APPENDIX B

INSPECTION CHECKLIST

OTHER REFERENCE
DOCUMENT REF:
SECTION
CONTENTS
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3
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DESCRIPTION
Inspection Checklist
Drawing Register
Instruction Register
Submission of Request for Work / Inspection Forms
Outside Testing of Materials
Materials / Manufactured Material for Used on Site
Request for Inspection and Testing
Request for Inspection
Final Inspection and Test Checklist
Project Handover Form
Project Filing Index
PQS Change Form
Non-conformances Report
Corrective Action Request
Log :Non-Conformance
Log : Corrective Action
Form IA : Complaint/Routine Inspection Form (Rd. Maint.)
Form 1B : Remedial Action Request Form (Rd. Maint.)
Form IC : Project Record (Rd. Maint.)
Form 2A : Accident Report Form
Form 2B : Remedial Action Request (Road Accident)
Form 2C : Project Record (Road Accident)
Checklist : Receiving Items - Materials & Equipment
Checklist : Earthworks - Site Clearing
Checklist : Earthworks - Replacement of Unsuitable Material

PAGE
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26
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Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :

Earthworks-Sand filling
Earthworks - Detailed Excavation
Earthworks - Excavation in Cut
Earthworks - Trimming to Formation Fill / Cut
Earthworks - Filing to Form Embankment
Toe Drain/ Berm/ Interceptor Drains
Roadside/ Median/ Shoulder Drains
Cast-in-situ - RC - Inspection of Reinforcement

27
28
29
30
31
32
33
34

34
35
36
37
38
39
40
41

Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :

Cast-in-situ - RC - Inspection of Formwork

Cast-in-situ - RC - Pre-Pour & During Pour Check
Delivery & Discharge Record for Ready Mix
Conduit Installatioan In Concrete Element
Load Test for Pile
Laying of Sub Base - Road Base Wet Mix
Premix Laying
Premix Laying (Post Laying)

35
36
37
38
39
40
41
42

42
43
44
45
46
47
48

Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :
Checklist :

Tack/ Prime Coating

Kerbworks
Road Diversion (Prior to opening to Traffic)
Road Diversion (After opening to Traffic)
Electrofusion Joint Record
Butt Fusion Joint Record
Lightning Protection System

43
44
45
46
47
48
49

OTHER REFERENCES
QUALITY CONTROL PLAN

DOCUMENT REF :
SECTION

NO
1
2
3
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5
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TECHNICAL PROCEDURE
INSPECTION CHECKLIST

CONSTRUCTION PROCESS
Inspection Checklist
Drawing Register
Instruction Register
Submission of Request for Work / Inspection Forms
Outside Testing of Materials
Materials / Manufactured Material for Used on Site
Request for Inspection and Testing
Request for Inspection
Final Inspection and Test Checklist
Project Handover Form
Project Filing Index
PQS Change Form
Non-conformances Report
Corrective Action Request
Log Non-Conformance
Log Corrective Action
Form IA : Complaint/Routine Inspection Form (Rd. Maint.)
Form 1B : Remedial Action Request Form (Rd. Maint.)
Form IC : Project Record (Rd. Maint.)
Form 2A : Accident Report Form
Form 2B : Remedial Action Request (Road Accident)
Form 2C : Project Record (Road Accident)
Checklist : Receiving Items - Materials & Equipment
Checklist : Earthworks - Site Clearing
Checklist : Earthworks - Replacement of Unsuitable Material
Checklist : Earthworks - Sand filling
Checklist : Earthworks - Detailed Excavation
Checklist : Earthworks - Excavation in Cut
Checklist : Earthworks - Trimming to Formation Fill / Cut
Checklist : Earthworks - Filing to Form Embankment
Checklist : Toe Drain/ Berm/ Interceptor Drains
Checklist : Roadside/ Median/ Shoulder Drains
Checklist : Cast-in-situ - RC - Inspection of Reinforcement
Checklist : Cast-in-situ - RC - Inspection of Formwork
Checklist : Cast-in-situ - RC - Pre-Pour & During Pour Check
Checklist : Delivery & Discharge Record for Ready Mix
Checklist : Conduit Installatioan In Concrete Element
Checklist : Load Test for Pile
Checklist : Laying of Sub Base - Road Base Wet Mix
Checklist : Premix Laying
Checklist : Premix Laying (Post Laying)
Checklist : Tack/ Prime Coating
Checklist : Kerbworks
Checklist : Road Diversion (Prior to opening to Traffic)
Checklist : Road Diversion (After opening to Traffic)
Checklist : Electrofusion Joint Record
Checklist : Butt Fusion Joint Record
Checklist : Lightning Protection System

