Annex 15 Form No.

REPUBLIC OF THE PHILIPPINES

PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP) PLGU LOGO

Province of Sultan Kudarat, Region12.

QC Inspection Report (QCIR)

Name of Project Construction of One (1) Unit Sitio Kebeng Barangay Salumping Warehouse with Solar Dryer
Project Location: Sitio Kebeng, Brgy. Salumping, Esperanza, Sultan Kudarat
Contractor: FPJ Construction and Supply Date Prepared: 5/18/2023
Inspection Report No. IRF-008
Contract No. PRDP-IP-RO12-SUK-033-ESP-012-2021-AF2-EU
Construction Activity Inspected
Ref. Pay Description Location Date Time Remarks
Item No.
900(6) Reinforced Concrete (Beam) RB1-(1-2) and (2-3) 5/18/2023 8:00 AM There is honeycombs in RB1-(1-2) and
(2-3).

Findings/Observations
A rough and stony surface appears on both sides of beam concrete near Column-1 of the support. (honeycomb)

Prepared by: Test Conducted?

Yes / No
Signature
Type of Test Needed
Name ELVIE MAE B. MURILLO
Title PPMIU Resident Engineer
Date NCR To be issued Reference NCR No.
/ Yes
Test/Inspection witnessed by No

Signature
Noted by:
Name CRYSTAL GARINO
Signature
Title RPCO/PSO/NPCO
Date Name ARMANDO B. TUERES
Title PPMIU Engineer
Note: See form filling-in instructions Date
Form Filling-in Instructions:

1 Fill out the form by diligently supplying all the required information asked for in this "QC Inspection Report form".

2 The space provided for "Project" shall indicate the specific Project to be inspected.
3 The IRF/Work Request reference number shall be Proj ID No IRF A XXX
Project ID no: = Indicated in the IMA
IRF = Acronym for the Inspection Request Form
A= = Area of Discipline
A= Architectural Works C= Civil Works
E= Electrical Works M= Mechanical Works
P= Plumbing and Sanitary Works S= Structural Works
XXX = is the sequential numbering system of the IRF
4 Under the "Construction Activity Inspected" box, the PPMIU Engineer doing the inspection MUST diligently fill in all
the information required to clearly determine the details of the:
a The "Reference Pay Item No." as per Contract BOQ.
b The detailed "Description" of the 'Reference Pay Item No." which includes the specific activities under
inspection as well as its "Location, "Date", "Time" and "Remarks" in the corresponding spaces provided
herein.
5 The detailed findings made or concluded after the conduct of the inspection shall be indicated in the space provided
for "Findings/Observations".
6 The PPMIU Engineer should indicate the name of any inspectorate team present during the inspection who witness
the activity, after which shall fill out the space provided for the "Test/Inspection Witnessed by".
7 The Inspector shall also indicate in the form whether the "Pay Items" inspected needs to be tested further or not and if
there is indeed a test needed, he/she must specify the particulars of the test needed.
8 If a sort of violation/out of track processes are being carried out by the people inspected, meaning, a "Non-Conformity
Report" should be issued, MUST be also indicated in the space provided so as to inform the PPMIU Head and come
up with the necessary course of action before he/she affix his/her signature.