Checklist No.
: ARTL/BKRP/C/01 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to km
226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid Annuity
Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR CLEARING & GRUBBING
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the method statement approved ?
Removed and Disposed of Trees, Shrubs, Bushes, stumps, roots,
2
grass, weeds, top organic soil and other rubbish
3 Required excavation carried out
4 Backfilled the excavated pits with suitable material
5 Compacted the backfill material properly
6 Filed Density results are ok
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/02 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR EMBANKMENT / SUBGRADE
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the method statement approved ?
2 Is the material from approved source ?
3 Does the material contain and deleterious content ?
4 Does the material contain over size stones/boulders ?
5 Is the previous layer approved ?
6 Is the layer thickness as per specification ?
7 IS approved machinery used for spreading ?
8 Are the levels within tolerance limit ?
9 Is the field density result satisfactory ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/03 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR GSB / WMM
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the method statement approved ?
2 Is the material from approved source ?
3 Is the material as per approved gradation ?
5 Is the previous layer approved ?
6 Is the layer thickness as per specification ?
7 IS approved machinery used for spreading ?
8 Are adequate level pegs arranged ?
9 Are the levels within tolerance limit ?
10 Is the field density result satisfactory ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/04 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR PRIME COAT / TACK COAT
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the method statement approved ?
2 Is the material from approved source ?
3 Is the surface properly cleaned ?
5 Lab equipment available for spray test ?
6 Is the surface to primed free from moisture ?
7 Is the weather foggy, rainy, dusty or windy ?
8 Is the rate of spraying as per specification ?
9 Is the surface temperature more than 10 o C ?
10 Are proper safety arrangements done ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/05 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR DBM / BC
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the Previous layer approved ?
2 Is the Method Statement approved ?
3 Is the Weather foggy, rainy, dusty or windy ?
4 Is adequate machinery available ?
5 Is thermometer for recording temperature available ?
6 Is the Laying record available ?
7 Any segregation found on surface ?
8 Are the levels within specification limits ?
9 Are the Samples tested at lab found ok ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/06 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR DLC
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the Previous layer approved ?
2 Is the Mix design / Method Statement approved ?
3 Is the Weather foggy, rainy, dusty or windy ?
4 Is adequate machinery available ?
5 Required cubes casted/Specimen taken ?
6 Concrete conveying arrangement found acceptable ?
7 Any segregation found on surface ?
Placing/compaction/finishing/Workmanship for concrete
8
found acceptable ?
9 Are the levels within specification limits ?
10 Samples tested at lab/site are found ok ?
11 Curing arrangements made ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/07 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR PQC
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the Previous layer approved ?
2 Is the Mix design / Method Statement approved ?
3 Is the Weather foggy, rainy, dusty or windy ?
4 Is adequate machinery available ?
5 Required cubes casted/Specimen taken ?
6 Concrete conveying arrangement found acceptable ?
7 Any segregation found on surface ?
Placing/compaction/finishing/Workmanship for concrete
8
found acceptable ?
9 Are the levels within specification limits ?
10 Samples tested at lab/site are found ok ?
11 Curing arrangements made ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/08 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR KERB LAYING
Location : Date :
Layer : RFI No:
S.no Description Yes No
1 Is the Previous layer approved ?
2 Is the Method Statement approved ?
3 Concrete conveying arrangement found acceptable ?
4 Is the alignment found acceptable ?
5 Curing arrangements made ?
6 Is Adequate safety arrangements provided ?
Was a nonconformace / non compliance found ? Yes / No
Description :
Recommended action:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/09 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR REINFORCEMENT
RFI No: Date:
Structure Chainage: Carriageway : LHS / RHS / Both Sides
Type of Structure: Main Carriageway / Service Road
Component of Structure:
S.no Description Yes No
1 Is the grade of reinforcement as per specification & drawing ?
Are reinforcement bars free from rust,oil,grout,admixtures
2
and fractures ?
3 Is the bar bending schedule approved ?
4 Are the rebars tied as per bending schedule ?
5 Are main steel bars and secondary bars securely tied ?
6 Is the required cover for reinforcement maintained ?
Does the lapping length meet the required specifications
7
and are the laps are staggered?
