Pouring Permit

CONTRACTOR : FFJJ CONSTRUCTION CONTRACT NO. : MMIPII-LMC-016

ACTIVITY : Construction of Bridge-Siphon LOCATION : Pagalungan & Pikit Mun.
STRUCTURE : STATION :
DATE REQUESTED : TIME: DATE OF INSPECTION :
PART OF STRUCTURE : VOLUME TO BE POURED :

No. ITEM OF WORKS CONTRACTOR DATE NIA INSPECTOR DATE REMARKS

I PRELIMINARY WORKS

A. Plans and Specification FFJJ Construction MMK

II CONCRETING WORKS

A. Lines and Grades FFJJ Construction RHP

B. Formworks Installation FFJJ Construction PIC

C. Reinforced Steel Bars FFJJ Construction PIC

D. Embedded Items FFJJ Construction PIC

E. Concrete Consolidations FFJJ Construction PIC

F. Provision and Facilities FFJJ Construction PIC

G. Foundation FFJJ Construction PIC

H. Concrete Handling and
FFJJ Construction MTQC
Conveyance
I. Mixing Equipment FFJJ Construction MTQC

J. Aggregates MTQC

1. Fine Aggregates FFJJ Construction MTQC

2. Coarse Aggregates FFJJ Construction MTQC

K. Water FFJJ Construction MTQC

L. Cement FFJJ Construction MTQC

M. Sampling and Testing FFJJ Construction MTQC

Requested by:

ROEL C. BRIONES, CE

Project Manager, FFJJ Construction

Recommending Approval: Approved:

ABDULLAZIS B. MABANG, MPS REYNALDO M. SARIGUMBA

Head, Batulawan Sub-Office Manager, Engineering Division

NIA-Midsayap Office
I. PRELIMINARY WORKS
A. Plans and Specifications
[ ] – Plans are approved for Construction, Revision properly noted.
II. CONCRETING WORKS
A. Lines and Grades
[ ] – Station, coordinates, elevationsand grades and grade are checked & verified as per
GFC Plan & Specs.
B. Formworks Installation
[ ] – Constructed, braced, cleaned and shaped as to required lines and grades.
[ ] – Formworks are free from defects, concrete covering meet the minimum
requirements.
C. Reinforced Steel Bars
[ ] – Bar sizes, class, length, number of bars, spacing, splicing, bar bending, and concrete
covering conforms to the GFC plan and specifications.
D. Embedded Items
[ ] – Items and fixtures that are to be embedded are installed and in good working
condition.
E. Concrete Consolidation
[ ] – Vibration and/or other compacting devices are in place and in good working
condition.
F. Provision and Facilities
[ ] - Protective facilities were provided against sun, and rain.
[ ] – Equipment and/or apparatus needed for maintenance are provided (e.g. fuel, lube)
G. Foundation
[ ] – Excavation, dimensions, sand & gravel blanket in placed as per GFC and specs
requirements.
H. Concrete Handling and Conveyance
[ ] – Chutes were provided and are installed in conformance with specifications.
I. Mixing Equipment
[ ] – Mixer is cleaned and in good working condition and conform ASTM C-94
[ ] – Transit Mixer
[ ] – Bagger Mixer
J. Aggregates
1. Fine Aggregates
[ ] – Fine aggregates are of appropriate quality as per specifications. Requirements are
free from foreign material.
2. Coarse Aggregates
[ ] – Coarse aggregates are appropriate quality as of specs. Requirements are free from
foreign material.
K. Water
[ ] – Water used for mixing was cleaned and suitable for concreting
L. Cement
[ ] – Cement were stored not more than three (3) months, hardened, lumpy or bagged
was segregated & not allowed for mixing.
M. Sampling and Testing
[ ] – Slump test & cylinder wer taken for testing. At least three (3) samples were required.