Office of the President

NATIONAL HOUSING AUTHORITY

Caraga Regional Office

DATE

CONCRETE POURING PERMIT

Name of Project/Location NHA-Butuan City New Villages 3A

Contractor Two Aces Construction & Supply

Part of Structure to be poured Estimated Volume (m3)

Station, Limits/Section

Date of Pouring Time of Pouring

Requested by:

Contractor :

(Name and Signature)

CHECKLIST
Concrete Vibrator Field Density Test

Protective Covering Materials Beam/Cylinder Molds

Warning Signs/Barricades/Flagmen Curing Materials

Concrete Saw Slump Conce

Concrete Block Spacers Plumbness

Quality of Materials Used (Result of Design/Trial M
Finishing Tools/Equipment (Screeder, broom, etc.)
Test Reports, etc.)
Line and Grade alignment (form setting, elevation, etc.) Lighting system

Required construction equipment Electrical layout (Roughing ins/embedments)

Rebars sizes, spacing and number Plumbing layout (Roughing ins/embedments)

Rebars installation requirements Falsework/formworks adequacy

Checked by:

Materials Engineer Date :

(Name and Signature)

REMARKS/
RECOMMENDATIONS

Project Inspector Date :

(Name and Signature)

REMARKS/
RECOMMENDATIONS
Request : Disapproved:

REMARKS/
RECOMMENDATIONS

EVE RIZALLE LHYN E. BOCO

NHA - Senior Engineer A

(Name and Signature)

Accreditation No.
he President
SING AUTHORITY
gional Office

OURING PERMIT

3A

ly

(Name and Signature)

CKLIST
Field Density Test

Beam/Cylinder Molds

Curing Materials

Slump Conce

Plumbness
Quality of Materials Used (Result of Design/Trial Mix,
Test Reports, etc.)
Lighting system

Electrical layout (Roughing ins/embedments)

Plumbing layout (Roughing ins/embedments)

Falsework/formworks adequacy
EVE RIZALLE LHYN E. BOCO
NHA - Senior Engineer A

(Name and Signature)

 NATIONAL HOUSING AUTHORITY

DATE Nov. 15, 2012

CONCRETE POURING PERMIT

Name of Project/Location Land Development of NHA-Balangayan Butuan Project, Brgy. Pagatpatan, Butuan City

Contractor Regional Infrastructure Development Corporation

Part of Structure to be poured PCCP Estimated Volume (m3) 96.75 cu.m.

Station, Limits/Section

Date of Pouring Nov. 16, 2012 Time of Pouring

Requested by:

Contractor : EVAJANE D. BOHOL - RIDC Proj. Engr.

(Name and Signature)

CHECKLIST
Concrete Vibrator Field Density Test

Protective Covering Materials Beam/Cylinder Molds

Warning Signs/Barricades/Flagmen Curing Materials

Concrete Saw Slump Conce

Concrete Block Spacers Plumbness

Finishing Tools/Equipment (Screeder, broom,
etc.)
Line and Grade alignment (form setting,
elevation, etc.)
Required construction equipment
Quality of Materials Used (Result of Design/Trial Mix,
Test Reports, etc.)
Lighting system
Electrical layout (Roughing ins/embedments)

Rebars sizes, spacing and number Plumbing layout (Roughing ins/embedments)

Rebars installation requirements Falsework/formworks adequacy

Checked by:

Materials Engineer Date :

(Name and Signature)

REMARKS/
RECOMMENDATIONS

Project Inspector Date :

(Name and Signature)

REMARKS/
RECOMMENDATIONS
REMARKS/
RECOMMENDATIONS

Request : Disapproved:

REMARKS/
RECOMMENDATIONS

SUNDAY N. ARGUILLAS, JR.

NHA - Project Engineer

(Name and Signature)

Accreditation No.
atpatan, Butuan City

189

96.75 cu.m. 165

OL - RIDC Proj. Engr.

d Signature)

ult of Design/Trial Mix,

embedments)

embedments)

y
LLAS, JR.
ngineer

nature)