Title Page

  • Concrete Placement Sign Off:

  • Client / Site

  • Job Number:

  • Conducted on

  • Prepared by

  • Pour Description

  • Pour Location

  • Number of Cubic Yards;

  • Specified Concrete;

  • Attendees

Concrete Placement

  • Have all dimension been checked against the contract drawings and RFI's that pertain to this area?

  • Has all rebar and wire mesh been checked against shop drawings?

  • Have adequate supports (wire chairs) been installed so that rebar and wire mesh remain in position during the pour?

  • Is the vapor barrier installed correctly and meet the proper mil thickness

  • Have anchor bolts been checked for proper placement?

  • Are forms and rebar/mesh clean and free of debris/rust/scaling ?

  • Are all electrical floor boxes set?

  • Has the elevations of all electrical conduits and plumbing lines been verified as (not to high in the pour) ?

  • Floor drains all set and at the proper elevations and locations.

  • Are there any sleeves, recesses or misc embeds that need to be placed?

  • Is the perimeter insulation installed at the proper locations.

  • Has expansion material been placed at all the specified locations.

  • Is the correct concrete mix design being supplied for the area being poured?

  • Pictures

  • Acceptance Signatures:

  • Signature

  • Signature

  • Signature

  • Signature

  • Signature

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