Republic of the Philippines
Province of Oriental Mindoro
MUNICIPALITY OF PINAMALAYAN
CONCRETE POURING PERMIT
Name of Project Rehabilitation Of Road
Location Sitio Burol Brgy. Pambisang Malaki to Brgy. Inclanay – Brgy. Pambisang
Malaki Boundary, Pinamalayan Oriental Mindoro.
Contractor GREEN ISLAND ENTERPRISES
Date of Pouring
Time of Pouring
Estimated Volume (m3)
Requested by:
GREEN ISLAND ENTERPRISES
Contractor’s Name / Signature
CHECKLIST
Concrete Vibrator Field Density Test
Protective Covering Materials Beam Cylinder Molds
Warning Signs/Barricades/Flagmen Curing Materials
Concrete Saw Slump Cone
Concrete Block Spacers Plumbness
Finishing Tools/Equipment (Screeder, broom, Quality Materials Used (Result of Design/Trial
etc.) Mix, Test Reports, etc.)
Line and Grade Alignment (form setting, Lighting System
elevations, etc.)
Required construction equipment Electrical Layout (Roughing-ins/embedments)
Rebars sizes, spacing and number Plumbing Layout (Roughing-ins/embedments)
Rebars installation requirements Falsework/formworks adequacy
Checked by: Date:
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REMARKS / RECOMMENDATIONS
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Request: _____ Approved _____ Disapproved
REMARKS / RECOMMENDATIONS
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ENGR. MANOLITO E. MASCULINO
Municipal Engineer
