PileCap

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
Br-IS-PC-05 Inspection for Blinding Concrete placing:
5 4 22/12/2010 Mr. Tuan Mr Xuan
Inspection for Blinding Concrete Elevation
Br-IS-PC-06
6 4 & Dimensions: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
Inspection of Formwork Coordinate &
Br-IS-PC-07
7 4 Elevation: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
Br-IS-PC-08 Inspection for Steel Reinforcement:
8 4 22/12/2010 Mr. Tuan Mr Xuan
Inspection for Rebar, Formwork &
Br-IS-PC-09
9 4 Construction Preparation Work: 22/12/2010 Mr. Tuan Mr Xuan
rev.04
Br-IS-PC-10 Inspection for Sampling of placed Concrete:
10 4 22/12/2010 Mr. Tuan Mr Xuan
Br-IS-PC-11 Inspection for Concreting of Pile Cap:
11 4 22/12/2010 Mr. Tuan Mr Xuan
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
Form Br-IS-PC Revision Record:
14 03/06/2011 Mr. Tuan Mr Xuan
+ List all of the revision details.
file:///conversion/tmp/activity_task_scratch/682507638.xlsRevRecPCap Page 1/24

Br-IS-PC-01 rev.04
TỔNG CÔNG TY ĐẦU TƯ PHÁT TRIỂN ĐƯỜNG CAO TỐC VIỆT NAM - VIET NAM EXPRESSWAY CORP.
BQLDA ĐƯỜNG CAO TỐC HỒ CHÍ MINH - LONG THÀNH - DẦU GIÂY
HỒ CHÍ MINH - LONG THÀNH - DẦU GIÂY EXPRESSWAY PROJECT MANAGEMENT UNIT
Project: NORTH - SOUTH EXPRESSWAY CONSTRUCTION PROJECT Package (Tên gói thầu): 1A
(HO CHI MINH CITY - DAU GIAY SECTION) Station: Km 4+000 - Km 7+500
(Tên dự án: Dự án đường cao tốc Bắc - Nam đoạn TP HCM - Dầu Giây) (Lý trình: Km 4+000 - Km 7+500)
Consultants (TV): CONSORTIUM OF NIPPON KOEI AND TEDIS Contractor (NT): CHINA ROAD AND BRIDGE CORP.
LIST OF ACCEPTANCE MINUTES FOR PILE CAP CONSTRUCTION

Danh muïc nghieäm thu thi coâng Beä moùng
Work Item (Haïng muïc): Pile cap of Pier /Abutment (Beä moùng truï / mố )
Comment
No. Check List Signed Date
(Nhaän
(Soá) (Danh muïc) (Kyù teân) (Ngaøy)
xeùt)
01 List of Acceptance Minutes for Pile Cap construction (Danh muïc nghieäm thu thi coâng Beä moùng)
02 Inspection for Foundation Hole Elevation (Bieân baûn nghieäm thu cao ñoä hoá moùng) OK
03 Inspection for Pile Position, Level & Cut-off (Bieân baûn kieåm tra vò trí, cao ñoä & caét ñaàu coïc) OK
04 Inspection for Sampling of Blinding Concrete (Bieân baûn laáy maãu beâ toâng loùt) OK
05 Inspection for Blinding Concrete Placement (Baùo caùo ñoå beâtoâng loùt) OK
06 Inspection of Formwork Coordinate & Elevation (Bieân baûn kieåm tra toïa ñoä & cao ñoä vaùn khuoân) OK
07 Inspection for Steel Bar (Bieân baûn nghieäm thu coát theùp) OK
08 Inspection for Rebar, Formwork& Const. Preparation (B/baûn n/thu c/theùp, v/khuoân& ch/bò thi cg) OK
09 Inspection for Sampling of Concrete (Bieân baûn laáy maãu beâ toâng) OK
10 Inspection for Concreting of Pile Cap (Bieân baûn kieåm tra ñoå beâtoâng Beä moùng) OK
11 Inspection of Structure completed (Bieân baûn kiểm tra bộ phaän kết caáu hoaøn thaønh) OK
Concrete Compressive Strength Test results (Keát quaû thí nghieäm cöôøng ñoä beâ toâng) OK
Plan of Pile Cap
Remarks:
(Nhaän xeùt)
Acceptance: Ö Accepted Not accepted

