Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Type of Floor system

  • Epoxy type system

  • Urethane cement system

  • Polish system

  • Other

  • List other

Conditions of Existing Floor

  • Existing epoxy to remove

  • Existing epoxy, no removal, prep for overcoat

  • Removal of carpet, VCT or a mastic

  • Removal of a ceramic or mortar

  • Was a concrete hardness test performed by sales prior to the job start?

  • Is the concrete or substrate hard or soft?

Floor contaminants

  • Is there excessive dirt?

  • Are there any oils, fluids or stains in the floor?

  • Is there any standing or leaking water on the floor?

Engineering Obstacles

  • Are there any type of bolts or metals that need to be removed? If yes how many and add photos

  • Are anchor joints or keyways needed? If so list what areas in notes

  • Are control joints being prepped or filled for this job?

  • Are control joints being re opened after repairs?

  • Are control joints being caulked?

  • How many linear feet of control joints?

  • Are cracks being filled or repaired on this project?

  • How many linear feet if crack repairs?

  • Is there any areas that require a slurry or skim coat to repair spalling or exposed aggregate?

  • List the approximate square footage

Product information

  • Have the tech data sheets been reviewed for proper application?

  • Have the mixing ratios and times requirements been reviewed?

  • List the mixing ratio and mixing time requirements

  • What is the required surface profile for the products being applied? (CSP READING)

Machine hazards

  • Deflected concrete or unlevel concrete.

  • Bolts, rebar or protruding rebar

  • Floor drains or inlaid obstructions?

  • Note any other hazards or obstructions

Contract Variances

  • Are the any areas of repair, changes or others items noted in this report not in the original bid or contract scope of work? Please note items in notes

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