FORMAT NO.

; CV-500

INSPECTION /TEST REORT PROJECT NO.: 6648

EARTH / ROAD WORKS AFI No.:

REPORT NO.:
DATE:

Project / No, : Item :

Location : Subcon. Name :

DWG No. : (Rev.No.) :

A. Description & Location :

Specification Check
B. Item to be Checked Date
standard Sat. Unsat.

1. Material for backfill are suitable and approved

2. SUB-GRADE
- Excavation / Formation Level
- Visual Inspection
- Compaction test / Results

3. SUB-BASE COURSE
- Backfill / Formation level
- Visual Inspection
- Compaction test / Results

4. BASE COURSE
- Backfill / Formation Level
- Visual Inspection
- Compaction test / Results

5. SURFACE COURSE
- Asphalt finish Level
- Dimension check

6. Surface & Cleaning Condition

NAME / SIGNATURE DATE REMARKS

SUBCONTRACTOR
CONTRACTOR
OWNER
REV 0
SAMSUNG ENGINEERING CO., LTD.