RECORD OF REVISION TO TECHNICAL FORM Br-IS-PC (PILE CAP)

Rev. Revised/Checked
No. Form/Sheet No. Description on Revision Date Revised
No. by
List of Acceptance Minutes for Pile Cap
Br-IS-PC-01
1 4 construction: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
+ Remain the former sheet content.
Br-IS-PC-02 Inspection for Foundation Hole Elevation:
2 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Inspection for Pile Location:
Br-IS-PC-03
3 4 + Remain the former sheet content, 22/12/2010 Mr. Tuan Mr Xuan
rev.04

Br-IS-PC-04 Inspection for Blinding Sand:

4 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Br-IS-PC-05 Inspection for Blinding Concrete placing:
5 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Inspection for Blinding Concrete Elevation
Br-IS-PC-06
6 4 & Dimensions: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
+ Remain the former sheet content.
Inspection of Formwork Coordinate &
Br-IS-PC-07
7 4 Elevation: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
+ Remain the former sheet content.
Br-IS-PC-08 Inspection for Steel Reinforcement:
8 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Inspection for Rebar, Formwork &
Br-IS-PC-09
9 4 Construction Preparation Work: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
+ Remain the former sheet content.
Br-IS-PC-10 Inspection for Sampling of placed Concrete:
10 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Br-IS-PC-11 Inspection for Concreting of Pile Cap:
11 4 22/12/2010 Mr. Tuan Mr Xuan
rev.04 + Remain the former sheet content.
Inspection of Structure completed:
Br-IS-PC-12
12 4 + Add the item of '4. Visual shape & surface 03/06/2011 Mr. Tuan Mr Xuan
rev.04
checking'.
Acceptance Minutes of Pile Cap:
13 4 06/01/2011 Mr. Tuan Mr Xuan
+ Remain the former sheet content.
Form Br-IS-PC Revision Record:
14 03/06/2011 Mr. Tuan Mr Xuan
+ List all of the revision details.

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 LIST OF ACCEPTANCE MINUTES FOR PILE CAP CONSTRUCTION
Part A: Project & Record Information:
Project Name/Contract No. Ref. No
Client/Employer： Rev. No
Engineer： Date：
Contractor：

Part B: Document Submittal Discipline:

Architectural
Civil Electrical
Related Discipline： Mechanical QA/QC HSE
Others (xxxx)

No. Check List Signed Date Comment

01 List of Acceptance Minutes for Pile Cap construction

02 Inspection for Foundation Hole Elevation OK
03 Inspection for Pile Position, Level & Cut-off OK
04 Inspection for Sampling of Blinding Concrete OK
05 Inspection for Blinding Concrete Placement OK
06 Inspection of Formwork Coordinate & Elevation OK
07 Inspection for Steel Bar OK
08 Inspection for Rebar, Formwork& Const. Preparation OK
09 Inspection for Sampling of Concrete OK
10 Inspection for Concreting of Pile Cap OK
11 Inspection of Structure completed OK
Concrete Compressive Strength Test results OK

Plan of Pile Cap

Remarks:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM PROJECT MANAGER Q.C OFFICE ENGINEER IN CHARGE APPROVEN BY
 INSPECTION FOR FOUNDATION HOLE ELEVATION
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

Data
Elevation (m) - Point 1 2 3 4
Existing Actual
Ground Original
After Actual
Excavation Design
Difference (m)
Water Level (m)

Length - Width (m) L1 L2 L3 L4

Actual
Bottom of the hole Actual (total
Design(total
Difference

Remark:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR
 INSPECTION FOR PILE POSITION, LEVEL & CUT-OFF
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

DESCRIPTION
1. Quality OK NG
1.Number of piles Ö
2.Pile head height Ö
3.Horizontal position of pile Ö
4.Pile mass Ö
5.Equipment condition Ö
6.Removal and cleaning of loose concrete Ö
7.Removal and cleaning of harmful material Ö
8.Cut-off Quality Ö

Remark:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR
 INSPECTION FOR SAMPLING OF BLINDING CONCRETE
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

Number Concrete Air

Starting Finishin Vehicle Volume Name of Slump
No. of Temp. temper- Weather Remark
Time g Time No. (m3) Sample (cm)
Samples < 32º ature (°C)

1
2
3
4
5
6
7
8
9

Total 0 0

Remark :

Acceptance: Accepted Ö Not accepted

FOR CONTRACT0R CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

 INSPECTION FOR BLINDING CONCRETE PLACEMENT
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

General Information
Concrete Class C10-(Mix Design Name)
Design Conc.Vol. ; Actual Conc. Vol. 0.00 m3
Pouring method
Concrete mix ratio W/C (%) Water (L) Cement (kg) Sand (kg) Stone (kg) Additive (mL) Other
Design - 1m3
Actual - 1m³
Concrete supply & transport method : By agitator truck
Time Slump Conc. Temp. Volume No. of
No. Truck No.
Arrival Wait Start Finish (cm) (°C) (m3) Samples

