TECHNIP CONSORTIUM

DUNG QUAT REFINERY PROJECT

CONCRETE MIX ORDER AND POURING DOCKET COMBINED
DATE: STARTING TIME: QUANTITY: DESTINATION (AREA): CONSTRUCTION UNIT: DRAWING NO: Form No CONCRETE MIXING ORDER No.................... Subc. No Sheet QCF 008

1 of 1

CONSTRUCTION SUPERVISOR: BATCH PLANT NO.: MIX DESIGN: CONCRETE GRADE: PRODUCTION / FIELD SUPERVISOR:
NAME DATE

SLUMP:

SIGNATURE

PRODUCTION DETAILS
SAND: AGGREGATE TOTAL SAND + AGGREGATE CEMENT: WATER: ADMIXTURE ADMIXTURE TYPE: QUANTITY
...................m3

BATCH PLANT SUPERVISOR:

kg/m3 kg/m3 kg/m3 kg/m3 l/m3 l/m3 kg/0.5m3 kg/0.5m3 kg/0.5m3 kg/0.5m3 l/0.5 m3 l/0.5 m3
SPEEDY TEST % WATER= SPEEDY TEST % WATER= % = LITERS % = LITERS L NO M3

TOTAL WATER IN SAND AND AGGREGATE = FRESH CONCRETE TEST SAMPLES SLUMP REQUIRED ( mm ) MIN MAX No. PER YES

GRADE:
................

1ST DELIVERY TIME

................... AM / PM
NAME DATE SIGNATURE

CONCRETE POUR DETAILS

LORRY NO. TIME IN am/pm TIME OUT am/pm DELIVERY NOTE NO. QUANTITY M3

SITE SUPERVISOR:
SLUMP AIR TEMP. CONCR. TEMP. Cylinder ID no. AREA + STRUCTURE NO.

PLACING METHOD: PUMP CRANE AND BUCKET DIRECT FROM TRUCK OTHER:

TOTAL: COMPACTION METHOD: INTERNAL EXTERNAL BEAM

M3

FRESH CONCRETE TESTS: FRESH CONCRETE DENSITY TEST AIR CONTENT WATER / CEMENT RATIO SIEVE ANALYSIS

Test Report Number : No. No. No. No.

REMARKS :
ACCEPTED REJECTED

WITNESS BY: _____________________________ Name (Subcontractor) WITNESS BY: _____________________________ Name (Contractor) WITNESS BY: _____________________________ Name (Client)

_______________________________ Signed _______________________________ Signed _______________________________ Signed

__________________________ Date __________________________ Date __________________________ Date