appendix b
DESCRIPTION
checklistTRANSCRIPT
APPENDIX BINSPECTION CHECKLIST
2
OTHER REFERENCES
DOCUMENT REF:
SECTION
CONTENTSNODESCRIPTIONPAGE
1Inspection Checklist1
2Drawing Register2
3Instruction Register3
4Submission of Request for Work / Inspection Forms4
5Outside Testing of Materials5
6Materials / Manufactured Material for Used on Site6
7Request for Inspection and Testing7
8Request for Inspection8
9Final Inspection and Test Checklist9
10Project Handover Form10
11Project Filing Index11
12PQS Change Form13
13Non-conformances Report14
14Corrective Action Request15
15Log :Non-Conformance16
16Log : Corrective Action17
17Form IA :Complaint/Routine Inspection Form (Rd. Maint.)18
18Form 1B :Remedial Action Request Form (Rd. Maint.)19
19Form IC :Project Record (Rd. Maint.)20
20Form 2A :Accident Report Form21
21Form 2B :Remedial Action Request (Road Accident)22
22Form 2C :Project Record (Road Accident)23
23Checklist :Receiving Items - Materials & Equipment24
24Checklist :Earthworks - Site Clearing25
25Checklist :Earthworks - Replacement of Unsuitable Material26
26Checklist :Earthworks-Sand filling27
27Checklist :Earthworks - Detailed Excavation28
28Checklist :Earthworks - Excavation in Cut29
29Checklist :Earthworks - Trimming to Formation Fill / Cut30
30Checklist :Earthworks - Filing to Form Embankment31
31Checklist :Toe Drain/ Berm/ Interceptor Drains32
32Checklist :Roadside/ Median/ Shoulder Drains33
33Checklist :Cast-in-situ - RC - Inspection of Reinforcement34
34Checklist :Cast-in-situ - RC - Inspection of Formwork35
35Checklist :Cast-in-situ - RC - Pre-Pour & During Pour Check36
36Checklist :Delivery & Discharge Record for Ready Mix37
37Checklist :Conduit Installatioan In Concrete Element38
38Checklist :Load Test for Pile39
39Checklist :Laying of Sub Base - Road Base Wet Mix40
40Checklist :Premix Laying41
41Checklist :Premix Laying (Post Laying)42
42Checklist :Tack/ Prime Coating43
43Checklist :Kerbworks44
44Checklist :Road Diversion (Prior to opening to Traffic)45
45Checklist :Road Diversion (After opening to Traffic)46
46Checklist :Electrofusion Joint Record47
47Checklist :Butt Fusion Joint Record48
48Checklist :Lightning Protection System49
OTHER REFERENCES
DOCUMENT REF :QUALITY CONTROL PLAN
SECTIONTECHNICAL PROCEDURE
INSPECTION CHECKLIST
NOCONSTRUCTION PROCESSREPONSIBILITYREFERENCES
1Inspection ChecklistContractor / RE
2Drawing RegisterContractor / RE
3Instruction RegisterContractor / RE
4Submission of Request for Work / Inspection FormsContractor / RE
5Outside Testing of MaterialsContractor/RE
6Materials / Manufactured Material for Used on SiteContractor / RE
7Request for Inspection and TestingContractor / RE
8Request for InspectionContractor / RE
9Final Inspection and Test ChecklistContractor / RE
10Project Handover FormContractor / RE
11Project Filing IndexContractor / RE
12PQS Change FormContractor / RE
13Non-conformances ReportContractor / RE
14Corrective Action RequestContractor / RE
15Log Non-ConformanceContractor / RE
16Log Corrective ActionContractor / RE
17Form IA :Complaint/Routine Inspection Form (Rd. Maint.)Contractor / RE
18Form 1B :Remedial Action Request Form (Rd. Maint.)Contractor / RE
19Form IC :Project Record (Rd. Maint.)Contractor / RE
20Form 2A :Accident Report FormContractor / RE
21Form 2B :Remedial Action Request (Road Accident)Contractor / RE
22Form 2C :Project Record (Road Accident)Contractor / RE