(Söï chaáp thuaän) (Chaáp thuaän) (Khoâng chaáp thuaän)
FOR CONTRACTOR
CONTRACTOR FOR CONSULTANT
CONSULTANT
NHÀ THẦU TƯ VẤN
QC Manager Project Manager Structural Engineer Resident Engineer
CONSTRUCTION TEAM Q.C OFFICE PROJECT MANAGER ENGINEER IN APPROVED BY
Date: ĐỘI XÂY DỰNG Date:
QUẢN LÝ CHẤT LƯỢNG Date:
GIÁM ĐỐC DỰ ÁN Date:
CHARGE CHẤPTHUẬN BỞI
KỸ SƯ PHỤ TRÁCH
Br-IS-PC-02 rev.04
INSPECTION FOR FOUNDATION HOLE ELEVATION

Bieân baûn nghieäm thu cao ñoä hoá moùng
Date (d/m/yy- ngaøy,thaùng,naêm) :
Work Item (Haïng muïc) : Elevation of Existing Ground & After-Excavation (Cao ñoä maët ñaát hieän höõu & sau khi ñaøo)
Abutment/Pier (Moá/Truï) : Pier/Abutment ……….
Based on (Caên cöù vaøo): Shop drawing for Pier/Abutment (approved on ………………………)
1. Plan (Hình veõ)
2. Data (Soá lieäu)

Elevation (m) - Point 1 2 3 4 5 6 7 8 9
Existing Actual
Ground Original
After Actual
excavation Design
Difference (m)
Tolerance
Conclusion
Water Level
Length - Width (m) L1 L2 L3 L4 W1 W2 W3 W4

Actual
Bottom of the hole Actual (total)
Design(total)
Difference
Tolerance (Engineer's direction)
Conclusion
Remark:
(Nhaän xeùt)

(Chaáp thuaän) (Chaáp thuaän) (Khoâng chaáp thuaän)
FOR CONTRACTOR
CONSULTANT
Const. Team Surveyor Const. Manger Surveyor
CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR
ĐỘI XÂY DỰNG GIÁM SAT HIỆN TRƯỜNG GIÁM ĐỐC THI CÔNG GIÁM SÁT VIÊN
Br-IS-PC-03 rev.04
INSPECTION FOR PILE POSITION, LEVEL & CUT-OFF

Bieân baûn kieåm tra vò trí, cao ñoä & caét ñaàu coïc
Work Item (Haïng muïc) : Pile position, level & cut-off (Vò trí, cao ñoä & caét ñaàu coïc)
DESCRIPTION (Noäi dung)

2. Position & Level (Vò trí & Cao ñoä)

Pile No. M1R1 M1R2 M1R3
Coordinate &
X (North) Y (East) Z (Level) X (North) Y (East) Z (Level) X (North) Y (East) Z (Level)
Level
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion Ö OK NG OK-NG Ö OK NG OK-NG Ö OK NG OK-NG
Pile No. M1R4 M1R5 M1R6

Coordinate &
X (North) Y (East) Z (Level) X (North) Y (East) Z (Level) X (North) Y (East) Z (Level)
Level
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion Ö OK NG OK-NG Ö OK NG OK-NG Ö OK NG OK-NG
2. Cut-off Quality (Chaát löông caét ñaàu coïc) OK NG

2.a. Removal and cleaning of loose concrete Ö
2.b. Removal and cleaning of harmful material Ö
Note: Horizontal Deviation (Hor. Dev. - A): DX: Difference in X direction
A = (DX2+DY2)0.5 DY: Difference in Y direction
Remark:
(Nhaän xeùt)

(Söï chaáp thuaän) (Chaáp thuaän) (Khoâng chaáp thuaän)
FOR CONTRACTOR
CONSULTANT
Const. Team Surveyor Const. Manager Surveyor
Br-IS-PC-04 rev.04
Project: NORTH - SOUTH EXPRESSWAY CONSTRUCTION PROJECT Package (Gói thầu): 1a
(HO CHI MINH CITY - DAU GIAY SECTION) Station: km 4+000 - km 7+500
Consultants (TV): CONSORTIUM OF NIPPON KOEI AND TEDIS Contractor (Nhà thầu): CHINA ROAD & BRIDGE CORP.
INSPECTION FOR SAMPLING OF BLINDING CONCRETE

