CS23 Grout Placing - Rev 01

• Site

  Select

• Description

• Prepared by

• Sub Contractor / Self-Delivery

  Sub Contractor

  Self-Delivery

• Sub Contractor

• Location

  Media

• Drawing Reference

  Media

Preparation

• Date

  Date

• Grout request received

  Yes

  No

  N/A

• Area to Grout dimensions correct

  Yes

  No

  N/A

• Formwork supported & leak tight

  Yes

  No

  N/A

• Pockets / voids siphoned

  Yes

  No

  N/A

• Underside baseplate cleaned out

  Yes

  No

  N/A

• Grout specification requirements checked

  Yes

  No

  N/A

• Temperature within manufactures tolerance

  Yes

  No

  N/A

• Grout within expiration date

  Yes

  No

  N/A

• Expiration Date

  Date

• Method Statements/Risk Assessments in place

  Yes

  No

  N/A

Application

• Date

  Date

• Grout correctly placed

  Yes

  No

  N/A

• Test cubes taken and recorded

  Yes

  No

  N/A

• Finish correct to specification

  Yes

  No

  N/A

• Batch number of grout recorded

  Yes

  No

  N/A

• Batch number

  Yes

  No

  N/A

• Protection/Heating in place

  Yes

  No

  N/A

• Grout overspill cleaned from baseplate

  Yes

  No

  N/A

Final Inspection

• All areas complete for final inspection

  Yes

  No

  N/A

• Notification of Inspection raised

  Yes

  No

  N/A

• Approved for commencement of next Trade

  Yes

  No

  N/A

Remarks

• undefined

Name & Signature

• For Brims -

  Sign

• For Client

  Sign