Concrete Pre-Pour Inspection
Project Information
Project Number
Project Name
Inspection Date
-
Month
-
Day
Year
Date
General Information
Pour Date
-
Month
-
Day
Year
Date
Pour Time
Hour Minutes
AM
PM
AM/PM Option
Pour Location
Lift drawing is attached for inspection
Yes
No
Lift Drawing Upload
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of
Approved shop drawings are attached for inspection
Yes
No
Shop Drawing Upload
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of
Mix design #
Estimated CYD
Placement Method
Finish Type
Forms
Forms are in good condition
Yes
No
N/A
Forms are supported properly
Yes
No
N/A
Elevations are clearly marked on forms
Yes
No
N/A
Chamfer strip installed if required
Yes
No
N/A
Bulkheads are properly constructed
Yes
No
N/A
Water stop is properly installed
Yes
No
N/A
Pour scaffolding is setup and inspected for use
Yes
No
N/A
Proper access to pour area
Yes
No
N/A
Reinforcing Steel
Reinforcing steel is placed per plans and approved drawings
Yes
No
N/A
Proper clearance between reinforcing steel and forms
Yes
No
N/A
Proper clearance between reinforcing steel and finished grade
Yes
No
N/A
Proper clearance on reinforcing steel and embedded items
Yes
No
N/A
Third party inspection completed if needed
Yes
No
N/A
Block outs and Penetrations
Mechanical block outs are installed and properly located
Yes
No
N/A
Electrical block outs are installed and properly located
Yes
No
N/A
Anchor bolts are installed and properly located
Yes
No
N/A
Support embeds are installed and properly located
Yes
No
N/A
Signoffs
Contractor
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Owner's Representative
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Engineer's Representative
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Third party Inspection Representative
First Name
Last Name
Date
-
Month
-
Day
Year
Date
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