Client : Project : Sheet No.

Tunnel
SHOTCRETE TESTING: THICKNESS Heading
VERIFICATION Tunnel Meter (TM) to
Rounds Number to

TM from Location: TM from Location:

1 to
2 to
Round Number Round Number
1. Hole mm 1. Hole mm
2. Hole mm 2. Hole mm
3. Hole mm 3. Hole mm
4. Hole mm 4. Hole mm
Average mm Average mm
Required mm Required mm
Difference mm Difference mm
Remarks: Remarks:

TM from Location: TM from Location:

3 to
4 to
Round Number Round Number
1. Hole mm 1. Hole mm
2. Hole mm 2. Hole mm
3. Hole mm 3. Hole mm
4. Hole mm 4. Hole mm
Average mm Average mm
Required mm Required mm
Difference mm Difference mm
Remarks: Remarks:

TM from Location: TM from Location:

5 to
6 to
Round Number Round Number
1. Hole mm 1. Hole mm
2. Hole mm 2. Hole mm
3. Hole mm 3. Hole mm
4. Hole mm 4. Hole mm
Average mm Average mm
Required mm Required mm
Difference mm Difference mm
Remarks: Remarks:

Approved by Engineer: Issued by Contractor:

Name: ................................ Name: ................................

Sign : ................................ Sign : ................................

Date : ................................ Date : ................................