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KING'S GROUP

QA / QC INSPECTION REPORT

REQUEST FOR INSPECTION

Project Name: __________________________________________________________ Submission Date:

Location of Inspection: __________________________________________________________

Grid No.s & Level: __________________________________________________________ Check Request No:

Type of Work: __________________________________________________________


Previous NCR # (if any):
Concrete Class & Quantity: __________________________________________________________

Inspection Date / Time:


Inspection related to:

Excavation Re-inforcement Plaster


Backfil Concrete Others (plz specify)
Formwork Block Masonry __________________________

Site Engr. Name: ___________________________________________________________________ Time: ______________________

Date: ___________________________________________________________________ Signature: ______________________

Site Supervisor Name: ___________________________________________________________ Time: ______________________

Date: ___________________________________________________________________ Signature: ______________________

ACTION BY QA / QC ENGINEER AGAINST INSPECTION REQUEST


QA/QC Enigneer Remarks: ________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________
Sign: _______________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________
Date: _______________

Non-Conformity and/or reference to attached Non-Conformity Report (NCR) NCR#: Date: _______________

Accepted Rejected

Date: ______________
QA/QC Manager Signature:
______________________________________________ Time: ______________

Note: QA/QC department no objection doesn't relieve the respected site staff of his responsibilities.

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