REPONSIBILITY
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor/RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE
Contractor / RE

REFERENCES

Contract Reference:

N
O

DESCRIPTION

DRAWINGS REGISTER
JOB NO:
Received From:
SYNMORE BRIDGE CONSULT

DRAWING
NO

DATE
ISSUE

DATE
RECEIVE
D

REVISION
NO.

SUBMITTE
D TO

SUBMITTE
D BY

R
D

SYNMORE BRIDGE CONSULT

Contract Reference:

ITEM

INSTRUCTION REGISTER
Received From:

JOB NO:

INSTRUCTION NO.

DATE

INSTRUCTION DETAILS

SUBMISSION OF REQUEST FOR WORK / INSPECTION FORMS

START

Contractors must submit their requests for work/ inspection

together with a summary sheet for the next day work latest 10.00
a.m./ to RE office for compilation Requests submitted after
10.00 a.m. are considered as late requests.

Site clerk will check and acknowledge receipts. The request will be
handed to the respective Resident Engineer for further action.

LATE

ACCEPT

All late request is can only be

submitted through the section
Engineers for consideration
REJECT

Resident
Engineers
will comment
on thefor
requests,
if any,
and will
The
C.O.W
will scrutinize
the requests
missing,
incomplete
them
to the
C.O.W.,
before 5.00
p.m.
theHe
same
or distribute
wrong data,
such
as date,
signature,
stamp,
etc.
willday.
refer
to the parties concerned for correction. After correction, he will
then
check the
of requeststhe
given
to him
against
After
attending
to numbers
the work requested,
C.O.W.
or in
certainthe
case
summary
sheet.
Only
when
these
requests
tally
will
he
sign,
may be RE or ARE will comment and sign and date on
thedate
and
the requests
together
with
thesign
summary
sheet
to the
Thereturn
engineers
will comment,
date
and
on these
requests.
requests.
These
requests
are to be
returned
to Contractor
latest
by
admin
clerk
for
filing
purpose.
The requests
are
hen
sent
to
the
C.O.W
for
final
checking.
END had been carried out.
the day after the inspection

All rejected requests will be

returned to Contractor.

OUTSIDE TESTING OF MATERIALS

START

The samplings of the materials to be tested are to be carried out

jointly. The samples are prepared to the required sizes and
quantities

The samples are then marked, identified and kept by the

Consultant when these samples cannot be sent immediately for
outside testing.

The samples are sent to the outside labs under the supervision of
the Consultant.

If the outside labs permit supervision, Consultant staff will stay to

witness the samples testing. If the labs do not permit supervision,
the Consultant staff must personally hand over the samples to the
testing labs.

The Consultant will issue letter of

non compliance and to reject the
samples. The Contractor may
request new samples to be tested

Either case, the result of the testing are to be sent directly to the
Consultant site office. All other results are considered not
acceptable.

The Consultant will check the result aqaint the drawings and
specification for compliance.

Not Comply

If the results of the test comply with the drawings and

specification, the Consultant will issue letter of
acceptance for these materials to be used for the project.

END

MATERIAL/MANUFACTURED MATERIAL FOR USED ON SITE

START

Contractor submit specific manufactured materials on :

Sample, Technical Brochures, Method Statement, etc.

CRE check specification requirement:

ISO, SIRIM, CERTIFICATE, etc.

