Form No. 3-QI-02.

0 CLIENT: CONSULTANT: CONTRACTOR:

INSPECTION REQUEST
(CAST IN-SITU STRUCTURES)

Project No. & Name: Construction & Operate Phase 1 Green Riyadh Nursery project
Description of Work : [ Preparation for Casting / Casting / After Stripping of Forms / Application Date :
of Tanking Membrane /
Location of Work : Protection Coating ] Request No. :
Units to be Inspected :

Inspection Requested by: Request Received by:

Date: Time: Date: Time:

INSPECTION REPORT and CHECK LIST:
Works Ready for Inspection:
Activity Form Work Reinforcement Concreting Fittings & Stripping Curing Coating /
Cages Openings Tanking
Date
Time
*Form Work : *Concreting : *Stripping :
Supports, Beams & Bracings etc Concrete Class & Type Stripping Time
Dimensions Admixture Type & Quantity Stripping System
Straightness Slump Cracks or Damages
Deflection No. of Cubes Taken Surface Finish
Liner / Benching Amb. Temperature / Humidity *Curing: Water/Compound/Steam
Edges & Chamfer Concrete Temperature Condition
Water Tightness Pouring Method Period
Cleanliness Time Between Pours *Coating / Tanking
Release Agent Application Compaction / Vibration System Surface Preparation
*Reinforcement Cages: *Fittings & Openings: Application Method
Epoxy Touch -up Manhole Frames Unrepaired Voids Filling
Bends Conduits/Ducts/Box Outs Maintaining Curing Time
Bar Sizes & Spacing Steel Plates / Bolts Thickness (wet / dry) 
Concrete Cover Water Stops Priming & Tanking
Cage Stability Dowel Bars Placing of Protection Boards
*Make  mark for satisfied conditions and for unsatisfied conditions, make recommendation for rectifications.
Recommended Rectifications / Reason for Withholding / Permission to Proceed is Granted:

Recommended by : Date: Time:

Next Inspection Requested by:

Date: Time:
Second Inspection: Recommended Rectifications / Reason for Withholding / Permission to Proceed is Granted:

Inspected by: Date: Time:

Inspection Report Received by (Contractor) : Date: Time:
[After Permission is granted]

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