BIÊN BẢN KIỂM TRA CÔNG TÁC LẤY MẪU BÊ TÔNG LÓT
Date (d/m/yy-ngày/tháng/năm):
Work Item (Hạng mục): Placing blinding concrete for Pile Cap (Đổ bê tông lót bệ móng)
Abutment/Pier (Mố/Trụ) : Pier/Abutment ……….
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)
Khối Số Nhiệt độ Nhiệt độ
Thời gian Thời gian Biển số xe Độ sụt
Số lượng lượng Tên mẫu BT không khí (Thời tiết) Ghi nhận
bắt đầu kết thúc (cm)
(m3) mẫu thử < 32º (°C)
1
2
3
4
5
6
7
8
9
Total (Cộng) 0 0
Remark (Nhận xét):
Acceptance (Nghiệm thu): Accepted (Chấp thuận)Ö Not accepted (Không chấp thuận)
FOR CONTRACT0R
CONSULTANT
Const. Team Site Engineer Const. Manager Inspector
Br-IS-PC-05 rev.04
INSPECTION FOR BLINDING CONCRETE PLACEMENT

Baùo caùo ñoå beâtoâng loùt
Concreting date (d/m/yy - ngaøy,thaùng,naêm):
Work Item (Haïng muïc): Blinding Concrete for Pile Cap (Beâ toâng loùt cho Beä moùng)
General Information (Thoâng tin chung)
Concrete Class (Caáp beâ toâng) C10-(Mix Design Name)
Design Conc. Vol. (Kh/lg BT thieát keá) ; Actual Conc. Vol. (Kh/lg BT thöïc0.00 m3
Curing method (Phöông phaùp baûo döôõng) Bags + water (Bao boá + töôùi nöôùc)
Protection from raining (Baûo veä khi möa) Cover with plastic sheet (Che phuû baèng baït nhöïa)
Pouring method (Phöông phaùp ñoå) Buckets
Concrete mix proportion (Caáp phoái beâ toâng)
W/C (%) Water (L) Cement (kg)Sand (kg) Stone (kg) Additive (mL) Other
N/XM (%) (Nöôùc (L))(Xi mg (kg))(Caùt (kg)) (Ñaù (kg)) (Phuï gia (mL)) (Khaùc)
Design (Thieát keá) - 1m3
Concrete supply & transport method (Cung caáp & vaän chuyeån beâ toânBy agitator truck (baèng xe chôû beâ toâng)
Time (Thôøi gian) Slump Conc. Temp. Volume No. of
No. Truck No.
Arrival Wait Start Finish (Ñoä suït)(Nhieät ñoä BT)
(Theå tích BT) Samples
(STT) (Soá xe) (Ñeán) (Ñôïi) (Ñoå) (Keát.thuùc) (cm) (°C) (m3) (Soá lg maãu)
1
Total 0 0
Remark:
(Nhaän xeùt)

FOR CONTRACTOR
CONSULTANT
Br-IS-PC-05 rev.04
INSPECTION FOR BLINDING CONCRETE PLACEMENT

Baùo caùo ñoå beâtoâng loùt
Concreting date (d/m/yy - ngaøy,thaùng,naêm):
Work Item (Haïng muïc): Blinding Concrete for Pile Cap (Beâ toâng loùt cho Beä moùng)
Concrete Class (Caáp beâ toâng) C10-(Mix Design Name)
Design Conc. Vol. (Kh/lg BT thieát keá) ; Actual Conc. Vol. (Kh/lg BT thöïc0.00 m3
Pouring method (Phöông phaùp ñoå) Buckets
W/C (%) Water (L) Cement (kg)Sand (kg) Stone (kg) Additive (mL) Other
N/XM (%) (Nöôùc (L))(Xi mg (kg))(Caùt (kg)) (Ñaù (kg)) (Phuï gia (mL)) (Khaùc)
Concrete
ĐỘI supply & transportGIÁM
XÂY DỰNG method (Cung
SAT HIỆN caáp & vaänGIÁM
TRƯỜNG chuyeån
ĐỐCbeâ
THItoânBy
CÔNG agitator truck (baèng xe SÁT
GIÁM chôûVIÊN
beâ toâng)
Time (Thôøi gian) Slump Conc. Temp. Volume No. of
No. Truck No.
Arrival Wait Start Finish (Ñoä suït)(Nhieät ñoä BT)
(STT) (Soá xe) (Ñeán) (Ñôïi) (Ñoå) (Keát.thuùc) (cm) (°C) (m3) (Soá lg maãu)
Br-IS-PC-06 rev.04
INSPECTION OF FORMWORK COORDINATE & ELEVATION