Contractor submit to SBC Request for Inspection / Sampling for

testing. Visit to factory to carry out :1. Check on production as per technical brochure
2. Testing of the product for compliance to be
Specification
3. QA/QC

Testing on Consultant Lab / Outside lab.

FAIL

To write letter to reject materials

and to ensure materials removed
from site.

CRE approval on the mentioned materials.

Contractor ordering materials / material delivery.

RE check materials for compliance :

e.g. thickness, diameter, type, condition.

NO

OK
Material can be used on site

END

SYNMORE BRIDGE CONSULT

Contract Reference :

TO

ATTN

REQUEST FOR INSPECTION & TESTING

Resident Engineer

The following works/ test are ready for inspection / will be conducted
at .................................................(time) on ........................................(date)

DESCRIPTION OF WORKS
Submitted by :
Location
Contractor

Signature
:.................................
Scope of Work
:
Name

:.................................

Received by :
Synmore Bridge Consult

Signature
: .....................................

Name
:......................................

Sketches (if required)

Time / Date
:.................................
c.c

Time / Date

1
2

: .....................................

3
4

INSPECTION / TEST PROCEDURE

(Note) : Where required, include details of materials, labour, and plant/ equipment to be used)
Inspection / Test acceptable / passed. Works are allowed to proceed.
Remedial works listed below to be completed but no further inspection required.
Remedial works listed below to be completed and re-inspection required.

Signature : .(SBC)

Date : .

SYNMORE BRIDGE CONSULT

From :
To
:

Project Manager
Resident Engineer

REQUEST FOR INSPECTION

Following works are / will be ready for inspection at . (time) on ..(date)

Work is intended to commence at . (time) ... On (date) (24 hours notice must be given)

Description of works
Location
* see note

*note

:
:
:
:
:
:
:
: include details of materials, labour and plant, and number of delivery trucks to be used.

This request was received by : ............................................. at .. (time) on. (date)

.......................................................... (signature)

Inspected by : ..on .. at....

Engineer's Comments
a.
b.
c.

1. Delete as inapplicable
Inspection passed. The Contractor as allowed to proceed with the works.
Remedial works listed below to be completed and re-inspection is required afterward.
Remedial works listed below to be completed but no further inspection required.

Contractor's Representative

Engineer's Representative

.
on .. at .

on .. at

SYNMORE BRIDGE CONSULT

Contract Reference :

FINAL INSPECTION AND TEST CHECKLIST

Other References:

Location

Job No : .
Date : ..

Subcontractor : ....................................................................................
NO

ITEMS TO BE CHECKED

ACCEPTABILITY
YES
NO

REMARKS

Comments :

Contractor's Representative

Synmore Bridge Consult

Signature : .

Signature : .

Name

Name

: .

: .

SYNMORE BRIDGE CONSULT

Contract Reference :

PROJECT HANDOVER FORM

Location
Section

Other References:
Date :
CERTIFICATION
HANDOVER : PARTIAL / FULL COMPLETION

The followings components and works of project have been jointly inspected and handed-over to
. subject to the remarks / and or work instruction below ( if any )

EARTHWORKS

RESERVOIR

PIPELAYING

DRAINAGE WORKS

LANDSCAPING

BOOSTER STATION

EARTHWORKS

SCADA

M & E SERVICES

REMARKS / INSTRUCTION

( if none, please state )

Attachments : Yes / No
VERIFICATION

For SYNMORE BRIDGE CONSULT

For

Signature

Signature

Name

Name

Designation :

Designation :

OTHER REFERENCES

SYNMORE BRIDGE
CONSULT
QUALITY CONTROL PLAN

DOCUMENT REF :
SECTION

TECHNICAL PROCEDURE
PROJECT FILING INDEX

CATEGORY
1. Correspondence

2. Contracts

DESCRIPTION

CODE

JBA Incoming
SBC Incoming
SBC Outgoing
General - Incoming
General - Outgoing
Utilities Incoming
Utilities Outgoing
1.Majlis Perbandaran
2.TNB
3.JKR
4.KPLB
5.JABATAN PERHUTANAN
6.LLM
7.Land Matter
Contract Document
Progress Claim Variation
Order Contractual Claim

