Concrete: Repair work Inspection Checklist

Tag Description: Tag No.:

P. O. No.: Inspection Classification Area/Unit:

Subcontractor: Subcontractor Owner Turnover System:

Work Package: Company Other Sub – System:

Drawing No. :
Specification No. :
Agreed repair procedure: Yes No N/A
………………………………………………………………………………………………………….…………..
………………………………………………………………………………………………………………….…..

Surface Preparation :
- cut back to solid concrete ……………………………………………………………………………………….
- all loose material removed ……………………………………………………………………………………...

MATERIALS
Bonding Agent:
Manufacturer.……………………………………………………………………………………………………….
Product……………………………………………..Batch No. ………………………………………...…………
Method of mixing ..………………………………..Mix time……………………………………………………..
Method of application………………………………………………………………………………………………

Proprietary Repair Material:

Manufacturer……………………………………………………………………………………………………….
Product….…………………………………………..Batch No. ………………………………………………….
Method of mixing…………………………………..Mix time…………………..………………………………...
Method of application………………………………………………………………………………………………

Application :
- area well soaked (sand/cement repair) ………………………………………………………………………..
- bonding agent applied in accordance with the manufacturer’s recommendations……………………….
- repair material applied in accordance with the manufacturer’s recommendations………………………..
- repair material finished in accordance with the manufacturer’s recommendations………………………

REMARKS:
………………….………………………………………………………………………………………………………………………………………

Company
Name:

Signature:

Date:

C002.doc