appendix b

39
APPENDIX B INSPECTION CHECKLIST

Upload: eqa-amir

Post on 09-Nov-2015

220 views

Category:

Documents


0 download

DESCRIPTION

checklist

TRANSCRIPT

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 : ..