□全项 □出厂"]
["说明","全项为标准的全部检验项目，不包括可选项目。如需选做可选项目的应在检验项目中注明。检测依据未说明的采用判定依据中的试验方法。"]