Concrete Placement Report

• Job Number

• Conducted on

  Date

• Prepared by

• Location
  Address

Environmental

• Pour location, interior or exterior?

  Interior

  Exterior

• Is roof dried in this location?

  Yes

  No

  N/A

• Is roof painted in the area of slab pour?

  Yes

  No

  N/A

• Ambient Temperature

  Safe

  At Risk

  N/A

• Temperature

  Select 50-55 55-60 60-65 65-70 70-75 75-80 80-85 85-90 90-95 95-100 100-110 110-115 115-120

  • 50-55
  • 55-60
  • 60-65
  • 65-70
  • 70-75
  • 75-80
  • 80-85
  • 85-90
  • 90-95
  • 95-100
  • 100-110
  • 110-115
  • 115-120

• Is there sufficient lighting to permit proper placement and finish?

  Yes

  No

  N/A

• Is climate of pour area within acceptable temperature ranges as specified?

  Yes

  No

  N/A

• C.O. Monitors being used?

  Yes

  No

  N/A

• Who is monitoring C.O. Levels

  Shames

  Testing Agency

  Owners Consultant

• Recorded C.O. Levels

  0-15

  >15

• CO2 Levels being monitored?

  Yes

  No

  N/A

• Who is monitoring CO2 Levels?

  Shames

  Testing Agency

  Owners Consultant

• Recorded CO2 Levels<br><br>

  O-4,500 ppm

  >4,500 ppm

• Skylights removed for proper ventilation as required?

  Yes

  No

  N/A

• Are there a sufficient amount of fans for air movement?

  Yes

  No

  N/A

Administration/Documentation

• Do you have a copy of the approved correct mix design? (If yes, provide photo of cover page showing mix I.D. number)

  Yes

  No

  N/A

• Is contractor placing concrete in accordance with approved sequence placement plan?

  Yes

  No

  N/A

• Is contractor in possession of the approved slab saw cut plan?

  Yes

  No

  S1.1

• Is contractor in possession of the list of approved trucks that are allowed to supply concrete to the project?

  Yes

  No

  N/A

Sub grade and Base

• Sub grade has been reconditioned and re compacted per the specifications?

  Yes

  No

  N/A

• Has sub grade been shot with a calibrated laser to insure compliance with the elevation shown on the approved plans?

  Yes

  No

  N/A

• Base material delivered is in compliance with the submittal and specifications?

  Yes

  No

  N/A

• Base material has been installed to the required thickness and compacted per the specifications?

  Yes

  No

  N/A

• Base has been compacted at perimeter of the building up to the CMU, around all columns and all pipes penetrating the slab.

  Yes

  No

  N/A

• Has sub grade been proof rolled? If so, is there any signs of rutting present?

  Yes, no rutting

  Yes, rutting present

  No

• Has all loose and un compacted base material been removed from inside the area to be poured?

  Yes

  No

  N/A

• Has choker material been installed (if required)?

  Yes

  No

  N/A

• Vapor barrier required?

  Yes

  No

  N/A

• Is vapor barrier free of wrinkles and damage?

  Yes

  No

  N/A

Reinforcement

• Rebar size and spacing per plans?

  Yes

  No

  N/A

• Is rebar properly supported with sufficient cover to allow for specified depth of saw cuts?

  Yes

  No

  N/A

• Is rebar supported at proper elevation for slab thickness?

  Yes

  No

  N/A

• Are trim bars installed where required?

  Yes

  No

  N/A

• If exterior pour, what is temperature of reinforcement?

  Acceptable

  Not acceptable

Formwork

• Forms and longitudinal construction joints have been located outside of action alleys.

  Yes

  No

  N/A

• Is the lumber provided a min. of 1-1/2" thickness dressed on at least 2 edges and one end to insure a tight fit?

  Yes

  No

  N/A

• Is the top edge of the form beveled to min. of 30 degrees as required by the specifications?

  Yes

  No

  N/A

• Are dowels installed flat and spaced according to plans or spec?

  Yes

  No

  N/A

• Is the proper form release agent as defined in the specifications and approved submittals, on site in the work area and readily available in quantity necessary to cover the forms for the area of slab being placed?

