CONCRETE POURING REQUEST

Date:
Location:
Level:
Supplier:
Batchplant:

General Information
Type of structure:
Concrete Strenght:
Max size of aggr.:
Slump:

Pre-pouring inspection checklist

Item for inspection Site Engr. QA/QC Remarks
1. Line and Grade
2. Sub-base preparation/foundation fill
3. Gravel Bed
4. Lean Concrete
5. Waterproofing/water stop
6. Rebars
7. Formworks
8. Electrical Embedment/Blockout
9. Mechanical Embedment/Blockout
10. Sanitary Embedment/Blockout
11. Fire Protection Embedment/Blockout
12. Architectural Embedment/Blockout

Pouring Statistics
Schedule Pouring Date: Actual Pouring Date:
Schedule Pouring Time: Actual Pouring Time:
Scheduled Completion Time: Actual Completion Time:
Estimated Volume(cu.m): Actual Volume (cu.m):
(as per plan) (poured)

Approve by:
Construction Project Manager safety Engineer

signed over printed name signed over printed name

 CONCRETE POURING REQUEST

Date:
Location:
Level:
Supplier:
Batchplant:

General Information
Type of structure:
Concrete Strenght:
Max size of aggr.:
Slump:

Pre-pouring inspection checklist

Item for inspection Site Engr. QA/QC Remarks
1. Line and Grade
2. Sub-base preparation/foundation fill
3. Gravel Bed
4. Lean Concrete
5. Waterproofing/water stop
6. Rebars
7. Formworks
8. Electrical Embedment/Blockout
9. Mechanical Embedment/Blockout
10. Sanitary Embedment/Blockout
11. Fire Protection Embedment/Blockout
12. Architectural Embedment/Blockout

Pouring Statistics
Schedule Pouring Date: Actual Pouring Date:
Schedule Pouring Time: Actual Pouring Time:
Scheduled Completion Time: Actual Completion Time:
Estimated Volume(cu.m): Actual Volume (cu.m):
(as per plan) (poured)

Requested by:
Construction Project Manager Safety Engineer

signed over printed name signed over printed name

Approved by:
QA/QC Manager Safety Engineer
signed over printed name signed over printed name