Concrete Pour Card

• Location
  Address

• Client

• Date

  Date

• Foundation No.

• Revision No.

• Date of Excavation

  Date

• Date of Placement

  Date

• Drawing No.

• Mix Design

• Batch Ticket Numbe(s)

Foundation Details (Excavation) - Remarks, Initial, Date

• Dimensions of Excavation (LxWxH) (ft)

• Soils/Rock Encountered (Match Boring logs)

• Rock/Flow Fill Base ( Type, Size, Amount)

(Rebar) - Remarks, Initial, Date

• N/S Mat Bars (Size, Qty, Spacing)

• E/W Mat Bars ( Size, Qty, Spacing)

• Number of Mats

• Vertical Dowels (Size, Qty)

• L/Hook Bars (Size, Qty)

• U bars (Size, Qty)

• Add. Rebar-

• Add. Rebar-

• Add. Rebar-

(Anchor Bolts) - Remarks, Initial, Date

• Embedded or Drilled

• Propper Projection (Y or No, Height?)

(Concrete) - Remarks, Initial, Date

• Actual Concrete Vol. (Cu. Yds)

• Concrete Placement (Pump, Chute, Hopper)

• Field Added Admixtures

• Cold Joint/Shear Key (Y or N)

• TOC Elevation

• Additional Comments

• Subcontractor (Company)

• Subcontractor (Signature)

  Sign

• Subcontractor (Date)

  Date

• Contractor (Company)

• Contractor (Signature)

  Sign

• Contractor (Date)

  Date

• Owner Rep/Testing/Inspector (Company)

• Owner Rep/Testing/Inspector (Signature)

  Sign

• Owner Rep/Testing/Inspector (Date)

  Date