CONCRETE POURING

REQUEST
Control No. : Date :
Contract Package: Supplier :
Level :
Location : (Attached Key Plan/s) Batch Plant : (Location)

GENERAL INFORMATION
Batch Wt. (kg/m3)
Type of Structure : _______________ Cement : _________ Admixture
: _______________ Water : _________ Retarder : _______
Reference Drawings : _______________ 3/4” CA : _________ Plasticizer : _______
Reference No. : _______________ 1/2” CA : _________
Concrete Strength : _______________ 3/8” CA : _________ Slump : _______
Max. Size Aggr. : _______________ Fine Aggr. : _________
Transit Mixer Fly Ash. : _________
Capacity : _______________ Silica Fumes : _________

PRE-POURING INSPECTION CHECKLIST

Item for Inspection Concurrence
Contractor ESCA Remarks
1. Lines and Grade
2. Sub-base Preparation /Foundation Fill
3. Gravel Bed
4. Lean Concrete
5. Waterproofing/Water stop
6. Rebars
7. Formworks
8. Electrical/ Auxiliary Embedment/Blockout
9. Mechanical Embedment/Blockout
10. Sanitary/ Plumbing Embedment/Blockout
11. Fire Protection Embedment/Blockout
12. Architectural Embedment/Blockout
13. Structural Embedment/ Blockout
POURING STATISTICS
Scheduled Pouring Date : __________ Actual Pouring Date : _____________
Scheduled Pouring Time : __________ Actual Pouring Time : _____________
Scheduled Completion Time : __________ Actual Completion Time : _____________
Estimated Volume (cu.m.) : __________ Actual Volume (cu.m.) : _____________
(As per plan) (Poured)
Requested by: (To be filled by the Contractor)
QA/QC Officer: Safety Officer:
__________________________ __________________________
Sign over Printed Name/Date Sign over Printed Name/Date

Inspected by: Approved Disapproved Approved with

Comments
Comments:
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
__
Safety Officer: (Contractor) Safety Officer: (ESCA)
__________________________ __________________________
Sign over Printed Name/Date Sign over Printed Name/Date

Approved by: (To be filled up by ESCA)

Construction Project Engineer: Construction Project Manager:
__________________________ __________________________
Sign over Printed Name/Date Sign over Printed Name/Date
Note: Request of inspection must be performed after 24hours upon requisition

F-PMD-001
Rev.2;12/15/19