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SPECIAL INSPECTION DAILY REPORT

Project Name:
Project Location:
SCO ID #:
Date of Inspection:
Inspector:
Inspector's Company:

SI Company Project No.

Inspection Type(s):
Circle One:

Continuous

Time Inspection Begun:

Periodic
Time Inspection Completed:

Area Inspected:
Describe Inspections Made:

List Tests Performed:

1
2
3

Discrepancies Observed:
1
2
3
4

Discrepancy Notice #
(if applicable)
DN #
DN #
DN #
DN #

Corrections completed while on site:

1
2
3
4
Comments:

To the best of my knowledge, the work inspected was in accordance with the contract documents,
except as noted above.
Inspector's Signature:

(A copy of this report is to remain at job-site. Use additional sheets if necessary.)

Date:

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Contractor's Initials:

(A copy of this report is to remain at job-site. Use additional sheets if necessary.)

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Date:
Project:
Contractor Initials:
Comments (Continued):

(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)

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(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)

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Date:
Project:
Contractor Initials:
Comments (Continued):

(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)

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(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)

Out of Specifications (Y?N)

No. Samples Taken

Admixture Added (Y/N)

Gallons of Water Added

Date :

Material Temperature

Air Percentage (%)

Final Slump

Initial Slump

No. Drum Revolutions

Elapsed Time

260 Town Hall Drive, Suite C

Morrisville, NC 27560
P: (919) 380-8750
F: (919) 380-8752

Final Placement Time

Arrival Time

Batch Time

Ticket Number

Total Cubic Yards Delivered

Cubic Yards Carried

Truck No.

Sequence No.

Stewart Engineering, Inc.

Temperature :

Project :

Concrete Mix Design:

Concrete Placement Chart

Placement Location: