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CONCRETE POUR RECORD

Pour No. Date :


Site/Location Theoritical Quantity : Actul Quantity :
Chainage/Structure ID Grade of concrete : Mix Code:
Drawing No. Rev :
Concrete
Discharge Time Slump / Flow Concrete in m3 No of Cylinders
Temp Any Other
Sr.no Delivery Ticket No. Time of arrival / Cubes
Cumulative o samples taken
Start Finish mm Quantity C sampled
Quantity

Checked By LI QA/QC Representative Witnessed /Checked By Client's Representative


Signature

Name

Date

Aug 2022 page1of1 I2114-OPR-ITP-FM-003C (00)

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