23Checklist :Receiving Items - Materials & EquipmentContractor / RE
24Checklist :Earthworks - Site ClearingContractor / RE
25Checklist :Earthworks - Replacement of Unsuitable MaterialContractor / RE
26Checklist :Earthworks - Sand fillingContractor / RE
27Checklist :Earthworks - Detailed ExcavationContractor / RE
28Checklist :Earthworks - Excavation in CutContractor / RE
29Checklist :Earthworks - Trimming to Formation Fill / CutContractor / RE
30Checklist :Earthworks - Filing to Form EmbankmentContractor / RE
31Checklist :Toe Drain/ Berm/ Interceptor DrainsContractor / RE
32Checklist :Roadside/ Median/ Shoulder DrainsContractor / RE
33Checklist :Cast-in-situ - RC - Inspection of ReinforcementContractor / RE
34Checklist :Cast-in-situ - RC - Inspection of FormworkContractor / RE
35Checklist :Cast-in-situ - RC - Pre-Pour & During Pour CheckContractor / RE
36Checklist : Delivery & Discharge Record for Ready MixContractor / RE
37Checklist :Conduit Installatioan In Concrete ElementContractor / RE
38Checklist :Load Test for PileContractor / RE
39Checklist :Laying of Sub Base - Road Base Wet MixContractor / RE
40Checklist :Premix LayingContractor / RE
41Checklist :Premix Laying (Post Laying)Contractor / RE
42Checklist :Tack/ Prime CoatingContractor / RE
43Checklist :KerbworksContractor / RE
44Checklist :Road Diversion (Prior to opening to Traffic)Contractor / RE
45Checklist :Road Diversion (After opening to Traffic)Contractor / RE
46Checklist :Electrofusion Joint RecordContractor / RE
47Checklist :Butt Fusion Joint RecordContractor / RE
48Checklist :Lightning Protection SystemContractor / RE
Contract Reference:DRAWINGS REGISTEROTHER REFERENCES:
JOB NO:Received From:
SYNMORE BRIDGE CONSULT
NODESCRIPTIONDRAWING NODATE ISSUEDATE RECEIVEDREVISION NO.SUBMITTED TOSUBMITTED BYRECEIVED FROMRECEIVED BYREMARKS
SYNMORE BRIDGE CONSULTContract Reference:INSTRUCTION REGISTEROTHER REFERENCES:
JOB NO:Received From:
ITEMINSTRUCTION NO.DATEINSTRUCTION DETAILSREMARKS
SUBMISSION OF REQUEST FOR WORK / INSPECTION FORMS
START
REJECTACCEPTLATEAll rejected requests will be returned to Contractor.All late request is can only be submitted through the section Engineers for considerationENDThe C.O.W will scrutinize the requests for missing, incomplete or wrong data, such as date, signature, stamp, etc. He will refer to the parties concerned for correction. After correction, he will then check the numbers of requests given to him against the summary sheet. Only when these requests tally will he sign, date and return the requests together with the summary sheet to the admin clerk for filing purpose.The engineers will comment, date and sign on these requests. The requests are hen sent to the C.O.W for final checking.
After attending to the work requested, the C.O.W. or in certain case may be RE or ARE will comment and sign and date on the requests. These requests are to be returned to Contractor latest by the day after the inspection had been carried out.Resident Engineers will comment on the requests, if any, and will distribute them to the C.O.W., before 5.00 p.m. the same day.Site clerk will check and acknowledge receipts. The request will be handed to the respective Resident Engineer for further action.Contractors must submit their requests for work/ inspection together with a summary sheet for the next day work latest 10.00 a.m./ to RE office for compilation Requests submitted after 10.00 a.m. are considered as late requests.
