Title Page
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Site name and number
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Conducted on
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Prepared by
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Principal Contractor
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Area/Location - attach DWGs
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Drawing No
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Method of Placing
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Concrete Class
Items
Pre-Concrete Check
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Formation - Line & Level
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Formation - Condition
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Blinding - Line & Level
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Setting Out
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Reinforcement
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Formwork - Line & Level
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Built in items (bolts, starter bars, etc)
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Joint details incl. waterbars
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Cleanliness
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Adequate/Safe Working Areas
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Temp. Works Design Cert.
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Permit to Load Signed
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Approval to Pour Concrete Sign Off
Post Concrete Check
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Min. Strike Time/Cube Strength
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Line, Level & Plumb
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Concrete Finish
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Starter Bars - Position
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Inserts, bolts & joints
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Defects/Comments
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Post Concrete Check Sign Off
Final Sign Off
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Principal Contractor Sign Off
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Hannafin Contractors Sign Off