3. Project Admit)

Site Diary
Request For Inspection
QC Form
NCR Form
CAR Form
Site Instruction
Shop Drawing
Memo
Method Statement
Employee File
Stationary / Office Equipment
Overtime
Petty Cash Claim

4. Meeting & Reports

Laporan Kemajuan Bulanan Ringkasan

Kemajuan Bulanan Laporan Kemajuan
(Mesyuarat Tapak) Minutes of Site
Meeting Site Coordination Meeting
(Utilities) Site Safety & Health Meeting
Safety & Health Audit Report
Environmental Audit Report

5. Laboratory & Testing

Lab. Equipment Survey

Equipment Mackintosh
Probe Record
Air Test
Concrete Cube

ISSUE NO :

REVISION NO :

DATE :

CP - 1.1
CP - 1.2
CP - 1.3
CP - 1.4
CP - 1.5
CP - 1.6
CP - 1.7
CP - 1.7.1
CP - 1.7.2
CP - 1.7.3
CP - 1.7.4
CP - 1.7.5
CP - 1.7.6
CP - 1.7.7
CT - 2.1
CT - 2.2
CT - 2.3
CT - 2.4
PA - 3.1
PA - 3.2
PA - 3.3
PA - 3.4
PA - 3.5
PA - 3.6
PA - 3.7
PA - 3.8
PA - 3.9
PA - 3.10
PA - 3.11
PA - 3.12
PA - 3.13
PA - 3.14
MR 4.1
MR 4.2
MR 4.3
MR 4.4
MR 4.5
MR 4.6
MR 4.7
MR 4.8
LT - 5.1
LT - 5.2
LT - 5.3
LT - 5.4
LT - 5.5
PAGE : 1/2

OTHER REFERENCES

SYNMORE BRIDGE
CONSULT
QUALITY CONTROL PLAN

DOCUMENT REF :
SECTION

TECHNICAL PROCEDURE
PROJECT FILING INDEX

CATEGORY

CODE

DESCRIPTION
LT - 5.6
LT - 5.7
LT - 5.8
LT - 5.9
LT - 5.9.1
LT - 5.9.2
LT - 5.9.3
LT - 5.9.4
LT - 5.9.5
LT - 5.10
LT - 5.11
LT - 5.11
LT - 5.12
LT - 5.13

FDT Test Record (sand / earth) Water

Sampling
Water Pressure and Tightness
Preliminary Testing
1.Aggregate
2.Sand (Concrete / Filing)
3.Earth (Compaction Test)
4.Trial Mix
5.Geotextile
6. Mill Certificate
Unsuitable Material
Weather Chart
Rain gauge reading
Independent Lab
6. Survey

7.Health, safety and

Environment

ISSUE NO :

Boundary
EGL
Soil Profile - remove of unsuitable
Cross - section Plan
As-Built Drawing

SV - 6.1
SV - 6.2
SV - 6.3
SV - 6.4
SV - 6.5

R.O.W.

SV - 6.6

Safety Equipment
Traffic Control

HS - 7.1
HS - 7.2

REVISION NO :

DATE :

PAGE : 1/2

SYNMORE BRIDGE CONSULT

Contract Reference :

Other References:

PQS CHANGE FORM

DOCUMENT CHANGES

Name of Requestor / Proposer

Document References No

Reasons of Change

Description of Changes

Attachments

Yes / No

Requested by

Name & Signature

Date

Date

VERIFICATION
Are Changes Acceptable?

Action / Comments

Verified by

Yes / No

:
Resident Engineer

APPROVAL
Are Changes Acceptable?

Remarks

Approved by

:
Assistant Resident Engineer

Yes / No

Date

SYNMORE BRIDGE CONSULT

Document Ref :

Other References:

NON-CONFORMANCES REPORT

SECTION

NON-CONFORMANCE FROM (Name of the Company)

.
DATE NCR RAISED
DATE NCR RAISED

OTHER
EXACT LOCATION
LAB
TYPE OF INSPECTION AND TESTING

RECEIVING

IN-PROGRESS

FINAL

Material Description : ... Supplier : . D/O No : .. P/O No. : ..

