Format for information for inspection of Ongoing /Completed Word

R&b Sub Division :Gandevi

R&b Division : Navsari
PART 1-Work Information(To be filled by) : )

1.0 GENERAL Work is: ONGOING COMPLETE

1.1 Date of inspection : 17-12-2018

1.2 Name Of Quality Monitor: Harilal Desai

1.3 Name of Road: Antliya Game Panchayat Ghar To Ramla Faliya Ghol Faliya Damar Road

1.3.a Start chainage : 0.00

1.3.b End chainage: 0.440

1.4 Package No: 36

1.5 Length:0.00 Km,Flexible Pavement,0.44 Km.C.C./Other Pavement = Total 0.44 KM

1.6 Technical Sanction Cost: Rs 1360300.00

1.7 Name of Agency: Radhe Associate

1.8 Date of Start of the Work: 1-10-2018

1.9 Stipulated Date of Completion: 31-3-2019

1.10 Actual Date of Completion(If Work Completed):Work in Progress

1.11 Name of officer Present:J R Patel

1.11 Stage:Stage 1

2.0 Provision Made

PART 'A' PROVISION MADE IN THE ABOVE WORK

-Clearing & grubbing, GSB: Gr I 100 mm, GSB Gr II 100 mm , WMM 125 mm, BBC 37.50 mm, Carpet 25 mm,
Seal coat 0.018 cu m per 10 sq mt , CD Work, Road furniture.

PART 'B' POSIOTION OF WORK AT THE TIME OF INSPECTION

Work is completed up to WMM layer.

3.0 INSPECTION BY QA/QC OR SENIOR OFFICERS and ACTION TAKEN

(if provision inspection is done)

Date Of Visit Inspected by Observation Action Taken By Office With Date

N.A N.A N.A N.A

PART-II- Observation of QM for Ongoing/Completed work
1.0 QUALITY ARRANGEMENT - Observations (In Case Of Onging Work Only)

Observations:

Engineer Present or NOT

Whether
Whether Field Whether
Necessary
Laboratory Equipments
Sr No Equipments
Establishment have been
At Plant Site At Paver Site Available
(Y/N) Used(Y/N)
(Y/N)

1 Y Y Y Y Y

* If Engineer of Agency is Not Present on Site Then Proposed Dissection as per Tender Clause(i.e Rs
16500/-Month)

Grading : S

2.0 ATTENTION TO QUALITY:(in Case Of Ongoing Works Only)

Observation - item 2a:Maintenance Of QC Registers:

Based on executed quantities Whether QC Register part |

whether all mandatory tests maintained as per
Sr No
conducts provisions
(YES/PARTLY/NO) (YES/PARTLY/NO)

1 YES YES

* Observation -item 2b:verification of test Results(P-Conforms,F-Does Not Conform);

Results of the Test Result as per QC Whether the test

test conducted Register at the same result recorded
Sr No Name Of Tests by QM at a location.(Mention the in QC register
defined location Page No.of QC Register found correct?
(P / F / (N/A)) Also(P / F / (N/A))) (P / F / (N/A)

1 WMM Gradation P/0.080 P/pg no-73 Y

Grading : S

3.0 GEOMETRICS :The QM Should Take at least two measurements in 1 KM length and if found that
the Roadway and Carriageway is inadequate QM may take more observation.
Observation -item 3 a:Roadway width & Carriageway.

Sr Carriageway Super Extra Junction

Chainage Camber Remarks
No Width(m) Elevation Widening improvement

1 0/080 3.85 ok . . . sec-1

2 0/060 3.85 ok . . . sec-2

OBSERVATION REGARDING THE QUALITY OF ITEM OF WORK;

4.0 EARTHWORK :
OBSERVATION -item 4 a:Quality of Material for Embankment/Sub Grade:

On Visual Classification
Location Identify the group symbol & Write Quality of Material is acceptable(Y/N)
(Type of soll)

N.A N.A N.A

Grading : N.A

N.A
OBSERVATION -item 4 b:Workmanship for Embankment and sub Grade Construction:

LAB TEST (AS Per Record) Engineer Present or NOT

Field
Moisture
Sr No Field
MDD Content Dry Density Compaction
CBR OMC % (%) Density
gm/cc gm/cc Adequate(Y/N)
gm/cc

N.A N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A

OBSERVATION -item 4 c:Side,Slope And Profile:

