Quality Management DOC NO.

Fossil Contracting
Form Earthworks Fill
Checklist

REV. NO. 0
EFFECTIVE DATE. 03/04/2014
Project Contract No

Section --------------------------------------------------
Inspection Request No ------------------------------
Chainage -----------------to-------------------------- Drawing No ----------------------------------------
Fill layer No--------------------------------------------
Date -----------------------------------------------------
Items checked Checked by (Initial) Remarks
Foreman Resident Engineer
latest drawing
revision used
material source
sampled and
approved
Survey - Natural
ground / previous
layer recorded
Clear and grub
approved
Previous layer
approved
Fill compaction - No
of roller passes
(……..)
Rock fill
Density test taken
and approved
(attach copy of lab
results)
Survey payment line
measured and
recorded
Formation level

Approved Yes Rejected Yes

No No
Name Signature Date

Contractor Rep ---------------------

-------------------- ----------------
Resident Engineer --------------------
-------------------- ----------------