Bieân baûn kieåm tra toïa ñoä & cao ñoä vaùn khuoân
Date(d/m/yy - ngaøy, thaùng, naêm):

Work Item (Haïng muïc): Formwork of Pile Cap (Vaùn khuoân beä moùng )
Plan (Hình veõ)

Top Corner 1T 2T 3T 4T
Coordinate &
X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev)
Level
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion OK OK OK OK OK OK OK OK
Bottom Corner 1B 2B 3B 4B
Coordinate &
X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev) X (North) Y (East) Z (Lev)
Level
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion OK OK OK OK OK OK OK OK
enterline Point 5 6 7 8
Coordinate &
X (North) Y (East) X (North) Y (East) X (North) Y (East) X (North) Y (East)
Level
Design (m)
Actual (m)
Difference (mm)
Hor. Dev. (mm)
Tolerance (mm)
Conclusion OK OK OK OK
Note: Horizontal Deviation (Hor. Dev. - A): DX: Difference in X direction
A = (DX2+DY2)0.5 DY: Difference in Y direction
Remark :
(Nhaän xeùt)

FOR CONTRACTOR
CONSULTANT
Const. Team Surveyor Const. Manager Surveyor
MINISTRY OF TRANSPORT Central Mekong Delta Region Connectivity Project (CMDCP) -
Dự án Kết nối Khu vực Trung tâm Đồng bằng Mê-kông
(CMDRCP)
BỘ GIAO THÔNG VẬN TẢI

Cuu Long Corporation for Investment,
Development and Project Management COMPONENT:
of Infrastructure (CIPM) CONTRACTOR: CRBC - VINACONEX CDM Smith, WSP Finland &
E&C Yooshin Consultant JV
TỔNG CÔNG TY ĐẦU TƯ PHÁT TRIỂN NHÀ THẦU: Tổng Công ty xây dựng Cầu (DDIS) -Liên danh Tư vấn
CONTRACT PACKAGE: CW1B CAO LANH BRIDGE đường Trung Quốc (CRBC) – Công ty
VÀ QUẢN LÝ DỰ ÁN. HẠ TẦNG GIAO Thiết kế, Hỗ trợ Đấu thầu và
GÓI THẦU: CW1B - CẦU DÂY VĂNG CAO LÃNH Cổ phần Đầu tư Xây dựng & Kỹ thuật
THÔNG CỬU LONG (CIPM)
Vinaconex (VINACONEX E&C) Giám sát Thi công (DDIS)
INSPECTION FOR STEEL BAR

BIÊN BẢN KIỂM TRA CỐT THÉP
Date (dd/mm/yy - ng/th/naêm):
Work Item (Haïng muïc): Steel bar for pile cap (Coát theùp beä coïc)
Location (Vò trí) : Pier/Abutment ……….
Number
Dia -meter (mm) Length (mm)
Rebar No Đường kính (mm) Chiều dài (mm) Remark
Số lượng
Cốt thép số Design Actual Design Actual Design Actual Ghi nhận
Thiết kế Thực tế Thiết kế Thực tế Thiết kế Thực tế
Description (Diễn giải) Conclusion (Kết luận)
Reinforcing bars (Cốt thép) OK NOT OK

a/ Size (Kích thước)
b/ Number (Số lượng)
c/ Splicing / Overlap (Nối/độ dài mối nối)
d/ Ties / Rigidity (buộc/cứng chắc)
Remark (Ghi nhận):
Acceptance (Sự chấp thuận): Accepted (chấp thuận): Not accepted (không chấp thuận):
FOR CONTRACTOR FOR CONSULTANT


