Moaimlenomee Work, National Rural Infrastructure Development Agency y Ministry of Rural Development, Government of India 7 Format QB Version 2021.0- Part I Format for information to QM for Inspection of Ongoing/Completed Bridge Work PARTL- Work Information ( z AMirinfenomee Wor 1. GENER 1. Work: (check any one box) lin-Progress Completed Il. Date of inspection: EE 26069099 Nom ][ coud II Name of quality monitor (QM): Ev: UMEesh MEHTA i _}sam |] cove} IV. | State: { Thorh armel District: |p aLowmau. Block: Patom_ V. Name ofbridse® [PTs Badge Teco aM. Road Seedtom_Palgt Location Wh Ro VI. Package number.: OH HBRLI5 ad. VIL Sanctioned length of the bridge. 43.30] Deviation in length of the bridge (If any).: AB30 ™ VIII. Reasons for deviation (if any): — IX. Estimated cost (as cleared by GOD: Rs 149.860 Lakh X. Technical sanction cost: Rs. 14-866 i XI. Awarded cost: Rs. 1335] Lakh XII. Expenditure: (ifwork is ongoing) a. Expenditure done: [ Rs. Lakh b.Bills pending: Rs. Lakh ‘Total expenditure =(atb) [Rs Lakh XIIl, Completion cost: (if work is completed) Bap qe LakhXIV. Date of award of work: (date/ month/ year) XV. Date of'start of work: (date/ month/ year) of completion:(date/ month/year) [09 | [10 2048 XVI Actual date of completion: (date/ month/ vear)(in case of completed work): 63 |Lto | 2o\% 03, Jj {lo ort a3 |fo3 {20291 2, PHYSICAL PROGRESS: (Ongoing/Completed) Construction programme and Physical progress (Strike off whichever not applicable): Memof work | Units | Quantity [Quantity | Completed Fill in start and completion dates | Delay in js perDPR executed | percentage months ofitem | Progress | Stat — |Completion status} Date Date Oo ® | @ @ 6) © fo) ®& ©) D i) Layout rear ii) Foundation le oe , ‘ Thy Duc i) Substructure an Actual ry Duc iv) Superstructure. AW ‘Actual tual weionwes | De tual vi) Approaches i ee E vii) Mandatory boards! Due Signage ete. Actual 3. PARTICULARS OF THE BRIDGE: 3.1 Type ofthe bridge (according to HFL) SK Submersible {on-submersible| (according to Material) RCC Steel Composite Pre-Stress 3.2. Type of foundation Open Raft Pile Well 3.3 Length of bridge A380 m| 3.4. Number of spans and spans length BX 14-6OM37 3.8 3.9 3.10 3.1 3.13 3.14 3.15 3.16 3.17 3.18 Width of the bridge Footpaths provided If provided, width of footpath Formation Level (F.L.) Highest Flood Level (HFL)/Ordinary Flood Level (OFL) Bed level (Lowest) Catchment area Linear waterway at HFL Design discharge Design velocity Foundation levels (a) Piers (b) Abutments (©) Returns Foundation Strata Safe Bearing Capacity (SBC) River protection works provided or not _ if provided Type of Substructure (@ Piers — (b) Abutments — f.GO0 im Yes {___No m m 100°955 m | [100-455 m m in nm cumec mis Pi fim] [P2 Yom ] [ps m Pa m PS m P6 m P7 m | | Ps m| |P9 m :[aL_Besm] [a2 [acsm RI Bre5m][R2_ [36Sn tons/m Yes No Rigid boulder apron Flexible boulder apron] Solid circular Hollow circular Walll type pier Any other type: Gravity type Spill through Box type Counter fort type Any other type:(9 Retums- 3.19 Type of bearings : 3.20. Test report of bearings available or not 3.21 Type of superstructure 3.22 Type of expansion joints 3.23 Type of wearing coat 3.24 Type of drainage spouts 6 Counter fort.” s 042. Box type Tied returns Cantilever type Any other type Elastomeric Pot PTFE Rocker & Roller Any other type: Yes No RCC Solid slab T Beam slab Voided slab Box girder Any other type: Steel Plate girder Truss frame ‘Arch bridges Cable stayed Suspension Bailey bridges Buried Copper plate Bituminous Strip seal Modular Finger type Any other type: RCC Bituminous ‘As per IRC SP As per Design«Desi Hoang rye lane HOC Cis AA" Mandinge oF double tie HEC cha A touting vil 1" vor modiueay novere streayes, [eC ean 1" feng Bayete lanes (HEC elas 70 bevaing, 7 double tins HEC cha Janding, which