Is there adequate spacing provided between
8
reinforcement bars for pouring concrete ?
9 Are safety arrangements adequate ?
Remarks:
Contractor's EPC Contractor/ Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/10 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to
km 226+500 under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid
Annuity Mode (Package – OD-3) (Length 47.500 km)
CLIENT : National Highways Authority of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In Association with ROTRANS
INDEPENDENT ENGINEER
Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CHECKLIST FOR SHUTTERING / FORMWORK
RFI No: Date:
Structure Chainage: Carriageway : LHS / RHS / Both Sides
Type of Structure: Main Carriageway / Service Road
Component of Structure:
S.no Description Yes No
1 Are the work materials in good condition ?
Are the formwork panels smooth,clean and applied with
2
sufficient form oil or stripping agent prior to use ?
3 Is the alignment and location of formwork checked ?
Is the work line, slope and level as per drawing and
4
specification ?
5 Is the work line free from any gaps and spaces between forms ?
6 Are tie bolts used for formworks ?
Is the work structure firm and rigid with firm footing
7
support ?
Is there adequate and satisfactory amount of formwork,
8
temporary supports, shoring, braces and ties ?
Is the formwork capable of withstanding pouring pressure
9
?
10 Has proper access arrangement been provided?
Has the formwork and steel reinforcement been approved
11
prior to pouring of concrete ?
12 Are shear keys provided for next lift of concrete ?
13 Are safety arrangements adequate ?
Remarks:
Contractor's EPC Contractor/Concessionaire's NHAI/Independent Engineer's
Representative Representative Representative
Checklist No. : ARTL/BKRP/C/11 R0
Development of Six Lane Badakumari – Karki Section of NH-130-CD Road from km 179+000 to km 226+500
under Raipur-Visakhapatnam Economics Corridor in the state of Odisha on Hybrid Annuity Mode (Package –
OD-3) (Length 47.500 km)
Client : National
: National Highways
Highways AuthorityAuthority
of India of India
: M/s SA Infrastructure Consultants Pvt. Ltd. In
INDEPENDENT ENGINEER
Association with ROTRANS Infra Projects Pvt.Ltd.
CONCESSIONAIRE : M/s Badakumari Karki Road Private Limited
EPC CONTRACTOR : M/s Adani Road Transport Limited
CONSTRUCTION CONTRACTOR : M/s Wagad Infra Projects Private Limited
CHECK LIST FOR STRUCTURAL CONCRETE
RFI NO. DATE OF ACTIVITY STARTING
CHAINAGE THEORITICAL QUANTITY
TYPE OF STRUCTURE ACTUAL QUANTITY
ELEMENT DETAILS DATE OF ACTIVITY CLOSE
GRADE OF CONCRETE REF.DRAWING NO
CHECKED & FOUND OK
DESCRIPTION REMARKS
YES NO N/A
PCC Top Level
PCC Surface cleaned
Allignment Checked
Centre lines checked
REINFORCEMENT
a) Dia & Shape ( as per BBS )
BEFORE CONCRETING
b) Extra Reinforcement
(Apart from Drawing )
c) Extra Laps ( if any )
d) No.Of Chairs & Length
e) Binding As per specification
f) Cover to Reinforcement
FORMWORK
a) Center lines
b) Shuttering line,Level & Plumb
c) Demoulding agent applied
d) Concrete top level
e) Supports adequecy
EMBEDED ITEMS ( If any )
a) BOLTS
c) INSERTS
Contractors Representative EPC contractor/Concessionaire Representative NHAI/IE Representative
a) Date of Concreting
b) Weather
c) Ambient Temperature
CONCRETING
d) Mix grade
e) Vibrator & needle
f) Slump
g) Time of concrete start
h) Time of concrete end
i) No. of cubes for sampling
j) Cube identification
Contractors Representative EPC contractor/Concessionaire Representative NHAI/IE Representative
a) De-shutturing on and at time
POST CONCRETING
b) Surface of the structure
c) Plumb within acceptance
e) Repair of
f) Dimensions are
g) Curing method
h) Curing started on & at time
i) Any other observations
Contractors Representative EPC contractor/Concessionaire Representative NHAI/IE Representative