Br-IS-PC-07 rev.04
INSPECTION FOR REBAR, FORMWORK AND CONSTRUCTION PREPARATION WORK

(Bieân baûn kieåm tra coát theùp, vaùn khuoân vaø coâng taùc chuaån bò thi coâng)
Date (dd/mm/yy - ng/th/naêm):
Work Item (Haïng muïc): Pile Cap (Beä moùng)
Location (Vò trí): Pier/Abutment ……….
Item (Haïng muïc) Tolerance/Description (Dung sai/ Mieâu taû)
1. Formwork (Vaùn khuoân) OK NG
Length (Beà roäng/daøi vaùn khuoân)
Section dimensions (Kích thöôùc maët caêt ngang)
Position in plan view (Vò trí treân maët baèng)
Straightness (Ñoä thaúng)
Flat surface (Ñoä phaúng beà maët)
Cleanliness (Ñoä saïch)
Chamfer (Vaùt goùc)
Supporting/falsework (Choáng ñôõ- Daøn giaùo)
Overall judgement Accepted (Nghieäm thu) Not accepted (Khoâng nghieäm thu)
2. Reinforcement (Coát theùp)
Re-bar size, length& lapping (Ñöôøng kính, chieàu daøi& moái noái)
Position (Vò trí)
Covering (lôùp baûo veä)
Spacer (con keâ)
Rigidity of rebar cage (Ñoä cöùng chaéc loàng theùp)
Cleanliness (Ñoä saïch)
Starter bars for column (Coát theùp chôø thaân truï)
3. Construction Preparation Work (Coâng taùc chuaån bò thi coâng)
Concrete batching plant (Traïm troän beâtoâng)
Concrete transport (Vaän chuyeån beâtoâng)
Concrete class (Caáp cuûa beâtoâng)
Concrete vibrating tamper (Ñaàm rung)
Concrete penetrating vibrator (Ñaàm duøi)
Electricity (Caáp ñieän)
Concrete pump (Bôm beâtoâng)
Cement (Ximaêng)
Sand (Caùt)
Aggregate (Cấp phoái)
Water (Nöôùc)
Additive (Phuï gia)
Other (Khaùc)
Remark:
(Nhaän xeùt):

FOR CONTRACTOR
CONTRACT0R FOR CONSULTANT
CONSULTANT
Br-IS-PC-08 rev.04
Project: NORTH - SOUTH EXPRESSWAY CONSTRUCTION PROJECT Package (Gói thầu): 1a
(HO CHI MINH CITY - DAU GIAY SECTION) Station: km 4+000 - km 7+500
Consultants (TV): CONSORTIUM OF NIPPON KOEI AND TEDIS Contractor (Nhà thầu): CHINA ROAD & BRIDGE CORP.
INSPECTION FOR SAMPLING OF CONCRETE
BIÊN BẢN KIỂM TRA CÔNG TÁC LẤY MẪU BÊ TÔNG
Date (d/m/yy-ngày/tháng/năm):
Work Item (Hạng mục): Concreting of Pile Cap (Đổ bê tông Bệ móng)
Abutment/Pier (Mố/Trụ) : Pier/Abutment ……….
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)
Thời Khối Số Nhiệt độ Nhiệt độ
Thời gian Biển số Tên Độ sụt (Thời
Số gian kết lượng lượng BT không khí Ghi nhận
bắt đầu xe mẫu (cm) tiết)
thúc (m3) mẫu thử < 32º (°C)
1
2
3
4
5
6
7
8
9
10
11
12
Total (Cộng) 0.0 0
Remark (Nhận xét):
Acceptance (Nghiệm thu):Accepted (Chấp thuận) Ö Not accepted (Không chấp thuận)
FOR CONTRACTOR
CONTRACT0R FOR CONSULTANT
CONSULTANT
Const. Team
CONSTRUCTION TEAM
Site Engineer
SITE ENGINEER
Const. Manager
CONSTRUCTION MANAGER Inspector
INSPECTOR
Br-IS-PC-09 rev.04
INSPECTION FOR CONCRETING OF PILE CAP

Bieân baûn kieåm tra ñoå beâtoâng beä moùng
Concreting Date (d/m/yy - ngaøy,thaùng,naêm):