yer produc severe plreanes, | Any other type 3.26 Whether approaelios are fenton i lig ff Filling | Partly coatings and fillings 3.27, ‘Type ot pitching in approaches 1 [bontder pile tun | | Concrete block 3.28) Whether bench marks and alignment are established: | Yeu near the bridge site (give location and RL) ‘[ Sacntiom Location: Location: nC L vlondard ‘Type of Railings ‘ | Su - _ S Any other type: a QUALITY CONTROL: _ ; = 1. Location of Field Laboratory Paley 11 Geoctapqed photograph of luborstory uploaded on: (dated mouth/yeur):| JH, Reason for delay in extablishinent of field laboratory (Uf x0): 1V, Detuili- of contractor, executing, the work: Name of continetor | PAN number | Mobile munber | Veanil 1D | fateh Paensjorn bu 9999404040ae va ate: (Response for waiatainny quality contol reste par é, Seconysinwoer aviltabite at ales (t 1 Detiibo oF contactors cunt iy - Duration of posting at nit SL] Namwateontiaetr's | iotity mnutor | Mobile muiber : at alte AW oeugst esse AL NAL Fron ‘To V {dase Cov WOOD 2405 19 19,0 4 fof 94992099) \ VA Detaitcot hod ot PTY suponvisinys the works K Duration of posting at site | * Mout oh htt! Hinployeo mumber | Mobito number | Dutation ef po al Tak SS} ivecutive tingineet) From To | at : —— [i [Pe oh hoga = = ONO T | 9 9.0102 | WW. Uetails of estan eugineer eporvisny the work und wuntaining qual ity control repister Bartell: Nate of aysistant Duration of posting at st Kawployee number | Mobile number {2 jae ensinoet From To [iy [ Danteh Mhaneds : z P20 |92-09.909 NUL Dols ot the jive enginece supervising the work! } St Pini. : Name of junior Bieta ace i shee Vinployee munber Mama pa ‘bode = AN List ot equipment a latte in theta tabs ee Warlatte oguipaneat that ane in weeking eandition 0 | I | alt X_List of equipment not avaitatte in thet tatePecan SIE TATE Bs IN se say ay gre oti we a TL, Deena citroen of ccapseyraent Semen TALL sepraene arc a aca RAE Be TIS Se Ae ee eat va Cra Carer WA i Crmem ieee WS od SE Come Come WL fo. Comenm Cineme WEE we a Comer Canes WAL | mi Wie Mie Waco WWE if wi, Cotoe Simeminane Macatee nat Seo Ome Ziminene Cone6 EARLIER INSPECTIONS BY NOM, SQM or SENIOR DEPARTMENTAL 7 4 AND ACTION TAKEN STATEMENT: : ee Se name and designation of the officer who had inspected the work): (Please indicate’ Name and Designation of the Head of PIU .. Mobile Number of the Head of PI E-mail of the Head of PIU, Date ‘and Designation, Stage of work at the time Major observations: ee 7 . a a 2 af ofinspectng officer of inspection with dat isit M/CEJ/SE) a a 5 » Shukdeo ; al ta a Foumdakten | “6 oP | Bueno] fie ¢gam) Ew AHab | Super ciuudier — \@ , 4 v Adon ae) ’ ae 7 Surer-S}uyr > nn —_— Koa eS (sam) Signature of the Head of PIU. Seal of PIU Address of the PIU..... Date:— Makndemoner Worle — National Rural Infrastructure Development Agency Ministry of Rural Development, Government of India Format QB Version 2021.0- Part II / Report of National Quality Monitor [)/State Quality Me le (To be filled-up by OM) 1. GENERAL DETAILS: 1. Date of inspection: 26-069 09% Nom ][ code] UL Name of Quality Monitor (QM) [Exp MESH MEA TA (check relevant box and fill code) “Shay ham q_ | District: Block: Palaynauy Datom_. {som ]| cose] Til. State: IV. Name ofBrige a tacaion [HL BrIdgE 1 Rad Ke oF Coad Seclh paleri “ke kerrinjad ih V. Package number: THIFBRLIE VI. Physical status of work: a‘ Ongoing ‘Completed tan fem antl « (checkV anyone box) VII. Present status of work: (check boxes as applicable) Layout Foundation Substructure ‘Suverstructure Protection work Avoroaches 1 Finishing stage VIII. Photographic or video-graphic records (optional) of all hidden items like reinforcements of foundations/ sub structures/ super structures etc. are kept by PIU, till Defect liability period is over for bridge for any future