Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
PROCEDURAL CHECKLIST
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In use
VERIFICATION CHECKLIST
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In use
NON-CONFORMANCE
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Identified by Contractor
NON-CONFORMANCE REPORT
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Submitted
UNDERLYING LOT
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Conforms.
ANALYSIS OF AUDIT SAMPLE
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Soaked CBR
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Gradings
LABORATORY CBR Clause R 23.3
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Laboratory assessments soaked CBR
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70% mass passing 19mm sieve
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Assigned values comply with table R 23.1
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Testing frequency one per 1000m2
INSITU FIELD CBR Clause R 23.3.3
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Project specific CBR requirement
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Penetrometer cone at least 6mm diameter
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Adjustments CBR complies with table R23.2
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Testing frequency one per 200m2
CONSTRUCTION Clauses R 23.5, R 23.6
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No sub grade zone in Rock excavation.
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In-situ material unsuitable and removed.
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Sub-grade replacement density 100%
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Sub-grade zone depth 200mm
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Acceptable INSITU covered immediately.
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Sub-grade finish uniform appearance
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No pounding of water finished surface
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Sub-grade zone width meets design.
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Sub-grade tolerance 0mm above 60mm below.
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Sub-grade zone batters.
NON-CONFORMANCE
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Identified by audit
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Report requested
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Signature