QR-2000-02

SMALL PROJECTS GROUP QUALITY CONTROL MAINTENANCE SERVICE

RECORD NO. : SI / PO Number :
SYSTEM NO. : CONCRETE POUR REPORT Client :
ITEM :
PCWBS : LOCATION :
FWBS : DRAWING NO. :
PRE POUR ACTIVITY
FIELD ENG. / QC INSPECTOR
ITEM SUPERVISOR CONTRACTOR MCL - SPG MCL - Client
DATE DATE DATE DATE
BLINDING CONCRETE

FORMS/LAYOUT

REINFORCEMENT

DOWEL & ANCHOR BOLTS/BOX

EMBEDDED PLATE

SLEEVE

U/G PIPE

PLUMBING

ELECTRICAL

WATER STOP

ACID PROTECTION

CONSTRUCTION JOINT

EXPANTION JOINT

POUR ACTIVITY

POUR DATE : SUPPLIER :

WEATHER : AMBIENT TEMPERATURE :

SLUMP : CONCRETE TEMPERATURE :

ADDITIVE : AIR CONTENT :

TEST SPECIMEN No. : QUANTITY SPECIMEN REQ'D :

POUR TERMINATED : AMB. TEMP. DURING CURE :

REASON :
CONCRETE DESIGN MIX :

ATTACH COPY OF CONCRETE SUPPLIER BATCH TICKETS TO THIS FORM

REMARKS :

CONTRACTOR : --------------
DATE :

COMPANY : MCL -SPG

DATE :

CLIENT : MCL -Client

DATE :