OUTSIDE TESTING OF MATERIALS
START
The samplings of the materials to be tested are to be carried out jointly. The samples are prepared to the required sizes and quantities
The samples are then marked, identified and kept by the Consultant when these samples cannot be sent immediately for outside testing.
The samples are sent to the outside labs under the supervision of the Consultant.
The Consultant will issue letter of non compliance and to reject the samples. The Contractor may request new samples to be testedIf the outside labs permit supervision, Consultant staff will stay to witness the samples testing. If the labs do not permit supervision, the Consultant staff must personally hand over the samples to the testing labs.
Either case, the result of the testing are to be sent directly to the Consultant site office. All other results are considered not acceptable.
The Consultant will check the result aqaint the drawings and specification for compliance.
Not Comply
If the results of the test comply with the drawings and specification, the Consultant will issue letter of acceptance for these materials to be used for the project.
END
MATERIAL/MANUFACTURED MATERIAL FOR USED ON SITE
START
Contractor submit specific manufactured materials on : Sample, Technical Brochures, Method Statement, etc.
CRE check specification requirement: ISO, SIRIM, CERTIFICATE, etc.
Contractor submit to SBC Request for Inspection / Sampling for testing. Visit to factory to carry out :-1. Check on production as per technical brochure2. Testing of the product for compliance to be Specification3. QA/QC
FAILTesting on Consultant Lab / Outside lab.
To write letter to reject materials and to ensure materials removed from site.CRE approval on the mentioned materials.
Contractor ordering materials / material delivery.
NORE check materials for compliance : e.g. thickness, diameter, type, condition.
OK
Material can be used on site
END
SYNMORE BRIDGE CONSULT
Contract Reference :REQUEST FOR INSPECTION & TESTINGOther References:
TO :Resident EngineerATTN :The following works/ test are ready for inspection / will be conductedat (time) on (date)
DESCRIPTION OF WORKS
Location:
Scope of Work:Sketches (if required)
(Note) : Where required, include details of materials, labour, and plant/ equipment to be used)
Submitted by : ContractorSignature:Name:Time / Date: Received by : Synmore Bridge Consult Signature: Name: Time / Date:
c.c1324
INSPECTION / TEST PROCEDURE
Inspection / Test acceptable / passed. Works are allowed to proceed.Remedial works listed below to be completed but no further inspection required.Remedial works listed below to be completed and re-inspection required.
Signature : .(SBC)Date : .
SYNMORE BRIDGE CONSULT
From :Project ManagerTo:Resident EngineerREQUEST FOR INSPECTION
Following works are / will be ready for inspection at . (time) on ..(date)Work is intended to commence at . (time) ... On (date) (24 hours notice must be given)Description of worksLocation: * see note: : : : : :
*note: include details of materials, labour and plant, and number of delivery trucks to be used.This request was received by : at .. (time) on. (date) (signature) Inspected by : ..on .. at....
Engineer's Comments1. Delete as inapplicablea. Inspection passed. The Contractor as allowed to proceed with the works.b. Remedial works listed below to be completed and re-inspection is required afterward.c. Remedial works listed below to be completed but no further inspection required.
Contractor's Representative
. on .. at . Engineer's Representative
on .. at
SYNMORE BRIDGE CONSULT
Contract Reference :FINAL INSPECTION AND TEST CHECKLISTOther References:
Location: Job No : . Date : ..Subcontractor: ...
NOITEMS TO BE CHECKEDACCEPTABILITYREMARKS
YESNO
Comments :
Contractor's Representative
Signature : .
Name : . Synmore Bridge Consult
Signature : .
Name : .