DESCRIPTION OF DEFICIENCY

.......

Reported by Originator
Received By : . Date :

Date

Proposed Depositiion to be submitted by this Date : ..

PROPOSED DIPOSITION
Use-As-Is

Rework

Repair

Removal

Replace

Reject / Scrap

Return to Supplier

Approved disposition shall

be completed by this DATE :

PROPOSED
DISPOSITION
COMPLETED

Acceptable

Comments
Verified and Closed Out
By

.
Prepared By

..
Date

..
Approved By

.
Date

Not Acceptable

Reviewed By

.
Date

Date :

SYNMORE BRIDGE CONSULT

Document Ref :
SECTION

Other References:

CORRECTIVE ACTION REQUEST

NON-CONFORMANCE FROM (Name of the Company)

.
DATE NCR RAISED
DATE NCR RAISED

REFER NCE NO :
EXACT LOCATION

CORRECTIVE ACTION REQUEST

Investigation :

Attachments :

Yes / No

Corrective Action :

Attachments :

Yes / No

Signature of QA / QC Coordinator :

Date :

VERIFICATION / FOLLOW UP
Is Implementation
Verified :

Signature

CAR Closing Date :

Yes / No

:
Reporter

Signature

:
Chief Resident Engineer

SYNMORE BRIDGE CONSULT

SYNMORE BRIDGE CONSULT
Job No :
NCR NO.

NON-CONFORMATION LOG
ISSUED TO

DATE ISSUED

CLOSED-OUT
DATE

Job No :
CAR NO.

FOLLOW-UP
DATE

ACTION/
DESPOSITION

NON-CONFORMATION LOG
ISSUED TO

DATE ISSUED

CLOSED-OUT
DATE

FOLLOW-UP
DATE

CORRECTIVE
ACTION BY

SYNMORE BRIDGE CONSULT

FORM

1A

Report No :

COMPLAINT / ROUTINE INSPECTION FORM

1.

LOCATION
* Please mark and attach herewith the related existing road layout sketch

2.

TYPE OF DAMAGE
To be filled by complainer / SO

Contract Reference :
Other References:

SIGNED BY :

.
COMPLAINER / S.O.
NAME

DATE

SYNMORE BRIDGE CONSULT

FORM

1B

Report No :
REMEDIAL ACTION REQUEST FORM

1.

Contract Reference :
Other References:

REMEDIAL ACTION
DESCRIPTION OF REMIDIAL TO BE CARRIED OUT :

DATE REMEDIAL WORKS EXPECTED TO BE COMPLETED : ______________________________________

SIGNED BY :

_________________________
S.O.

DATE : ____________________

DESCRIPTION OF ITEM USED DURING REMEDIAL WORKS *.

NO
1
2
3

ITEM
MATERIAL
MACHINERY
MANPOWER

QUANTITY

AMOUNT (RM)

OTHER
TOTAL (RM)

2.

MANAGEMENT FOLLOW UP AND COMMENT

TITLE AND SIGNATURE

COMMENTS

DATE

Clerk of Works
Resident Engineer
Assistant Resident Engineer

SYNMORE BRIDGE CONSULT

FORM : 1C
DATE

PROJECT RECORD
REPORT NO

DESCRIPTION

Other References:

RECEIVED
RECEIVED BY
FROM

REMARKS

SYNMORE BRIDGE CONSULT

FORM

2A

Contract Reference :

Report No :

Other References:

ACCIDENT REPORT FORM

LOCATION : _____________________

AREA : ___________________________

DATE : ___________________

1. DETAILS OF PERSON
SURNAME

GIVE NAME

NATURE OF INJURY AND ON SITE TREATMENT

GIVEN :