reference or nots (Check V any one box) Yes NoRANGEMENTS-OBSERVATIONS (in case of ongoing works ony): Re iaurrv ar 2 QUALITY) ratory showing the available equipments to be uploaded) c d photograph of the labo! Whadher field laboostory extablisheds(eheek ¥ emp ane Bax) i Yes Panty No of fie Isbocatory is same as ether oestion eae (check ¥ anyone bax) Godicated by PIU in format part T.. Whater necessary equipment as indicated in part-1 areactually [~]yes rari ae available: (check ¥ any ‘one bor) TV. Whether oguipment’s have been used: (check vamp one bax) ye] Teo 1 {Jv fall necessary equipment is not available, whether you have varied thom with the list of deficient equipment’s provided Yes No by PIU in formst Part-l: (check any one bax) V1. Calitrstion of equipment done or not: (checkY any ome bax) Yes No NIL Whether contractor's engineer as per Part-I of this format, is available at site: (check¥ any one bax) Yes No ‘whether You are satisfied with alternative arrangement made to maintain QCR-E (check any one bax) IX. Whether lab technician end other staff is available for test Iherstony: (check/ any one bax) inthe Nes No VIM. If contractor's engincer as per Part-1 of this report is not available, [~ [yes Panly No Gadng ant: Fike Held borstog & not Seblished overall Hem grading shall be U. [anyone or more sch tems are sreded parly or no, overall item grading shall be SRL Item Grading-2: (Check d exy one box) S SRI ul] EF this tom is graded SRLU, write clear reasons and suggestions for (eyfovement, indicating important | decion equipments: pout we - 0" | an Wwe 3. ATTENTION TO QUALITY (in case of ongoing works only): L_ Maintenance of Quality Control Test Registers: (2) Based on executed quantities, whether all mandatory re iy No tests conducted: (chech/ any one bas) = basil (b) Whether Quality control test register maintained as pet provisions: (check ¥ any one bax) Yes Partly No Partly No (c) Whether QC register part II maintained and test results monitored as per provisions: (check ¥ any one bax) hes 0bem of Wo Quantity] "Quantity | Name ofthe | Numbero® | Namberot | Vesting aerer | executed test tests royuined tests aulequate DPR {as per evwonted, actually (ewe) quanti) eumducted Q ® ® @ ) 7 Foundation J —S —_}—!— m work Substmacture work Superstructune ~ work Appneach Slab ss and fixed items (Railing, kerb, Crash [barrier ete.) ae eee ‘Approach work , () If testing found inadequate, the reason : Negligence ; : Lack of equipment in tab : Lack of knowledge : Any other, please specifi: (0) _ Verification of test results: (C: conforming non-conforming) Quality control tests to be conducted by QM and the results to be matched with test results previously reconded in Quality control test re er, at the same component of the structure, Item of Name of Results of the ‘Test results as per {Results of the test) Whether the test Work Test test Quality Control test | conducted | results recorded in conducted by tert the same [previously by QM] Quality control QM atthe location atdelined | test register and component of | (Mention the Page no. location, ats conducted by the structure, of Register) (C/N) QM are in (cm) conformity? (Yes/No) o 2) ) l=) ©(a) Whether nnconforites recorded in QCRAV by AE have been rected and = recorded in Quality control test register again as conformites, a (Check ey one ox) [le Ce] (0) Inordertoascesthe quality of concrete in case of dob, Te(NDD such Rebound Hammer es, Ua Sonic Pale Velciy (UY) oa has been conducted: (Check any one, ‘box) ’ ifany Non Destructive Yes No Gviding note: Ifthe QC registers are not maintained ‘or verification of test resulis are not conforming, Ser S ee A NeSMHOSU anyone ormeresbtens ae pad pany ere, ove tem gang shall be SRI. Item Grading-3: (Check anyone bes) s] SRI ] u {okies graded SRV, write clear