FORM No.

PR 808-01-A1
Subc. No.
CONCRETE PRE-PLACEMENT CHECKLIST Consecutive no.
Sheet : 1 of 1
DATE: DOCKET No: STARTING TIME:
QUANTITY: M3 CONCRETE GRADE:
DISTINATION ( AREA ) : MIX DESIGN:
CONSTRUCTION UNIT: STRUCTURE ITEM: SLUMP:
DRAWING NO: ______________________________________ MIX ORDER _________________________
NO:
SUBCONTRACTOR
ITEMS TO BE CHECKED BEFORE APPROVAL IS GIVEN SIGNATURE & DATE
NAME DATE
FOUNDATION / STRUCTURE ( CLEAN-UP OR COMPACTION )

FORMS - LINE & GRADE

FORMS - CLEAN-UP OR COATINGS ( OIL OR SEALER )

FORM INSULATION IN PLACE

STEEL REINFORCEMENT

WATERSTOP

METAL TIES & ANCHORAGES

EQUIPMENT EMBEDMENTS (ANCHOR BOLTS, etc.)

RECESS / BLOCKOUT / RESERVATIONS / WEEPHOLES

CONSTRUCTION JOINTS INSPECTION

GEOTEXTILE AND / OR POLYTHENE SHEETING IN PLACE (PAVING)

ELECTRICAL CONDUITS & OTHER

ELECTRICAL EARTHING

POUR CLEAN-UP (WASHED OUT, BLOWN OUT)

LIGHTING FOR NIGHT PLACEMENT

VIBRATOR & SPARES, OTHER AUXILLIARY EQUIPMENT

ACCESS FOR CONCRETE TRUCKS

CURING ( WATER , MEMBRANE OR CURING COMPOUND )

MATERIAL AVAILABLE FOR EMERGENCY CONSTRUCTION JOINT

REMARKS:
ACCEPTABLE TO POUR  YES
 NO (LIST UNACCEPTABLE ITEM(S) AND EXPLAIN)

SIGNED :
Subcontractor Name Date

SIGNED :
Contractor Name Date

SIGNED :
Company Name Date

JP 1000 NLG
Attachment PR 808-01-A1 (01/03)