SYNMORE BRIDGE CONSULT
PROJECT HANDOVER FORMContract Reference :
LocationSectionOther References:Date :
CERTIFICATION
HANDOVER : PARTIAL / FULL COMPLETION
The followings components and works of project have been jointly inspected and handed-over to . subject to the remarks / and or work instruction below ( if any )
EARTHWORKS
RESERVOIR
PIPELAYING
DRAINAGE WORKS
LANDSCAPING
BOOSTER STATION
EARTHWORKS
SCADA
M & E SERVICES
REMARKS / INSTRUCTION
( if none, please state ) Attachments : Yes / No
VERIFICATION
For SYNMORE BRIDGE CONSULT
Signature : Name : Designation :
For
Signature : Name : Designation :
SYNMORE BRIDGE CONSULTOTHER REFERENCES
DOCUMENT REF :QUALITY CONTROL PLAN
SECTIONTECHNICAL PROCEDURE
PROJECT FILING INDEX
CATEGORYDESCRIPTIONCODE
1. CorrespondenceJBA IncomingSBC IncomingSBC OutgoingGeneral - Incoming General - Outgoing Utilities Incoming Utilities Outgoing1. Majlis Perbandaran2. TNB3. JKR4. KPLB5. JABATAN PERHUTANAN6. LLM7. Land MatterCP - 1.1CP - 1.2 CP - 1.3CP - 1.4CP - 1.5CP - 1.6CP - 1.7CP - 1.7.1CP - 1.7.2CP - 1.7.3CP - 1.7.4CP - 1.7.5CP - 1.7.6CP - 1.7.7
2. ContractsContract Document Progress Claim Variation Order Contractual ClaimCT - 2.1CT - 2.2CT - 2.3CT - 2.4
3. Project Admit)Site DiaryRequest For InspectionQC FormNCR FormCAR FormSite InstructionShop DrawingMemoMethod StatementEmployee FileStationary / Office EquipmentOvertimePetty Cash ClaimDiesel RecordPA - 3.1 PA - 3.2 PA - 3.3 PA - 3.4 PA - 3.5 PA - 3.6 PA - 3.7 PA - 3.8 PA - 3.9 PA - 3.10 PA - 3.11 PA - 3.12 PA - 3.13 PA - 3.14
4. Meeting & ReportsLaporan Kemajuan Bulanan Ringkasan Kemajuan Bulanan Laporan Kemajuan (Mesyuarat Tapak) Minutes of Site Meeting Site Coordination Meeting (Utilities) Site Safety & Health Meeting Safety & Health Audit Report Environmental Audit ReportMR 4.1MR 4.2MR 4.3MR 4.4MR 4.5MR 4.6MR 4.7MR 4.8
5. Laboratory & TestingLab. Equipment Survey Equipment Mackintosh Probe Record Air TestConcrete CubeLT - 5.1 LT - 5.2LT - 5.3 LT - 5.4LT - 5.5
ISSUE NO :REVISION NO :DATE : PAGE : 1/2
SYNMORE BRIDGE CONSULTOTHER REFERENCES
DOCUMENT REF :QUALITY CONTROL PLAN
SECTIONTECHNICAL PROCEDURE
PROJECT FILING INDEX
CATEGORYDESCRIPTIONCODE
FDT Test Record (sand / earth) Water SamplingWater Pressure and TightnessLT - 5.6 LT - 5.7LT - 5.8
Preliminary Testing1. Aggregate2. Sand (Concrete / Filing)3. Earth (Compaction Test)4. Trial Mix5. Geotextile6. Mill Certificate Unsuitable Material Weather Chart Rain gauge reading Independent LabLT - 5.9 LT - 5.9.1 LT - 5.9.2 LT - 5.9.3 LT - 5.9.4 LT - 5.9.5 LT - 5.10 LT - 5.11 LT - 5.11 LT - 5.12 LT - 5.13
6. SurveyBoundaryEGLSoil Profile - remove of unsuitableCross - section PlanAs-Built Drawing
R.O.W.SV - 6.1 SV - 6.2 SV - 6.3 SV - 6.4 SV - 6.5
SV - 6.6
7. Health, safety and EnvironmentSafety Equipment Traffic ControlHS - 7.1 HS - 7.2
ISSUE NO :REVISION NO :DATE : PAGE : 1/2
SYNMORE BRIDGE CONSULT
Contract Reference :PQS CHANGE FORMOther References:
DOCUMENT CHANGES
Name of Requestor / Proposer :
Document References No :
Reasons of Change :
Description of Changes :
Attachments : Yes / No
Requested by : Date :
Name & Signature :
VERIFICATION
Are Changes Acceptable? : Yes / No
Action / Comments :
Verified by : Date : Resident Engineer
APPROVAL
Are Changes Acceptable? : Yes / No
Remarks :
Approved by : Date : Assistant Resident Engineer
SYNMORE BRIDGE CONSULT
Document Ref :NON-CONFORMANCES REPORTOther References:
SECTION.NON-CONFORMANCE FROM (Name of the Company).
