Annex 17 Form No.

Republic of the Philippines

PHILIPPINE RURAL DEVELOPMENT PROJECT (PRDP)
SUMMARY OF QUALITY CONTROL TEST PERFORMED

as of June 25, 2020

Municipality of: Prosperidad/San Luis Province of: Agusan del Sur Region: Caraga Contract No.
Project Name: CONCRETING OF BUCAC-MARCELINA-MAHAPAG-SAN VICENTE FMR PACKAGE 3: CONCRETING OF SAN VICENTE-MAHAPAG FMR Referrence No. PRDP-IB-RO13-ADS-007-000-000-2015-B-R1
Project Location: Prosperidad-San Luis, Agusan del Sur Period Covered: March 14, 2020 - June 25, 2020

Quantity Date
Lab. No. Item Description Station Represented Date Tested Kind of Test Test Result Spec's Remarks / Recommendation
Represented Sampled

ITEM 311-Portland Cement Coarse Aggregates 1,500 cu.m. 4-Jun-20 4-Jun-20 Quality Test SG = 2.61
Concrete Pavement Absorption = 5.48

CBMMS BONAGUIT-FA311-S1 ITEM 311-Portland Cement Fine Aggregates 75 cu.m. 4-Jun-20 16-Jun-20 Grading Analysis see attached file DPWH Specs Passed
Concrete Pavement

CBMMS BONAGUIT-CA311-S1 ITEM 311-Portland Cement Coarse Aggregate 75 cu.m. 4-Jun-20 16-Jun-20 Grading Analysis see attached file DPWH Specs Passed
Concrete Pavement

Submitted by: Check by: Reviewed by: Approved by: Noted by:

GILBERT SILOT ANA G. TIU VIRGINIA M. URBIZTONDO DEANNA P. FUDALAN RHIDGE L. BERDERA
Material Engineer/ Contractor PPMIU-Resident Engineer PPMIU Engineer PPMIU Head RPCO Rural Infrastructure Specialist

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