reaons and eget fr inprovenn, oe be ead/ 4. FOUNDATION: A) Ongoing (Work in progress) ate of inspection-in % 1, Foundation Piers, Abutments and Returns progecss a / Abutments: [AT___% a % Piers: tt % mm %) [__%) (re_%) [Ps _% re 9 7%) [re %) [9 %]) Returns: = [Re] (RE Tocation’ | Grade of | Quality of material is adequate as per quality | Testing | Grade Itemof | concrete control register of | (SU) work Cement [Coarse Fine Steel_| concrete aggregate | aggregate a @) GB) 4) (3) ©). (8) a Location’ | Grade] Formwork ] Reinforcement | Workability [Compaction [Curing | Grade nem of | of | qualityand | checked by Of | arrangement | arrangements | (gy work | concrete | arrangements | competent | Concrete authority a @) Q) @ ©) © @ ) ph Fal IL. Whether Cement’and Steel tests (other than those provided by supplier), got conducted by Yes No f bored independent laboratories: (Check Zany one box) Whether flushing of bore before and after placement of reinforcement done in case o| uncased cast-insitu piles. Yes No (Check Jany one bax) aTV, Whether a least 600MIM extra length of pile casted beyond cut off level, to be dismanny o laitance effect eee = 7 J. Whether bottom plugging in case of well foundation carried out by using tremie method only 7 (Check’any one box) Yes No B) Completed work Location] Grade | Compressive | Testing of | Surface | Sizeand| Quality | Grade Itemof | of | stengthof | concrete | acceptability | shape as } assessment | (S/U) work | concrete] Concrete | cubes by and per | bypersonal cubes as per | NQM(if | workmanship | design | judgment Quality any) Control Test Register M | @ @) 4) (5) 6 @ @) 1. Whether Cement and Sted tests other than provided by supplier, got conducted by independent Iaboratories: I In order to asess the quality of concrete in case of doubt, if any, Non Destructive Test (NDT) ‘such as Rebound hammer test, Ultra Sonic Pulse Velocity (UPV) ete. has beer (Check/any one box) (Cheekany one box) Yes No sn conducted: Yes No Item Grading-4; (check 7 any one box) 8 U = a (this tem is grade as U, ler reasons and suggestions for improvement are tobe recorded). Y Guiding note: I quality of ether material or workmanship, the overall fem shall be graded as"U™ ¢ é5. SUBSTRUCTURE A) Ongoing (Work in progress) Location’ | Grade of | Quality of materials adequate as per quality | Testing | Grade Hem of | conerete control register of | (SU) work Cement | Coarse Fine Steel | concrete aggregate | aggregate cubes by NQM (ifany) oO @) @) @ (3) © | (8) | Location’ | Grade ] Formwork | Reinforcement | Workability | Compaction | Curing | Grade Htemof | of | qualityand | checked by Of | arrangement | arrangements | (57) work | concrete | arrangements | competent | Concrete authority © ® Q) @ (5) © o (8) Whether granular/ sandy filling behind the abutments and returns done properly: - (Check/any one box) Yes No i. Whether marking with paint is done on bridge components with date of casting for concrete: (Check/any one box) Yes No Il, Whether Cement and Steel tests other than provided by supplier, got conducted by independent laboratoric Yes No (Check any one box)B) Completed work Grade | Compressiv ] Testing | Surface | Size | Quality | Weep Riding | Grade [ Locatio | of | estengh | of |accenabil] | & [assessment] holes | tums | (SU) | | wort |coneet | of Conercte | corercte | iyand. | Shape by personal] Adequac eee eeer a teste cubes by | workman | asper | judgment | y (For | perQualiy | NOM Gr] ship | design abutment Control any) + and Test return) | Register Lo Te | & 6) gl @ | ao A | pele Peete Wy ee se = yilog ly 3 : ze y g ele Ty lates es ses 8 ali I. Whether Cement and Steel ‘ests other than provided by supplier, got conducted by independent laboratories: (Checkvany one box) Yes No HI. In order to assess the quality of concret case of