DATE NCR RAISEDDATE NCR RAISED
EXACT LOCATION LAB OTHER
TYPE OF INSPECTION AND TESTING RECEIVING IN-PROGRESS FINAL
Material Description : ... Supplier : . D/O No : .. P/O No. : ..
DESCRIPTION OF DEFICIENCY
....... Reported by Originator Date
Received By : . Date : Proposed Depositiion to be submitted by this Date : ..
PROPOSED DIPOSITION
Use-As-Is Rework Repair Removal Replace Reject / Scrap
Return to Supplier
Approved disposition shall . .. .. . be completed by this DATE : . Prepared By Date Approved By Date
PROPOSED DISPOSITIONCOMPLETED Acceptable Not Acceptable
. Comments Reviewed By Date
Verified and Closed Out By . Date :
SYNMORE BRIDGE CONSULT
Document Ref :CORRECTIVE ACTION REQUESTOther References:
SECTION.NON-CONFORMANCE FROM (Name of the Company).
DATE NCR RAISEDDATE NCR RAISED
EXACT LOCATION REFER NCE NO :
CORRECTIVE ACTION REQUEST
Investigation : Attachments : Yes / No
Corrective Action : Attachments : Yes / No
Signature of QA / QC Coordinator : Date :
VERIFICATION / FOLLOW UP CAR Closing Date :
Is Implementation Yes / No Verified :
Signature : Signature : Reporter Chief Resident Engineer
Job No :NON-CONFORMATION LOGPage of
SYNMORE BRIDGE CONSULT
NCR NO.ISSUED TODATE ISSUEDCLOSED-OUT DATEFOLLOW-UP DATEACTION/DESPOSITIONREMARKS/COMMENTSSIGNATURE
SYNMORE BRIDGE CONSULT
Job No :NON-CONFORMATION LOGPage of
CAR NO.ISSUED TODATE ISSUEDCLOSED-OUT DATEFOLLOW-UP DATECORRECTIVE ACTION BYREMARKS/COMMENTSSIGNATURE
SYNMORE BRIDGE CONSULT
FORM : 1A Report No :Contract Reference :
COMPLAINT / ROUTINE INSPECTION FORMOther References:
1. LOCATION* Please mark and attach herewith the related existing road layout sketch
2. TYPE OF DAMAGETo be filled by complainer / SO
SIGNED BY :
. COMPLAINER / S.O.
NAME : DATE :
SYNMORE BRIDGE CONSULT
FORM : 1B Report No :Contract Reference :
REMEDIAL ACTION REQUEST FORMOther References:
1. REMEDIAL ACTION
DESCRIPTION OF REMIDIAL TO BE CARRIED OUT :
DATE REMEDIAL WORKS EXPECTED TO BE COMPLETED : ______________________________________
SIGNED BY :
