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04-Request For Backfilling

This document is a work inspection request form from ABC Construction Corporation for backfilling. It requests inspection of items like approved fill material, soil poisoning, layer thickness, embedments, and test results. The contractor and project supervisor must check off items and sign before the quality control team can approve and the VP of construction operations can note the request.

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Renellie Yruma (Ren)
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101 views1 page

04-Request For Backfilling

This document is a work inspection request form from ABC Construction Corporation for backfilling. It requests inspection of items like approved fill material, soil poisoning, layer thickness, embedments, and test results. The contractor and project supervisor must check off items and sign before the quality control team can approve and the VP of construction operations can note the request.

Uploaded by

Renellie Yruma (Ren)
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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F - ABCD - 43FLBLDG - 04

ABC Construction Corporation


TYPE YOUR PROJECT NAME
Project :

Date Prepared WIRB No.

WORK INSPECTION REQUEST


FOR BACKFILLING

REQUESTED BY : Name/ Designation :


Contractor : Signature :

Note : All signatories should print their name and sign.

AREA (Pls. enclose key plan) GRIDLINE/LOCATION LEVEL STRUCTURE

PREPARED BY CHECKED BY INSPECTED BY


CHECK ITEMS
CONTRACTOR PROJECT SUPERVISOR QC

1.0 Approved Fill

2.0 Soil Poisoning

3.0 Layer Thickness

4.0 FDT Results Passed

5.0 Embeds

6.0 Electrical

7.0 Mechanical

8.0 Fire Protection

9.0 Plumbing

REMARKS :

CHECKED BY : RECOMMENDING APPROVAL :

PROJECT SUPERVISOR QC

APPROVED BY : NOTED BY:

VP-CONSTRUCTION OPERATIONS

NOTE : This form must be submitted to The QC TEAM, duly accomplished including the work inspection report for the
pre-concreting and signed by the corresponding Contractor's Personnel-in-Charge at least 24 hours before
actual pouring.

Rev. 0 August 27, 2019

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