MATERIALS SUBMISSION COMPLIANCE CHECKLIST

Prepared by: Checked by: Reference Number :

Project title Davao City Bulk Water Supply Project Design
Monna A. San Diego Wilson R. Emano
MAT-DBW-C048
Revision No.
Client Apo Agua Infrastuctura Inc. Date of Check 31-Jul-20 Construction
A

A DETAILS OF MATERIAL SUBMISSION

Description of Proposed Material: Ready Mixed Concrete Holcim Type 1 4000psi
Proposed use of material: Structural Concrete
Brand and Make of Proposed Material: Safecon
Attached Reference: Test Results
B COMPLIANCE CHECK LIST

Does the Specific Detail of

Properties Designer Details of Proposed Material
proposed material comply
4000psi 3/4" Type 1 4000psi 3/4" Type 1 See attached test result YES NO
YES NO
YES NO
YES NO
YES NO
YES NO
C DEVIATION BOX (THIS BOX SHOULD BE COMPLETED BY THE CONTRACTOR IN CASE A DEVIATION IS REQUIRED)

Description of Deviation:
Section / Clause of Employer's Requirements
Are the examples of previous use correct?
Will further deviations be needed on other plant
components as a result of this deviation?
 MATERIALS SUBMISSION COMPLIANCE CHECKLIST
Prepared by: Checked by: Reference Number :
Project title Davao City Bulk Water Supply Project Design
Monna A. San Diego Wilson R. Emano
MAT-DBW-C048
Revision No.
Client Apo Agua Infrastuctura Inc. Date of Check 31-Jul-20 Construction
A

D DETAILED COMMENTS: Itemise any issues. Ensure that Safety, Environment and Quality are considered
If there are safety issues then ensure they are transferred to the safety plan. If there are commercial issues or risk ensure they are transferred to the risk register

No. Item Comment/s By Action/s By

E ADDITIONAL NOTES: Use as needed

For pipe bridge abutment, bored piles, OTP structures usage and other structures requiring 4000psi Type 1 (max agg. Size 3/4") structures
Please refer to the following SMCC for test reports of raw materials:
MAT-DBW-C038 - Crushed Gravel 3/4"
MAT-DBW-C039 - Fine Aggregates & Coarse Sand
MAT-DBW-C042 - ACS Admixture Retarder
MAT-DBW-C047 - Fine Sand

Pls see attached designer's approval for your reference.