doubt, if any Non Destructive Test (NDT), such as Rebound hammer test, Ultra Sonic Palse Velocity (UPV) etc. has been conduct (Check/any one box) Yes No [Guiding note: IF quality of cher man Item Grading-s; (check J any one box) on terial or workmanship is U, the overall item shall be graded a5 “U™ s] [Ju ] ‘his tem is graded as U, clear reasons and suggestions for ‘improvement are to be recorded). yal 166. SUPERSTRUCTURE (RCC Superstructure A) Ongoing (Work in progress) [Quali of material Workmanship z = g ae ack |@ z 3 ele| 223 |fibse] 284i 2 | 2 23|5 &¢ BP) S/ EER | sore BEE oe) Se] 2] e a ei] 8) 8) €)sf2qaz2e5292829 52) 92!) 2 | 22] 3 ee) 2 | 2/2/2528 2222393222 25) 258) & | 22 | 2 ©) | 4| 2) 222% s2824 ff24 28] Fe 7 & B/ 2/2 FEELG 22a E/E s 8 Bla E22" /228-/5 3 gte|s & | !1o)|@le @ ® @ [ag | an | a2 [03) Whether Cement and Steel tests other than provided by supplier, got conducted by independent laboratories: No (Check/any one box) Yes Guiding note: If quality of either material or workmanship is U, the overall tem shall be graded as Item Grading-6 Az 3 U (check J any one box) (this item is graded as U, clear reasons and suggestions for improvement are to be recorded). ” oF1) Completed work a alelel a] ele 4 aay a ala i c &| 3 2 q @ 3) 0) FD (3) Bs F131 3 F AES 3 § ‘| |= | | S| et = es = 1. Whether Cement and Steel tests other ¢ han provided by supplier, got conducted by independent laboratories: (CheekVany one box) Yes No H._In order to assess the quality of concrete in ease of doubt, Non Destructiv as Rebound hammer test, Ultra Sonic Pulse Velocity (UPV) ete. has been e Test (NDT) such sonducted if any: (ChoekVany one box) Yes No Item Grading-6 (check J any one box) Uf this item Nts U Sraded as U, clear reasons and suggestions for improvement are to be recorded). 1s(i) Stee! Superstructure AN) Ongoing (Work in progress) ] | ee Workmanship [ ye x 3 ‘i eae ElgliEls|2 |e 8 2 ce S 3 » oo 2 zg g Be eSal ga 3 5 fg £) 3) 8] 2] ey] Bs fas] iis [15 =] 3} 8 | 2] Bo! 32 Bia) sia |2E f/ 2/2] 2] ee] 22 G22] fee | 22 g/o) 2] /s8) gé eee] gee | ed S) (Ev e|R UG eee ye a /6 = oe Oeatea tela le \ol@ 91m — a Ta yh I. Presence of water spray or moisture in the vicinity of bridge such as waterfall or marshy wet land? (Cheek/any one box) a No I. Presence of industrial units nearby, which emit corrosive fumes or discharge chemical effluents? (Cheek/any one box) Yes No IIL. Presence of salinity in the atmosphere? (CheekVany one box) Yes No jaterial or workmanship is U, the overall i Hem Grading-GA: uU bA— (check f any one bax) l MA Uy this item is graded as U, cleur reasons and suggestions for improvement are to be recorded).B) Completed Work Material L Welding he \ ] “Presence of Corusion 2 lf No) | gié |? type of Bie 1s comsion and specific 7 = | lg ct Presence of nicole 3) 32) 22 =! Brittle SOE daseification 3) 22) 32 ! Buckling Rea al &/gf/s) 8s 5 (evo) | 6 sist) 28 ‘a 8 (2 | 8: 5 2 18 £8 8 2 jé | <° ©/@] 8 Perea © oO vaterfall or marshy wet land? Yes No UL Presence of industrial units nearby, which emit commosive times or discharge (CheekVany one box) chemical eftluet Yes IIL. Presence of salinity in the atmosphere? (CheckVany one box) Yes No Item Grading-6B: 3 U (check Z any one box) Uf this item is graded as U. clear reasons and suggestions for improvement ane to be recone. 2if Mil) Bailey Bridge Superstructure / / A) Ongoing (Work in Progress) Quality of Material = al af 2 325 ie aes a2 s Soe 25 3 2 ge 2 Bat z = 225 23 5 2 | 5Ee aes 3 = Bag z 2 a) 2) @) (4 6) 1) t L_ Any bolt and/ or rakers and tie plates are missing or loose?