Work Item (Haïng muïc): Concreting of Pile Cap (Ñoå beâ toâng Beä moùng)
Concrete Class (Caáp beâ toâng) C30-(Design Mix Name)
Design Conc. Vol. (Kh/lg BT thieát keá) Actual Conc. Vol. (Kh/lg BT thöïc teá 0.00 m3
Pouring method (Phöông phaùp ñoå) Pumping car (Xe bôm beâ toâng)
W/C (%) Water (L) Cement (kg) Sand (kg) Stone (kg) Additive (mL) Other
N/XM (%) (Nöôùc (L)) (Xi mg (kg)) (Caùt (kg)) (Ñaù (kg))(Phuï gia (mL)) (Khaùc)
Concrete supply and transport method (Cung caáp vaø vaän chuyeån beâ toBy agitator truck (baèng xe chôû beâ toâng)
Time (Thôøi gian) Slump (Ñoä suït) (cm) Conc. Temp. Volume No. of
No. Truck No.
Arrival Wait Discharge 1st 2nd (Nhieät ñoä BT)
(STT) (Soá xe) (Ñeán) (Ñôïi) (Ñoå) Laàn 1 Laàn 2 (°C) (m3) (Soá lg maãu)
1
2
3
4
5
6
7
8
9
10
11
12
Total 0 0
Remark:
(Nhaän xeùt)

FORCONTRACT0R
CONSULTANT
Br-IS-PC-09 rev.04
INSPECTION FOR CONCRETING OF PILE CAP

Bieân baûn kieåm tra ñoå beâtoâng beä moùng
Concreting Date (d/m/yy - ngaøy,thaùng,naêm):

Work Item (Haïng muïc): Concreting of Pile Cap (Ñoå beâ toâng Beä moùng)
Concrete Class (Caáp beâ toâng) C30-(Design Mix Name)
Design Conc. Vol. (Kh/lg BT thieát keá) Actual Conc. Vol. (Kh/lg BT thöïc teá 0.00 m3
Pouring method (Phöông phaùp ñoå) Pumping car (Xe bôm beâ toâng)
W/C (%) Water (L) Cement (kg) Sand (kg) Stone (kg) Additive (mL) Other
N/XM (%) (Nöôùc (L)) (Xi mg (kg)) (Caùt (kg)) (Ñaù (kg))(Phuï gia (mL)) (Khaùc)
DesignĐỘI
(Thieát keá) - 1m3
XÂY DỰNG GIÁM SAT HIỆN TRƯỜNG GIÁM ĐỐC THI CÔNG GIÁM SÁT VIÊN
Concrete supply and transport method (Cung caáp vaø vaän chuyeån beâ toBy agitator truck (baèng xe chôû beâ toâng)
Time (Thôøi gian) Slump (Ñoä suït) (cm) Conc. Temp. Volume No. of
No. Truck No.
Arrival Wait Discharge 1st 2nd (Nhieät ñoä BT)
(STT) (Soá xe) (Ñeán) (Ñôïi) (Ñoå) Laàn 1 Laàn 2 (°C) (m3) (Soá lg maãu)
Br-IS-PC-10 rev.04
INSPECTION OF STRUCTURE COMPLETED

Bieân baûn kieåm tra boä phaän keát caáu ñaõ hoaøn thaønh
Date (dd/mm/yy - ngaøy/thaùng/naêm) :
Work Item (Haïng muïc) : Pile cap (Beä moùng)
Working Drawing No. (B/veõ th/coâng soá) Shop drawing for Pier/Abutment (approved on ………………………)
1. Plan (Maët baèng)

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)
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
3. Construction Joint between Column & Pile Cap (Moái noái thi coâng giöõa Coät vaø Beä moùng) OK NG
Roughening the Construction Joint between Column & Pile Cap Ö
4. Visual shape & Surface Checking (Kieåm tra hình dang & beà maët) Tolerance/Description (Dung sai/Noäi dung) 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 (Chaáp thuaän) Not accepted (Khoâng chaáp thuaän)
Remarks
(Nhaän xeùt)