_________________________ DATE : ____________________ S.O.
DESCRIPTION OF ITEM USED DURING REMEDIAL WORKS *. NOITEMQUANTITYAMOUNT (RM)
1MATERIAL
2MACHINERY
3MANPOWER
4OTHER
TOTAL (RM)
2. MANAGEMENT FOLLOW UP AND COMMENT
TITLE AND SIGNATURECOMMENTSDATE
Clerk of Works
Resident Engineer
Assistant Resident Engineer
SYNMORE BRIDGE CONSULT
FORM : 1CPROJECT RECORDOther References:
DATEREPORT NODESCRIPTIONRECEIVED FROMRECEIVED BYREMARKS
SYNMORE BRIDGE CONSULT
FORM : 2A Report No :Contract Reference :
ACCIDENT REPORT FORMOther References:
LOCATION : _____________________ AREA : ___________________________ DATE : ___________________
1. DETAILS OF PERSON
SURNAME :
GIVE NAME :
OCCUPATION :
EMPLOYER :NATURE OF INJURY AND ON SITE TREATMENT GIVEN :
TIME INTO SHIFT :
2. DETAILS OF PROPERTIES/EQUIPMENT DAMAGES AND ENVIRONMENTAL CONCERNS
PROPERTIES/EQUIPMENT DAMAGED
NATURE OF DAMAGE
ENVIRONMENTAL CONCERNS
3. DESCRIPTION OF INCIDENT
FULL DESCRIPTION OF INCIDENT/NEAR MISS (PROVIDE SKETCH/PHOOGRAPHS AS NECESSARY)
4. LOSS PRODUCTION (include all person involved)
INCIDENT CAEGORYLT1FACMTCPDFCNM
DAYHOURS MINS
HOURS
5. EVALUATION
POTENTIAL FOR SERIOUS HARM / DAMAGEPROBABLE REOCCURRENCE RATEHAS SIMILAR EVENT OCCURRED BEFORE?
HIGH
MEDIUMLOWFREQUENTOCCASIONALRAREYESNO
SYNMORE BRIDGE CONSULT
FORM : 2B Report No :Contract Reference :
REMEDIAL ACTION REQUEST (ROAD ACCIDENTS)Other References:
LOCATION : _____________________ DATE : ___________________________ TIME : ___________________
IN ATTENDANCE : NO. OF PAGES : ____________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
ITEMDISCUSSIONACTION BYDATE
COMMENTS :
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
DISTRIBUTION-DATE-RECEIVED
INITIALDATEINITIALDATEINITIALDATEINITIALDATE
SYNMORE BRIDGE CONSULT
FORM : 2CPROJECT RECORD (ROAD ACCIDENT)Other References:
DATEREPORT NODESCRIPTIONRECEIVED FROMRECEIVED BYREMARKS
SYNMORE BRIDGE CONSULT
QUALITY CONTROL - INSPECTION CHECKLIST
RECEIVING ITEMS - MATERIALS AND EQUIPMENT
CONSTRUCTION PROCESS : IN-COMING INSPECTION DELIVERED BY OTHER MATERIAL AND EQUIPMENTDocument No. :Serial No. :Received By :Date : Time : ..............
Delivery Location : ..............
Name of the Supplier:
Type of the Material / Equipment:
D/O Number:
Delivery Date and Time:
ItemNature of InspectionInspected By (name in block letters)
I QUANTITY
2DIMENSION / SIZE
3CONDITION OF DELIVERED MATERIAL/EQUIPMENT
4DESCRIPTION OF ANY DAMAGES / IMPERFECTIONYes No
5MATERIAL/EQUIPMENT REJECTED
6MATERIAL SEND BACK TO SUPPLIERYes No
7 NON-CONFORMING MATERIAL PROPERLY Yes No
MARKED/SECURED IF LEFT ON SITE
Non-Conformance Report raised during inspection/re-inspectionYes No
Signature of Contractor. Full Name in block letters:
Synmore Bridge Consult. Full Name in block letters : ..
SYNMORE BRIDGE CONSULT
QUALITY CONTROL INSPECTION CHECKLIST
CONSTRUCTION PROCESS : EARTHWORKS______ SITE CLEARINGDocument No. :Serial No. :Received By :Date : Time : ..............
Location : ......................................................
ItemInspection AttributesContractors Rep.Consultant Rep.