(CheckVany one box)| | Yes No TL Any sway braces and/ or transom clamps are missing or loose? Yes No (CheckV any one box) TIT. Presence of any cracking in the Bailey bridge? (Check any one box) Yes No IV. Presence of any bends in bridge members? (Check/ any one box) Yes Guiding note: If any of panel PIN is missing or loose, the overall tem shall be graded as “U™ | Item Grading-6a: | (check S any one box) (fthis nem is graded as U, clear reasons and suggestions for improvement are to be recorded). Ss U > meta f et as Low Preseace of Comesion (Yes! No) | Yes. type of com | spec Fecetion Material @ & TIL Presence of eny cracking inthe Balley tridee? Vv. Presence of any beads in bridge member? | | | (CheckVany one box) (CheckVanyonebox) [| [Yes [se Cats Item Grading-6B: (check J any one box) See ‘tote: IFany of panel PIV me ph is missing or loose, he overall tem Shall be SSS Ce] (Uf this item ic graded as U, i ne eenineeceret cee tsg® \\f LOAD TEST |. Results of Load Test attached or not (check any one box) aS 7] If yes, comments required and copy of test results shall be enclosed. Item Grading-7: (Check J any one box) Guiding note: If load test is not done or not satisfactory, overall item grading shall be U. s U * ag If this item is graded U, write clear reasons and suggestions for improvement: aa 8. BEARINGS A) Types of Bearing (Tick “ appropriate) Roller and Rocker Bearing Elastomeric Bearing Pot cum PTFE Bearing Spherical Bearing Cylindrical Bearing Any other type B) Condition of Bearings (a) Metallic Bearings i. General Condition- any rusting / ceasing of plates! cleanliness or not 5 u ii, Functioning any excessive movement tilting’ jumping off guides s u iii, Greasingy oil bath required to be redone or not s u iv. Cracks in supporting member- Abutment cap, Pier cap, Pedestal, if any +s U ¥. Effectiveness of anchor bolts, whether in position and tight or not RTs U vi, Report any other defect or observation found. pe(b) Elastomeric Bearings Report condition of pals ~ Oxidation, Creep, Flattening, i. Report conditio BIEL Bulging, Splitting, Displacement if'any LK] ji, Report ~ Bearings are elean and free oF not iii, Report any other defect or observation found eee (©) Any type other tha ‘a’ and ‘b’ above Report - Any other defect or observation found Pea I. Whether test results of bearings are available or not: (CheckVany one box) Yes No Guiding note: If anyone of the sub-ter Item Grading-8: (check J any one box) ms are graded as U, overall item grading shall be U, s U (this item is graded as U, clear reasons and suggestions for improvement are to be recorded). 8! u% EXPANSION JOINTS AY Types of Eapanston folut (lek “appruprtiatey Nuried Lixpansion joint Hiller Joint with Copper Mate Asphaltic Mup Joint Compression Seal Joint Single Strip (Hox Seal Joint Reinforced Hlastomerie Joint ilar Stip / Hox Seal joint Reinforeed Coupled Elastomerie Joint B) Condition of Expansion Joluts i, Is there any crack in the wearing. coat ii, Wheth -xisting gap is improper ‘Any hardening / cracking, observed in bitumen filler iv. Any splitting/ oxidation/ creep/ bulging observed in neoprene scaling material ¥. — Corrosion/ damage to welds is visible vi. Presence of debris in the joint Report - any other defect or observation found Yes No ves | [fio Yes No Yes | [U-JN0. {Guiding note: W any response of qucsions in wah Hem 9 1s ¥es" he overall Hem shal be rade av pry Hem Grading-9: fy (check f any one box) [uJ Af sthis item is graded as U, clear reasons and suggestions for improvement are to be recorded)10. APPROACHES 10.1 Embankment Location | Suitability of soil | Compaction Side slopes Shoulders a (S/ SRV U) @ Q) @) (4) () om Ee i 10.2 Sub Base (G.S.B.) Location] Conforms] Material Dy 1% Comp-] Whether ‘Thickness | Measured Prescribed (RD) to | Suitable | density Grading | from | N/m action | compaction las per DPR| Thickness | Thickness is adequate (in (inmm) | provided (YN). | plasticity (YIN) mm) (YIN) angle aw @) kvm) |_ (4) (3) (6) @ (8) (9) a 10.3 Base Course (Non Bituminous (wMm) and