Title Page

  • Project Name:

  • Project No.

  • Slab Level:

  • Pour Number:

  • Select date

1. PREPARATION OF GROUT

  • All tendons checked for passage of air

  • Any tendons need drilling

  • Mixture

  • Cement type GP to AS3972 to be used

  • Any additives used (Viscocrete 10 or approved other)<br>If 'other', please provide detail

  • Water to cement ratio up to 0.45

  • (Maximum 9 litres of water per 20Kg of cement)

  • Water was measured

2. GROUTING PROCEDURE

  • Type of ducting used:

  • Check for looped tendons

  • Check intermediate points

  • Bucket operator confirms grout quality expelled

  • Check ducts are clear and have free passage of air

3. GROUTING RESULTS

  • Operators have checked perimeter for any leaks of grout

  • All tendons grouted and complete

  • Cable numbers not yet grouted

4. IF INCOMPLETE, WHY WAS DECK NOT FULLY GROUTED (Ignore if grouting complete)

  • 4a. Follow up required before signing off?

  • Send form to Construction Manager for review

COMMENTS / NOTES

  • Pump Operator (Print Name and Sign)

  • Bucket Operator (Print Name and Sign)

  • Nozzle Operator (Print Name and Sign)

CONFORMANCE

  • It is hereby confirmed that all post-tensioning tendons to the above noted slab / deck have been fully grouted

  • Main Contractor (Print Name and Sign)

  • Fortec Leading Hand (Print Name and Sign

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