1SURVEY (Name in block letter)
PassFaila
Pass
a Survey alignmentb
b Centre linec
c R.O.W setting outd
d Identifying R.O.W markerse
e Other
f Final Inspection for this item
2CHECK FOR EXISTING SERVICES (Name in block letter)
PassFaila
Pass
a TNB Cableb
b Telecom cablec
c Water pipe linesd
d Other services
e Final inspection for this item
Reason for failure or Re-inspection . . . .Non-conformance Report raised during inspection / re-inspection Yes NoNCR NO
Signature of Contractor : . Date : Time : ..Full Name in block letters : . Date : Time : ..
Synmore Bridge Consult : .. Date : Time : ..Full Name in block letters : .. Date : Time : ..
SYNMORE BRIDGE CONSULT
QUALITY CONTROL INSPECTION CHECKLIST
CONSTRUCTION PROCESS : EARTHWORKS______ REPLACEMENT OF UNSUITABLE MATERIALDocument No. :Serial No. :Received By :Date : Time : ..............
Location : ......................................................
ItemInspection AttributesContractors Rep.Consultant Rep.
1REPLACEMENT OF UNSUITABLE MATERIAL (Name in block letter)
Pass Faila
PassFail
a Location and extend of the pegged outb
b Cross-section survey carried outc
c Location of the spoil tips/dump site determinedd
d Replacement material from approved sourcee
e Excavation cleaned from all unsuitable materialgf
f Level survey of excavation done before replacement filling
g Each layer of replacement material is checked and testedh
h Other
Reason for failure or Re-inspection . . . . . . . . . .Non-conformance Report raised during inspection / re-inspection Yes NoNCR NO
Signature of Contractor : . Date : Time : ..Full Name in block letters : . Date : Time : ..
Synmore Bridge Consult : .. Date : Time : ..Full Name in block letters : .. Date : Time : ..
SYNMORE BRIDGE CONSULT
QUALITY CONTROL INSPECTION CHECKLIST
CONSTRUCTION PROCESS : EARTHWORKS______ SAND FILLING
Document No. :Serial No. :Received By :Date : Time : ..............
Location : ......................................................
ItemInspection AttributesContractors Rep.Consultant Rep.
1FILLING (Name in block letter)
Pass Faila
PassFail
a Sand material sampled, tested and approved prior to fillingb
b Site clearing completedc
c Cross-section survey of OGL before start fillingd
d Install centre line and toe pegse
e Sand material from approved sourcef
f Other
Reason for failure or Re-inspection . . . . . . . . . .Non-conformance Report raised during inspection / re-inspection Yes NoNCR NO
Signature of Contractor : . Date : Time : ..Full Name in block letters : . Date : Time : ..
Synmore Bridge Consult : .. Date : Time : ..Full Name in block letters : .. Date : Time : ..
SYNMORE BRIDGE CONSULT
QUALITY CONTROL INSPECTION CHECKLIST
CONSTRUCTION PROCESS : EARTHWORKS______ DETAILED EXCAVATIONDocument No. :Serial No. :Received By :Date : Time : ..............
Location : ......................................................
ItemInspection AttributesContractors Rep.Consultant Rep.
1SETTING OUT (Name in block letter)
Pass Faila
Pass Fail
a Plan set-outb
b Profile c
c Fails and gradesd
d Clearance from building and boundariese
e Other .f
f Final Inspection for this item
2EROSION CONTROL & SITE VISIT (Name in block letter)
PassFaila
PassFail
a Facilities to clean vehicles, plant and equipmentb
b Temporary construction exit for vehiclesc
c Silt trapd
d Diversion and dispersal of concentrated flowse
e Temporary dataf
f Others .g
g Final inspection for this item
Reason for failure or Re-inspection . .Non-conformance Report raised during inspection / re-inspection Yes NoNCR NO
Signature of Contractor : . Date : Time : ..Full Name in block letters : . Date : Time : ..
Synmore Bridge Consult : .. Date : Time : ..Full Name in block letters : .. Date : Time : ..