OCCUPATION :
TIME INTO SHIFT :
EMPLOYER

2. DETAILS OF PROPERTIES/EQUIPMENT DAMAGES AND ENVIRONMENTAL CONCERNS

PROPERTIES/EQUIPMENT DAMAGED

NATURE OF DAMAGE

ENVIRONMENTAL CONCERNS

3. DESCRIPTION OF INCIDENT
FULL DESCRIPTION OF INCIDENT/NEAR MISS (PROVIDE SKETCH/PHOOGRAPHS AS NECESSARY)

4. LOSS PRODUCTION (include all person involved)

INCIDENT CAEGORY
DAY
HOURS

LT1

FAC

MTC

PD

FC

NM

HOURS
MINS

5. EVALUATION
POTENTIAL FOR SERIOUS HARM /
DAMAGE
HIGH
MEDIUM
LOW

PROBABLE REOCCURRENCE RATE

FREQUEN
T

OCCASIONA
L

RARE

HAS SIMILAR EVENT

OCCURRED BEFORE?
YES
NO

SYNMORE BRIDGE CONSULT

FORM

2B

Contract Reference :

Report No :

Other References:

REMEDIAL ACTION REQUEST (ROAD ACCIDENTS)

LOCATION : _____________________

DATE : ___________________________

IN ATTENDANCE :

TIME : ___________________
NO. OF PAGES : ____________

__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
________________________________________
ITEM

DISCUSSION

ACTION BY

DATE

COMMENTS :
__________________________________________________________________________________________________________
__________
__________________________________________________________________________________________________________
__________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
____________________
DISTRIBUTION-DATE-RECEIVED
INITIAL

DATE

INITIAL

DATE

INITIAL

DATE

INITIAL

DATE

SYNMORE BRIDGE CONSULT

FORM : 2C
DATE

PROJECT RECORD (ROAD ACCIDENT)

REPORT NO

DESCRIPTION

Other References:

RECEIVED
RECEIVED BY
FROM

REMARKS

SYNMORE BRIDGE CONSULT

QUALITY CONTROL - INSPECTION CHECKLIST

RECEIVING ITEMS - MATERIALS AND EQUIPMENT
CONSTRUCTION PROCESS :

IN-COMING INSPECTION
DELIVERED BY OTHER
MATERIAL AND EQUIPMENT

Document No. :
Serial No.
:
Received By
:
Date : ......................

Time : ..............

Delivery Location

: ..............

Name of the Supplier

: ....................................................................

Type of the Material / Equipment

: ....................................................................

D/O Number

: ....................................................................

Delivery Date and Time

: ....................................................................

Item

Nature of Inspection

Inspected By (name in block letters)

QUANTITY

DIMENSION / SIZE

CONDITION OF DELIVERED MATERIAL/EQUIPMENT

DESCRIPTION OF ANY DAMAGES / IMPERFECTION

MATERIAL/EQUIPMENT REJECTED

MATERIAL SEND BACK TO SUPPLIER

NON-CONFORMING MATERIAL PROPERLY

MARKED/SECURED IF LEFT ON SITE

Yes

No

Yes

No

Yes

No

Non-Conformance Report raised during inspection/re-inspection

Signature of Contractor
Full Name in block letters

Yes

No

. ................................................................................
: ................................................................................

Synmore Bridge Consult

. ................................................................................

Full Name in block letters

: ..

SYNMORE BRIDGE CONSULT

QUALITY CONTROL
INSPECTION CHECKLIST
CONSTRUCTION PROCESS :

Document No. :
Serial No.
:
Received By
:
Date : ......................

EARTHWORKS______
SITE CLEARING

Time : ..............

Location : ......................................................
Item
1

Inspection Attributes
SURVEY

Contractors Rep.
(Name in block letter)
Pass

Consultant Rep.

Survey alignment

Fail

Pass
a
b

b
c
d
e
f
2

Centre line
R.O.W setting out
Identifying R.O.W markers
Other
Final Inspection for this item

CHECK FOR EXISTING SERVICES

c
d
e
(Name in block letter)
Pass

Fail

Pass

TNB Cable

Telecom cable

Water pipe lines

Other services

Final inspection for this item

Reason for failure or Re-inspection

.
.
.
.
Non-conformance Report raised during inspection / re-inspection
Yes
No
NCR NO

Signature of Contractor
Full Name in block letters

: .
: .