Bituminous Macadam (BM)) ‘Location Grading of | Plasticity Volume of ‘Compaction Design | Thickness [Thickness (RD) Aggregates| of Filler filler based on thickness | of each adequate (SU) | material | materiat | volumetric le per DPR| layer of | (S/U) (Sfuy Percent of —|analysis/ sand} WBM/ coarse | replacement | (mm) | WMM Aggregate | method (mm) (SU) 1 oy 2 @) ® @ 1 © @ | w10.4 Wearing Course Location Grading of [ Laying | Bitumen | Bitumen Observed thickness ‘Surface (RD) | Coarse | Temper {content %, as content enmes %, of la ; Aggregate | ature of | per QCR-I | (S/U) = “su | (SU) ae [As measured) S70 as per by ack NoM/soM | oO @ ® “@ () © @ | ® | | eS eee ] | | | | | 10.5 Protection Work: i Whether sanctioned DPR has the provision of protection works: [¥es le ] (checkV any one box) I. Type of protection work: (checkV baxes as applicable) Retaining wall Breast wall | Pespetwell | | “Any other type of Provection work \ 2 & M1 Quality of Materials: [Location] Stucture Type | Type of Protection [General quality of] Sizeand |Quiliyasement] RD (Retaining Wall/| work (RCC/CC/ | material conforms} shape as bypersonal sf Masonry/ wire | tospecifications |perdesign | judgement crate) (YesNo) | (YesNo) am fe} @) @ ) 6) | | | E — | ”cr os yy S sé n ctures YF Workmanship of Retaining structures Se a EL ose Siig Y 2 TT Workmanship ot Whe Have weep Adequacyof "SS 1D | ctainingstructures | honeyeombinglany | been provided weep holes RD | retaining, other defects are (Yes/No), (if provided) observed (Y/N) (Yes/No) a e _ a © ACOH Aeccetabee| ON so V. Incase, Stone masonry is used in ret ining structure: a) ‘Workmanship of stone masonry is acceptable: a. (checkVany one box) NN] Yes No ’) Bond stone has been provided in stone masonry: ve a (check/ any one box) Ie Guiding note: Wsub tem 102, 10, Tod ae Item Grading-10: Z - (check J any one box) 48 | _ u ( this item is graded SRI/U, write ‘graded as U, the overall item shall be U. clear reasons and suge QF estions for improvement) %(BRIDGE FURNITURE AND. MARKINGS: HLL Observations: Quality of Hide b (i) (SP Tr] Main tnformation Board Information Hoard E Uf this item is graded SRI/U, write ©] (psn) CTe ar reasons and sug | sestlons fir Improvement: 11.2 Observations: Quality of Bridge Furniture and Markings: (iii) and stones fixed on approaches : ww] [Le = (a (iv) Mandatory and caution SRI i | i 0 I this item is graded SRI/U, write clear reasons and suggestions for improvement: ee12. General Observations of QM, (including the observatio made during the — interacti 1d Contractor/Consult: Engincers): A. Observations about deficiency in project preparatio deficiencies in general and items which have hee (cheek Vor) : : A-No deficiency in project preparation noticed Contractor/Consultant engineers: (Give detailed observations about 1 left but are required as per site conditions): during the interaction with PIU Staff and fg UL. Deficiencies Observed: (checkY one ar multiple box) [[] Nomenclature of BOQ Htems is not clearly stated such as what type of binder (VG Grade/Emul the quantity of such items, [J] Number of spans are insufficient as per the s oO No provision of protective work in DPR but as, Per site conditions it is required. (e] Hydraulic Design & calculation for bridge design not pr rovisioned in DPR. [J Guard stone’ Crash barrier/ Road studs on approches are required to be provi DPR. hydrological condition. [71 Deviation from proposed Alignment, Any other comment: B. Whether the work has been completed in progress as occurred. If delay has occurred, whether the liq per work programme or the delay has recovered: (check V relevant box and fill details) lated damages have been withhold or Completed In progress Whether there was delay Work progres: As perschedule Yes No [ Extension of last date completion