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CONCRETE INSPECTION FORM

Project Name:
Activity Card Reference
Bid#:
DATE
ocation
From Station
To Station
COMMENTS !ES NO
General
Did you attend the Pre-Activity Meeting for this item?
Were you present during the majority of the work?
Pre-Placement
Have all past inspection and testing reuirements !een completed?
"i#e#$ !ase aggregate$ su!grade%
Has all placement euipment !een checked for operational condition?
"vi!rators$ screeds$ shovels$ trowels$ la!orers%
&s saw-cutting euipment reuired?
&f yes$ is it on stand!y and in operational condition?
Are inspectors and testers scheduled for !atch plant and field placement?
Are all materials in place and on hand for construction? "i#e#$ e'pansion
joints$ etc#%
&s euipment scheduled for saw-cutting joints within the reuired time frame?
Are approved curing materials on-site and euipment in operational
condition?
&s there any euipment on stand!y and in operational condition?
Has !atch plant inspection !een reviewed and are known reuirements
!eing addressed for this concrete placement?
Have on-site concrete placement reuirements !een reviewed? "i#e#$ no
water added on-site without permission from (ngineer%
Who will fill out logs and inspect concrete placement?
)eview what concrete finish is accepta!le or not?
*ime frame for removal of forms? How repairs will !e made if needed?
)eview curing of concrete procedure#
Are approved curing materials on-site and is euipment in operational
condition?
During Placement
&s the correct mi' design !eing used?
When concrete is placed$ is proper consolidation !eing performed?
&s !atch plant inspection !eing performed for this concrete placement?
CONCRETE INSPECTION FORM
Project Name:
Activity Card Reference
Bid#:
DATE
ocation
From Station
To Station
COMMENTS !ES NO
Was water added on-site without permission from engineer?
&s proper consolidation !eing performed?
&s the concrete !eing finished properly?
Were tests taken?
&f +,$ did you write the reason on !ack of this sheet?
Were all temperatures in spec?
Were all slumps in spec?
Did the tester provide field test information in writing?
&s a copy of the results attached?
Were the concrete test specimens protected for the first -.-hour period?
Post-Placement
&s the time frame for removal of forms !eing complied with?
Are proper curing procedures !eing used?
Are any repairs reuired$ at this time?
Did special circumstances e'ist?
/ist the special circumstances on the !ack of this sheet
"C INSPECTOR INITIAS
QA Sign-Off COMMENTS !ES NO
Did 01 complete the checklist accurately?
&f +,$ was a Deficiency written for improper 1hecklist?
2ive Deficiency +um!er from log
Did you have to write any other Deficiency?
2ive Deficiency +um!er from log
Do you take e'ception to allowing the work to progress?
"A INSPECTOR INITIAS
11PW form 01-34.
)ev 45647 PA2( -

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