Date : Time : ..
Date : Time : ..

Synmore Bridge Consult

Full Name in block letters

: ..
: ..

Date : Time : ..
Date : Time : ..

SYNMORE BRIDGE CONSULT

QUALITY CONTROL
INSPECTION CHECKLIST
CONSTRUCTION PROCESS :

Document No. :
Serial No.
:
Received By
:
Date : ......................

EARTHWORKS______
REPLACEMENT OF UNSUITABLE
MATERIAL

Time : ..............

Location : ......................................................
Item
1

Inspection Attributes

Contractors Rep.

REPLACEMENT OF UNSUITABLE MATERIAL (Name in block letter)

Pass

a
b
c
d

Consultant Rep.

Location and extend of the pegged out

Cross-section survey carried out
Location of the spoil tips/dump site determined
Replacement material from approved source

Fail

Pass
a
b
c
d
e

Fail

e
f
g
h

Excavation cleaned from all unsuitable material

Level survey of excavation done before replacement filling
Each layer of replacement material is checked and tested
Other

f
g
h

Reason for failure or Re-inspection

.
.
.
.
.
.
.
.
.
.
Non-conformance Report raised during inspection / re-inspection
Yes
No
NCR NO

Signature of Contractor
Full Name in block letters

: .
: .

Date : Time : ..
Date : Time : ..

Synmore Bridge Consult

Full Name in block letters

: ..
: ..

Date : Time : ..
Date : Time : ..

SYNMORE BRIDGE CONSULT

QUALITY CONTROL
INSPECTION CHECKLIST
CONSTRUCTION PROCESS :

Document No. :
Serial No.
:
Received By
:
Date : ......................

EARTHWORKS______
SAND FILLING

Time : ..............

Location : ......................................................
Item
1

Inspection Attributes
FILLING

Contractors Rep.
(Name in block letter)
Pass

a
b
c
d
e
f

Consultant Rep.

Sand material sampled, tested and approved prior to filling

Site clearing completed
Cross-section survey of OGL before start filling
Install centre line and toe pegs
Sand material from approved source
Other

Fail

Pass
a
b
c
d
e
f

Fail

Reason for failure or Re-inspection

.
.
.
.
.
.
.
.
.
.
Non-conformance Report raised during inspection / re-inspection
Yes
No
NCR NO

Signature of Contractor
Full Name in block letters

: .
: .

Date : Time : ..
Date : Time : ..

Synmore Bridge Consult

Full Name in block letters

: ..
: ..

Date : Time : ..
Date : Time : ..

SYNMORE BRIDGE CONSULT

QUALITY CONTROL
INSPECTION CHECKLIST
CONSTRUCTION PROCESS :

Document No. :
Serial No.
:
Received By
:
Date : ......................

EARTHWORKS______
DETAILED EXCAVATION

Time : ..............

Location : ......................................................
Item
1

Inspection Attributes
SETTING OUT

Contractors Rep.
(Name in block letter)
Pass

a
b
c
d
e
f
2

Consultant Rep.
Fail

Plan set-out
Profile
Fails and grades
Clearance from building and boundaries
Other .
Final Inspection for this item

EROSION CONTROL & SITE VISIT

Pass

Fail

a
b
c
d
e
f

(Name in block letter)

Pass

Pass

Fail
a

Fail

Facilities to clean vehicles, plant and equipment

Temporary construction exit for vehicles

Silt trap

Diversion and dispersal of concentrated flows

Temporary data

Others .

Final inspection for this item

f
g

Reason for failure or Re-inspection

.
.
Non-conformance Report raised during inspection / re-inspection
Yes
No
NCR NO

Signature of Contractor
Full Name in block letters

: .
: .

Date : Time : ..
Date : Time : ..

Synmore Bridge Consult

Full Name in block letters

: ..
: ..

Date : Time : ..
Date : Time : ..