PMCM Form-071 / Rev.

0 / 14 April 2016

PMQS CONSTRUCTION SOLUTIONS, INC.

IN-PROCESS CONCRETE INSPECTION

PROJECT NAME : CONTRACTOR :
LOCATION :
CLIENT :

REF. NO. : BUILDING IDENTIFICATION :

DATE REQUESTED :
TRUCK ARRIVAL CONTENT CONCRETE CONCRETE POURING ACTUAL GRAVEL SAMPLE SAMPLE
STRUCTURE MARK LOCATION
BODY NO. TIME (m³) STRENGTH (Mpa) START END SLUMP SIZE TAKEN I.D. NO.

PREPARED BY: CONFORME: NOTED BY:

CONTRACTOR'S SITE ENGINEER PMQS PROJECT INSPECTOR PMQS CONSTRUCTION MANAGER