Ifyes, fill below details Posted of delay Gnmantsy [____] Ifextension of last date, fill below details Period of extension (in months) ie ee |e ey Yes No CO Amount (in lakh) Amount (in lakh) Reason for delay/any other comment Amount of penalty on contractor Reason for delay/any other comment = oeSanctioned cost ( in lakh) Reason for extra cost Action taken by PIU Whether the work has been co: taken by the PIU (in case of co Whether the work is completed within the sanctioned cost Tf no, fill the below details mpleted within the sanctioned cost, if not, what is the action mplete works): (check V relevant box and fll details) yes | [ [No Completion cost in iki D. Observations about the action taken by the PIU on the observations of inspecting officers including SQMs and NOMs. (clearly offer comments about the action taken on the observations of Departmental Officers, State Quality Monitors and National Quality Monitors). Previous Previous QM's observtion QM's Designation (NOM) SQM DO “Action taken by PIU ‘Your observation about PIU's action pest é ye am1 Cummens adue difference ir reeds trade bs MOMS SWS in erie a NQHISQM Stal cris ste seciee meron Ceres af NOME SIM re on . mua advert ihe iMeraness in TOMS Ea. ces 6 came : ‘whedee any diReence humdi groeines gitsereaioms wT UBS yes eur camment on difirens it cheat B Othe wtereadons Famst on wow, Sos o 13. OVERALL GRADING BRIDGE WORK Mems Description Awardable | Awarded Grade Gra ieneral Details: 2 | Quality Arrangements SSRI - Mf 3 | Attention to Qu: S/SRUU Nea 4 | Foundation (Stage 1) su MA 5 | Sub-Structure (Stage II) SIU EAS 6 | Super-structure (Stage I) su @ & 7 | Load Test S/U Sh A- aring = : 1g. 10 be same as for condition of Bearing) i S A. Type of Bearing- Roller and Rocke Elastomerie Hearing, Pot cum PTFE Bearing, Spherical Bearing, oe Cylindrical Bearing Any other Bearing) B. Condition of bearing, su g 9 | Expansion Joint siU (Grading to be same as for condition of Expansion joints) S ‘Type of Expansion Joint- Buried Expansion joint, Filler Joint with Copper Plate, Asphaltic Plug Joint, Compression Seal Joint, Single Strip / Box Seal Joint, | —___ Reinforced Hlastomerie Joint, Modular Strip / Box Si inger Joint, Reinforced Coupled Elastomeric Joint, f Expansion Joint su Ci 10 | Approaches (Fo be U, ifany of the sub items (i). (ii), (iv) are SRI or U) SSRIU S (i) Embankment S/SRUU a (ii) Sub Base (G.S,.B) S/SRUU i (iii) Base Course S/SRUU (Non Bit 8 (WBM) and Bituminous(BM)) tet (iv) Wearing, Course S/ISRUU eS ee 6 1) Protection Work SSRUU gq11 _| Bridge Furniture and Merkings so > (io be U, if any of the sub items are U) Ss @ Main information Board SSRIU g (i Gitizen Information Board SSRI S (iii) Guard stone on approaches SISRVU a (iv) Mandatory and Caution signage SERVO Overall Grading S/SRI/U S Guiding notes for overall grading: + Ifall work items are “S”, the overall quality of work shall be “S” + Ifitems at sl. nos. 4, 5, 6, 7 and 8 are “S” and other items are either “SRI” or “U", the overall quality of work shall be “SRI” + Iany item at sr. nos. 4, 5, 6, 7 and 8 are “U”, the overall quality of work shall be “U”, imespective of the quality grading of other items, Signature of QM i Name of QM AOMWECH MENTA- 241612, Date14, QUALITY GRADING OF ITEMS OF BRIDGE WORKS: Item No. Trem for observation ‘Awardable | Awarded Grade Grade Tem No. 1 General Details Tem No. 2 Quality Control Arrangements S7SRITU [ Item No.3 ‘Attention to Quality s7sri7u_[ TtemNo.4 | Foundation s7U _ Trem No. 5 Sub structure S70 % Item No.6 | Super structure S7U Item No.7 | Load Test s7U = Tem No. 88 | Condition of Bearing 370 g tem No.9 | Expansion Joint 370 gj Trem No. 10 | Approaches (Stage I and Ill) S7SRI7U pom TemNo. 11 | Bridge furniture & marking STSRTT |g Overall Grading S/SRI/U Ss Signature of QM Name of QM. as