YES NO N.A

1.Layer thickness of Spreading not Greater than 200mm. N.A

2.Rolling done by vibratory roller. N.A

3.Field Test, FDD ,& FMC is done or not. N.A

4.Register of Earthwork is Maintained or not N.A

5.Line Level,Profile,Camber & Side slope is maintained or not N.A

Grading : N.A

N.A
5. Sub-Base(GSB)
Observation - Quality of material and Workmanship:
If Mix material is used (Mix Design is done or not) YES

Whether
LAB TEST (AS Per
Suitable Compaction is
Record)
Confirms form Adequate(Y/N) Observed
Prescribed
to plasticity Thickness
Sr No Thickness
Grading angle of Layer(In
Provided(Y/N)
MDD OMC (Y/N) PI & LL mm)
CBR (Y/N) FDD FMC
gm/cc %

0/080 . . . Y Y Y Y 100+100 Y

0/060 . . . Y Y Y Y 100 Y

Grading : S

6.0 Base Course

Observation - item No 6. Quality of material and Workmanship of WBM;

Filler
Volume
material Whether
Thickness of filler
Aggregate is non- Adequate
Location of each Thickness is material
confirms to plastic to compaction Remarks
(Km) layer of adequate(Y/N) percent
Grading(Y/N) desired is done
WBM(MM) of coarse
extent (Y/N)
aggregate
(Y/N)

N.A N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A
 Observation - item No 6.(b) Quality of material and Workmanship of WMM;
• If Mix material is used (Mix Design is done or not) YES

Filler
Volume of
material Whether
Thickness filler
Aggregate is non- Adequate
Location of each Thickness is material
confirms to plastic to compaction Remarks
(Km) layer of adequate(Y/N) percent of
Grading(Y/N) desired is done
WMM coarse
extent (Y/N)
aggregate
(Y/N)

0/080
125 Y Y Y . Y .
(Km)

0/060
125 Y Y Y . Y .
(Km)

Grading : S

7.0. Bituminous Course: Premix Carpet/Surface Dressing/BM/BUSG/Seal Coat/MSS;

Quality of Material And Workmanship of BT Layer(In Case of ongoing Works):

Whether Coarse
Write Mixing Temperature
Aggregate Whether the Binder is of
Sr No Location and Whether it is in
confirm to approved grade(Y/N)
Permissible limits.(Y/N)
Grading(Y/N)

N.A N.A N.A N.A N.A

7.0A Plant Site

YES NO N/A

1.0 Laboratory at plant Site Established N.A

2.0 Test Perform at Plant Site Lab N.A

2.1 Binder Content With Gradation N.A

2.2 Dry Mix Gradation N.A

2.3 Aggregate Test N.A

2.4 Bitumen Test N.A

2.5 Regular Temperature Check/Record N.A

3.0 Calibration of Asphalt Tank is done N.A

4.0 Temperature for Asphalt Mix Material N.A

4.1 Temperature for Asphalt Tank N.A

5.0 Technical Person for Testing Available or Not N.A

6.0 Vibrator Sensor Plate for Over Size Material N.A

7.0 B : Paver Site

YES NO N/A

1.Required Roller is Available on site N.A

2.Temperature Of Mix Material at Laying N.A

2.1 Camber Board Available or Not N.A

2.2 Site Cleaning is Properly Done N.A

2.3 Technical Staff / Sufficient Labour Available N.A

2.4 Spreading of Tack Coat N.A

7.0 C : Bitumen Extraction Tests Performed at Plant Site at the time inspection:

Wt of
%
Mix Wt of Mix % Asphalt % Asphalt
Wt.of Asphalt Remarks
with Without w.r.t reqd. as per
Asphalt(gm) w.r.t Pass/Fail
Asphalt Asphalt(gm) Aggregate Specification
Mix
(gm)

N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A

8.0 Observations - Workmanship of BT layer(In case of completed works):(Paver Site) FOR

: N.A

Thickness Whether
Write laying
Surface
and whether
evenness is
Sr Location it is in
within Remarks
No (km) Whether permissible
Thickness acceptable
Thickness is limit
in mm limit
adequate(Y/N) (Y/N)
(Y/N)

N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A

8.0.B Observations - Workmanship of BT layer(In case of completed works):(Paver Site)

FOR : N.A

Thickness Whether
Write laying
Surface
and whether
evenness is
Sr Location it is in
within Remarks
No (km) Whether permissible
Thickness acceptable
Thickness is limit
in mm limits
adequate(Y/N) (Y/N)
(Y/N)

