CONCRETE INSPECTION FORM

Project Name: Activity Card Reference

Bid#: DATE

Location
From Station
To Station

COMMENTS YES NO
General
Did you attend the Pre-Activity Meeting for this item?
Were you present during the majority of the work?
Pre-Placement
Have all past inspection and testing requirements been completed?
(i.e., base aggregate, subgrade)
Has all placement equipment been checked for operational condition?
(vibrators, screeds, shovels, trowels, laborers)
Is saw-cutting equipment required?
If yes, is it on standby and in operational condition?
Are inspectors and testers scheduled for batch plant and field placement?
Are all materials in place and on hand for construction? (i.e., expansion
joints, etc.)
Is equipment scheduled for saw-cutting joints within the required time frame?
Are approved curing materials on-site and equipment in operational
condition?
Is there any equipment on standby and in operational condition?
Has batch plant inspection been reviewed and are known requirements
being addressed for this concrete placement?
Have on-site concrete placement requirements been reviewed? (i.e., no
water added on-site without permission from Engineer)
Who will fill out logs and inspect concrete placement?
Review what concrete finish is acceptable or not?
Time frame for removal of forms? How repairs will be made if needed?
Review curing of concrete procedure.
Are approved curing materials on-site and is equipment in operational
condition?
During Placement
Is the correct mix design being used?
When concrete is placed, is proper consolidation being performed?
Is batch plant inspection being performed for this concrete placement?
 CONCRETE INSPECTION FORM

Project Name: Activity Card Reference

Bid#: DATE

Location
From Station
To Station

COMMENTS YES NO
Was water added on-site without permission from engineer?
Is proper consolidation being performed?
Is the concrete being finished properly?
Were tests taken?
If NO, did you write the reason on back of this sheet?
Were all temperatures in spec?
Were all slumps in spec?
Did the tester provide field test information in writing?
Is a copy of the results attached?
Were the concrete test specimens protected for the first 24-hour period?

Post-Placement
Is the time frame for removal of forms being complied with?
Are proper curing procedures being used?
Are any repairs required, at this time?
Did special circumstances exist?
List the special circumstances on the back of this sheet

QC INSPECTOR INITIALS
QA Sign-Off COMMENTS YES NO
Did QC complete the checklist accurately?
If NO, was a Deficiency written for improper Checklist?
Give Deficiency Number from log
Did you have to write any other Deficiency?
Give Deficiency Number from log
Do you take exception to allowing the work to progress?

QA INSPECTOR INITIALS
CCPW form QC-504
Rev 08/09 PAGE 2