PRE - CONCRETE INSPECTION CHECK LIST

Concrete Structure/Location : ___________________________________ Equipment/Structural Steel Drawing No. _______________________

Referenced Drawings : ________________________________________ U/G Electrical Drawing No. ________________________________
Concrete Rebar & Embed. Drawings No. __________________________ U/G Mechanical Drawing No. ______________________________

1. Forms 3. Sub-Foundation 5. Misc.

Survey Checked Piles Keyways

Orientation Compaction Blockouts
Location (Coord) Cleanliness Surface Roughened
Size Moisture Bonding Agent
Elevation Blinding Layer Type of Finish
Clean and Oiled Elevation Sets/Test Specimen
Chamfer U/G Mech. & Elect. Hot/Cold Weather Protection
Straight, Level, Plumb Joints
Adequate Bracing Special Placing Equip. Required
(Tremies, Pumps, Form Vibrators Screeds)
1. Re-Bar 4. Embedments Leakage System In Place
Grade Anchor Bolts (Diameter, Length, Type) Finished Slope
Size Anchor Bolts (Location, Projection)
Splices Per Survey Book
Spacing Anchor Bolt Sleeves
Clearance Anchor Bolt Grounding
Cleanliness Thread Projection
Adequate Support Weld Pads
Angle Iron
Inserts
Pipes
Conduits
Ground Wire/Earthing
Water Stop

6. Order Concrete To the Following Specifications:

Mix Design Quantity
Max. Aggregate Size Delivery Per Hour
Slump No. Of Test Cylinders/Set
Admixtures No. Sets Required

Remarks _______________________________________________________________________________________________

Subcontractor TAS PGN

Name : Name : Name :

Signature : Signature : Signature :

Date : Date : Date :

FORM : QA/QC - CV - PCI - 025