N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A
8.0.C Observations - Workmanship of BT layer(In case of completed works):(Paver Site) FOR : N.A

Thickness Whether Write laying

Surface and whether
Sr Location evenness is it is in
Whether Remarks
No (km) Thickness within permissible
Thickness is acceptable limit
in mm
adequate(Y/N) (Y/N) (Y/N)

N.A N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A

9.0 Observations - item No.8,Quality of Shoulders(In Case of completed Works.)

Whether Quality of Material Whether Camber is

Sr No Location Shoulder Material
is as Per Specification Maintained(Y/N)

N.A N.A N.A N.A N.A

10.0 Cross Drainage Works:

Whether general Quality of Whether general Quality of

the Workmanship is
Sr No Location Type of CD
material is acceptable Acceptable.
(Y/N) (Y/N)

N.A N.A N.A N.A N.A

Grading : N.A

N.A

11.0 CC Pavements

Thickness

General Quality of General Quality of

Location
Sr No material is acceptable. workmanship
(km) Thickness Acceptable (Y/N) acceptable(Y/N)
in mm (Y/N)

N.A N.A N.A N.A N.A N.A

Grading : N.A

N.A
12.0 Road Furniture and Marking:

A Fixed Or Not Quality as per Specification

Village Name Board NO

Road Sign Board NO

Junction Board NO

Guard Stone/indicator Stone: NO

200M Stone Fixed: NO

Km Stone Fixed NO

Logo Board YES YES

Main Information Board YES YES

Citizen Informatory Board NO

Grading : S

13.0 Other Observation,if Any:

-Proper compaction is necessary.
-Temporary Chainage shoulde be marked on site.

14.COMPLIANCE FOR FOLLOWING OBSERVATION ARE REQUIRES

1) Para Nos. 13
15. General Observation of SQL(Including the observations made during the interaction with PIU Staff and
contractor's/Consultant's Engineers):
N.A

15.1 Observation about deficiency in project preparation (Give details observation about deficiencies in
general and items which have been left but are required as per site condition)
-> N.A

15.2 Whether the work hase been complete or is in progress as per work program or delay has occurred.if
delay has occurred,whether the liquidated damages have been withhold or recovered
->N.A

15.3 Whether the work has been completed within the sanction cost,if not what is the action taken by the
PIU (in case of complete works).
->N.A

15.4 Observation about the action taken by PIU on the inspecting officers including SQMs and
NQMs.(Clearly offer comments about the action on the observation f Department officers,State Quality
Monitors)
->N.A

15.5 Comment about difference in observation made by NQMs/SQMs in earlier inspection (the NQM Shall
Study earlier inspection report of NOMs/SQMs.if Any adn his Clear Comments about the differences in
observation,if any)
->N.A

Grading : S :

Agency Rating : A

Signature: Signature:

Officer Present: J R Patel QM/ALQM/LQM: Harilal Desai

 - Overall Grading of Work
The overall grading calculated on the basis of item and sub item wise grading is given below:

Awarded
Sr.no Item Sub Item
Grading

1 Quality Arrangements ------- S

(a) Maintenance of QC register -

2 Attention to Quality
(b) Verification of tests results S

3 Geometric (a) Roadway width & Carriageway -

(a) Quality of Material N.A

4 Earthwork (b) Testing of Material N.A

(c) Workmanship N.A

5 Sub Base - GSB ------- S

(a) Base Course - WBM N.A

6 Base Course
(b)Base Course - WMM S

Quality of Material -

(a) Information and tests at plant site -

7 Bituminous Course
(b) Information and tests at paver site -

(c) Bitumen Extraction test N.A

(a) Bituminous Course A N.A

8 Bituminous Course (b) Bituminous Course B N.A

(c)Bituminous Course C N.A

9 Side shoulder ------- -

10 Cross Drainage Works ------- N.A

11 C.C. Pavements ------- N.A

12 Road Furniture ------- S

Overall Grading S

SITE PHOTOGRAPHS
Checking thickness of road at ch 0/060 Checking thickness of road at ch 0/060

Checking thickness of road at ch 0/080 Measuring width and camber of road at ch 0/080

Gradation of WMM material logo board

 SITE PHOTOGRAPHS

Main information board Measuring width and camber of road at ch 0/060

Checking thickness of road at ch 0/060 Checking thickness of road at ch 0/060