NO: INSPECTION REQUEST FORM FOR ASPHALTIC PREMIX Unless otherwise approved,this inspection request form shall be submitted

during the daily morning meeting among LTA,Contractor and QP(S) Contractor: Project: ER296-CONSTRUCTION AND COMPLECTION OF SENTOSA SAMWOH CORPORATION PTE LTD SK E&C

GATEWAY TUNNEL FROM TELOK BLANGAH ROAD TO KEPPEL ROAD / KAMPONG BAHRU ROAD/ LOWER DELTA ROAD AND ASSOCIATED ROAD WIDENING WORKS INTERCHANGE

To: LTA

Date: Time:

The work described below has been inspected by our Site Engineer and is complete and ready for your inspection. A checklist is attached overleaf. Location Checked and Requested By: Chainage Type of asphaltic premix Drawings Used for Construction Other Description Contractor's PM Name & Signature

The Meeting noted that the information provided by the Contractor is adequate/not adequate* QP(S) may proceed *delete where appropriate Request Rejected

INITIAL INSPECTION DECISION BY QP(S)

We have inspected the above referenced works and found them acceptable. You may proceed. However, please return the completed checklist upon completion of the remaining work. You cannot proceed. Please carry out corrective works as noted on the checklist and submit a fresh request for inspection. Other comments:

RTO/RE Name & Signature/ Date

FINAL INSPECTION DECISION BY QP(S)

___________________________________ QP(S) Name & Signature/Date work approved to start:___________________ LTA The above process for request for inspection of work by Contractor and approval by QP(S) is noted. _____________________________________ LTA's Representative/Date/Time work completed on:__________________________

CHECKLIST FOR ASPHALTIC PREMIX

Date/Time:
S/No 1 2 3 4 5

No.

Location:
Description of Works

Chainage:
Checked by Contractor Confirmed by QP(S)

Check for proper signing Check cleanliness of road surface or graded stone layer Check level of graded stone layer Removing loose stones and blind with quarry dust Machinery requirement: 5.1 Paver (equipped with sensor) 5.2 Tandom roller 5.3 Three-wheelled roller 5.4 Pneumatic roller

6 7 8 9 10 11 12 13 14 15 16 17

Apply tack coat Check temperature of premix Take premix samples at site or at plant Check and endorse on the Delivery Orders Check compaction of premix laid with nuclear density tester Check thickness of premix Ensure critical road lines to be painted Ensure existing manholes to be demarcated Ensure samples properly labelled and kept Send samples for testing Check sufficient temporary traffic devices if lane closure is required Others