FOR CONTRACTOR
CONSULTANT
Const. Team Surveyor Const. Manager Inspector Surveyor
Br-IS-PC-13 rev01
COÂNG TY ÑAÀU TÖ PHAÙT TRIEÅN ÑÖÔØNG CAO TOÁC VIEÄT NAM - VIETNAM EXPRESSWAY CORP.
BAN QUAÛN LYÙ DÖÏ AÙN ÑÖÔØNG CAO TOÁC TP HOÀ CHÍ MINH - LONG THAØNH - DAÀU GIAÂY (EPMU HLD)
Project: HCMC - Long Thanh - Dau Giay Expressway Construction Package (Goùi thaàu): 1a
Döï aùn: Xaây döïng ñöôøng cao toác TpHCM - Long Thaønh - Daàu Giaây Station (Lyù trình): Km 4+000 - Km 7+500
Consultant (TVGS): Nippon Koei - TediSouth Contractor (Nhaø thaàu): China Road & Bridge Corp.
INSPECTION OF BACKFILLING
Bieân baûn kieåm tra ñaát laáp hoá moùng
Work Item (Haïng muïc) : Backfilling for Pile Cap (Ñaát laáp hoá moùng)
Abutment/Pier (Moá/Truï) : Abutment A1 (Moá A1)
Base on (Caên cöù vaøo): Shop drawing for Abutment (approved on ………………………)

DAU GIAY
12000
1500 4500 4500 1500
1 2 3
250
250
6500
6500
250
4 5 6 250
1500 4500 4500 1500
HO CHI MINH
Approx. Ele. 0.00m

Visual check for bacfill material
OK NG
Density test of backfilling
Point 1 2 3 4 5 6
At Ele. 0.0m
Remark:
(Nhaän xeùt)
Acceptance: Accepted Not accepted

CONTRACTOR CONSULTANT
Const. Team Survey Engineer Const. Manager Inspector Survey Engineer
FOR CONTRACTOR FOR CONSULTANT
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

PileCap

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

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

file:///conversion/tmp/activity_task_scratch/682507638.xlsRevRecPCap Page 1/24

LIST OF ACCEPTANCE MINUTES FOR PILE CAP CONSTRUCTION

Plan of Pile Cap

Acceptance: Ö Accepted Not accepted

INSPECTION FOR FOUNDATION HOLE ELEVATION

1. Plan (Hình veõ)

2. Data (Soá lieäu)

Length - Width (m) L1 L2 L3 L4 W1 W2 W3 W4

Acceptance: Ö Accepted Not accepted

INSPECTION FOR PILE POSITION, LEVEL & CUT-OFF

DESCRIPTION (Noäi dung)

2. Position & Level (Vò trí & Cao ñoä)

Pile No. M1R4 M1R5 M1R6

2. Cut-off Quality (Chaát löông caét ñaàu coïc) OK NG

Acceptance: Ö Accepted Not accepted

INSPECTION FOR SAMPLING OF BLINDING CONCRETE

Number Concrete Air

Remark (Nhận xét):

INSPECTION FOR BLINDING CONCRETE PLACEMENT

Acceptance: Ö Accepted Not accepted

INSPECTION FOR BLINDING CONCRETE PLACEMENT

INSPECTION OF FORMWORK COORDINATE & ELEVATION

Date(d/m/yy - ngaøy, thaùng, naêm):

2. Data (Soá lieäu)

Acceptance: Ö Accepted Not accepted

BỘ GIAO THÔNG VẬN TẢI

INSPECTION FOR STEEL BAR

Description (Diễn giải) Conclusion (Kết luận)

Reinforcing bars (Cốt thép) OK NOT OK

FOR CONTRACTOR FOR CONSULTANT

CONSTRUCTION TEAM SITE ENGINEER CONSTRUCTION MANAGER INSPECTOR

INSPECTION FOR REBAR, FORMWORK AND CONSTRUCTION PREPARATION WORK

Acceptance: Ö Accepted Not accepted

Number Name Concret Air

Total (Cộng) 0.0 0

Remark (Nhận xét):

INSPECTION FOR CONCRETING OF PILE CAP

Concreting Date (d/m/yy - ngaøy,thaùng,naêm):

Acceptance: Ö Accepted Not accepted

INSPECTION FOR CONCRETING OF PILE CAP

Concreting Date (d/m/yy - ngaøy,thaùng,naêm):

INSPECTION OF STRUCTURE COMPLETED

2. Data (Soá lieäu)

Acceptance: Ö Accepted Not accepted

DESCRIPTION (Noäi dung)

Approx. Ele. 0.00m

Acceptance: Accepted Not accepted

CONSTRUCTION Q.C OFFICE PROJECT MANAGER INSPECTOR APPROVED BY

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