DOC NO.

: ANG/IMS/QMS-005

Page 1 of 2
CONCRETE POUR CARD

Project Site: - Pour Card No:

Contractor’s Name & W.O. No: Date of Casting:

Location of work:-

Drawing No. : - Drg. Rev. No. :

Level:-

Concrete Details:
Grade of Concrete: Average Concrete Temperature: ºC
Volume of concrete: Average Ambient Temperature: ºC
Concrete Mix Proportion: W/C Ratio:

Coarse Aggregate Source: Fine Aggregate Brand/Grade of Cement: Brand of

Source: Admixture :
Water
(litre/m3)
10 mm Chips 20 mm Chips Sand Cement Admixture
(kg/m3) (kg/m3) (kg/m3) (Kg/m3) (litre/m3)

Supply of concrete by: Ambuja Neotia/Procured RMC*/Contractor

* Above table need not be filled if supplied by RMC

*In case concrete supplied by RMC, mention the name of the RMC Supplier:
* Mix Design No.

Cement Consumption for Slurry:

Pour Details:
Date of Pour: Weather Condition:

Starting time of Pouring: Method of Pouring:

Closing time of Pouring: Method of Mixing:

No of Cube to be taken:

Average Slump at the time of Concreting:

Extra Reinforcement (if any):

No. of Laps: Dia/Nos of Dowels:

No’s /Dia of Chair Bar: Length of Chair:

Shape of Chair:

Cover Block: (Yes/No)

 DOC NO.: ANG/IMS/QMS-005

Page 2 of 2

Project:

CONCRETE POUR CARD

Check list attached: (Yes/No)

Form work Reinforcement Work Concreting Work

(Yes/No) (Yes/No) (Yes/No)
Ref. Checklist: Ref. Checklist: Ref. Checklist:
ANG/IMS/QMS-006 ANG/IMS/QMS-008 ANG/IMS/QMS-007

Electrical Work

Conduit Placement (if any)

Note: Cube test result to be separately attached with R/A Bills (If concrete issued by contractor) .

EIC (Civil) EIC (Electrical) Contractor’s representative

(As applicable)

Date: Date: Date:

Quality Control Engineer

(As applicable)

Date:

Nomenclature: EIC = Engineer-in-Charge