  Yes

  No

  N/A

• Have forms been installed to the elevation shown on the drawings, and plumb?

  Yes

  No

  N/A

• Are the perimeter rebar and re-entrant corner bars installed as shown on the structural drawings?

  Yes

  No

  N/A

• Are all structural columns within the area to be poured isolated with 1/2" close foam around the perimeter?

  Yes

  No

  N/A

Load Transfer

• Basket Type & Size

  Load baskets installed per plans

  No load baskets installed

  N/A

• Are baskets aligned properly and secure?

  Yes

  No

  N/A

• Are specified dowels installed?

  Yes

  No

  N/A

• Do specified dowels have proper spacing and alignment?

  Yes

  No

  N/A

Electrical

• Electrical slab penetrations are installed below finish floor, and marked with flagging?

  Yes

  No

  N/A

• All electrical conduits have specified cover?

  Yes

  No

  N/A

Plumbing

• Are plumbing pipe slab penetrations are installed per plans, and at proper elevation?

  Yes

  No

  N/A

• Has elevation of FCO, Floor Sinks, etc. been verified with same survey system used by concrete crew for laser screen calibration?

  Yes

  No

  N/A

Details/Equipment/Post Placement Materials Readiness

• Placement Method?

  Tailgate

  Pump

  Telebelt

• Evaporation Control?

  Yes

  No

  N/A

• Laser Screed (Boom Screed)

  SXP

  S240

  S22E/S15R/S10A

• Laser Screed (Stationary Non-Boomed)

  S485

  S840

  S940

• Trowel Machine, Blades

  Pans

  Combo

  Finish

  Plastic

• Hand Tools

  Floats

  Trowels

  Broom

• Concrete Saw

  Soff Cut X5000

  Soff Cut X4200

  Soff Cut X4000

  Other

• Saw Cut Blades

  Soff Cut FLX (silver)

  Soff Cut 1000 (purple)

  Soff Cut 2000 (green)

  Soff Cut 3000 (red)

  Other

• Vacuum

  Pulsvac

  Pro Vac

  SoffVac

Placement

• Verify Delivery Ticket

  Yes

  No

  N/A

• Allowable trim water noted?

  Yes

  No

  N/A

• Was slump adjusted prior to discharge?

  Yes

  No

• Slump uniform through placement?

  Yes

  No

  N/A

• Slump range

  4"

  4.5"

  5"

  5.5"

  6-6+

• Concrete temperature

  Safe

  At Risk

• Temp range

  Select 50-55 55-60 60-65 65-70 70-75 75-80 80-85 85-90 90-95 95-100 100-110 110-115 115-120

  • 50-55
  • 55-60
  • 60-65
  • 65-70
  • 70-75
  • 75-80
  • 80-85
  • 85-90
  • 90-95
  • 95-100
  • 100-110
  • 110-115
  • 115-120

• Mix delivery by supplier at acceptable intervals

  Good

  Bad

  Delayed spacing

• Was concrete surface wetted during finishing process

  Yes

  No

  Unknown

• Verify cure type and manufacturer

  Yes

  No

  N/A

• Finish around Edges, clean outs, floor sinks and drains OK

  Safe

  At Risk

  N/A

• Overall esthetics of slab

  Safe

  At Risk

  N/A

• Saw Cut depth

  Acceptable

  Not acceptable

• Cure application

  Wet cure blankets

  Wet cure sprinkler

  Micro fiber mop

  Spray applied

• Mix supplier representative on site

  Yes

  No

  N/A

Testing Agency/Consultant

• Does testing agency have a representative on site?

  Yes

  No

  N/A

• Proper sampling techniques per ACI?

  Yes

  No

  N/A

• Proper testing techniques per applicable ASTM Standards?

  Yes

  No

  N/A

• Samples properly stored in climate of 68-70 degrees?

  Yes

  No

  N/A

• Does sample storage facility have a hi-lo thermometer?

  Yes

  No

  N/A

• Is FF/FL testing required for this portion of work? (If yes, need to schedule testing with testing agency)

  Yes

  No

  N/A

General Comments

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