Inspection Report

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QUALITY MANAGEMENT SYSTEM

FIELD INSPECTION REPORT


Dok. No.: FM-29-PDA-2023 Doc Ref. : FM-PDA-CIVIL Rev No.: 1 Effective Date: June 07, 2023
BEFORE PLACING CONCRETE
NAMA PROYEK Inspection: Concrete Quality:

DATE
:
Project Name Plan: VOL. Plan:
Replacement Grating to Concrete Cover Drainage At Realization: Slump:
Additional Gypsum Bunker & Gypsum Bunker PENGECORAN
PILE CAP TIE BIEM PRECAST
BEAM WALL CHANNEL
PLATE COLUMN OTHER: ……........

No. Rincian Inspeksi Spesifikasi Pengecekan Lapangan Catatan


No. Inspection Details Specification A Field Check Remarks
A FORMWORK
1 Size & Dimension Shop Drawing Accepted Rejected
2 Firmness/Strength Accepted Rejected
3 Formwork Oil Accepted Rejected
4 Cleanliness Accepted Rejected
B REINFORCING STEEL
1 Size & Dimension Shop Drawing Accepted Rejected
2 Reinforcement distance Shop Drawing Accepted Rejected
3 Number of reinforcement Shop Drawing Accepted Rejected
4 Connection Accepted Rejected
5 Concrete covers Accepted Rejected
6 Bond Accepted Rejected
7 Neatness, straightness & Cleanliness No lost rust,oil, etc Accepted Rejected

STATUS
Approved Approved With Note Revised and Resubmitted

NOTES

Prepared By: Inspected / Witnessed By: Approved By:

Name: Name: Name:


Position: Position: Position:
Date: Date: Date:

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