1
2
3
4
5

Total 0 0

Remark:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

 INSPECTION OF FORMWORK COORDINATE & ELEVATION
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

No Quality acceptance type OK NOT OK

1 No debris and standing water
2 Is the formwork coated with release agent?
3 Template size qualified
4 Template material quality
5 Formwork installation quality
6 Whether the template is damaged
7 The seams of the formwork are tight
8 Reserved hole position
9 Formwork flatness and pre-camber
10 Mixed soil strength at formwork removal

Remark :

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

 INSPECTION FOR STEEL BAR
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

No. Quality acceptance type OK NOT OK

1 The appearance quality of the reinforcement
2 Lnspection report number of steel bars
3 The model specification of the steel bar
4 The number and size of steel bars
5 Connection Method
6 Protective Layer Thickness
7 Rebar Spacing
8 Bar Length
9 Welding quality
10 The location and quantity of embedded parts

Remark (Ghi nhận):

Acceptance (Sự chấp thuận): Accepted (chấp thuận): Not accepted (không chấp thuận):

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

 INSPECTION FOR REBAR, FORMWORK AND CONSTRUCTION PREPARATION WORK
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

Item Tolerance/Description
1. Formwork OK NG
Length
Section dimensions
Position in plan view
Straightness
Flat surface
Cleanliness
Chamfer
Supporting/falsework
Overall judgement Accepted Not accepted
2. Reinforcement
Re-bar size, length& lapping
Position
Covering
Spacer
Rigidity of rebar cage
Cleanliness
Starter bars for column
Overall judgement Accepted Not accepted
3. Construction Preparation Work
Concrete batching plant
Concrete transport
Concrete class
Concrete vibrating tamper
Concrete penetrating vibrator
Electricity
Concrete pump
Cement
Sand
Aggregate
Water
Additive
Other
Overall judgement Accepted Not accepted
Remark:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

 INSPECTION FOR SAMPLING OF CONCRETE
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

Number Name Concret Air

Starting Finishin Vehicle Volume Slump
No. of of e Temp. temper- Weather Remark
Time g Time No. (m3) (cm)
Samples Sample < 32º ature (°C)

1
2
3
4
5
6
7
8
9
10

Total

Remark :

Acceptance : Accepted Ö Not accepted

FOR CONTRACTOR
FOR CONSULTANT
CONSTRUCTION MANAGER
CONSTRUCTION TEAM SITE ENGINEER INSPECTOR
Inspector
 INSPECTION FOR CONCRETING OF PILE CAP
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

General Information
Concrete Class C30-(Design Mix Name)
Design Conc. Vol. Actual Conc. Vol. 0.00 m3
Curing method Bags + water
Protection from raining Cover with plastic sheet
Pouring method Pumping car
Concrete mix proportion
W/C (%) Water (L) Cement (kg) Sand (kg) Stone (kg) Additive (mL) Other

Design - 1m3
Concrete supply and transport method : By agitator truck
Time Slump (cm) Conc. Volume No. of
No. Truck No.
Arrival Wait Discharge 1st 2nd Temp.(°C) (m3) Samples

1
2
3
4
5
6
7
8
9
10
11
12

Total 0 0
Remark:

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION MANAGER
CONSTRUCTION TEAM SITE ENGINEER INSPECTOR
Inspector
 INSPECTION OF STRUCTURE COMPLETED
Project Name/Contract No.
Abutment/Pier No: File No:
Location: Weather:
Shop drawing of pile cap: Date:
(Approved on -----/------/-----------)

DESCRIPTION
2. Data
Coordinate 1 2 3 4
of Corner X (North) Y (East) X (North) Y (East) X (North) Y (East) X (North) Y (East)
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion OK OK OK OK
Elevation Location
of Surface 1 2 3 4 5 6 7 8 9
Design (m)
Actual (m)
Difference (mm)
Tolerance (mm)
Conclusion OK OK OK OK OK OK OK OK OK
Dimension Note
L1 L2 W1 W2
Design (m) Horizontal Deviation (Hor. Dev. - A):
Actual (m) A = (DX2+DY2)0.5
Difference (mm) DX: Difference in X direction
Tolerance (mm) -10 mm ≤ DL ≤ +50 mm DY: Difference in Y direction
Conclusion OK OK OK OK
3. Construction Joint between Column & Pile Cap OK NG
Roughening the Construction Joint between Column & Pile Cap Ö
4. Visual shape & Surface Checking Tolerance/Description OK NG
Straightness/Cuvredness - Ö
Flatness of horizontal/vertical surface ± 5 mm Ö
Repair of visual surface defects (cracks, honeycombs, spalls…) - Ö
Position of embedment (drainage pipe, …) - Ö
Overall Judgement Ö Accepted Not accepted
Remarks

Acceptance: Ö Accepted Not accepted

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAFER INSPECTOR
 FOR CONTRACTOR FOR CONSULTANT
NHÀ THẦU TƯ VẤN

CONSTRUCTION Q.C OFFICE PROJECT MANAGER INSPECTOR APPROVED BY

TEAM QUẢN LÝ CHẤT LƯỢNG GIÁM ĐỐC DỰ ÁN GIÁM SÁT VIÊN CHẤP THUẬN BỞI
ĐỘI XÂY DỰNG
NSULTANT
Ư VẤN

APPROVED BY
CHẤP THUẬN BỞI