KING'S GROUP
QA / QC INSPECTION REPORT
REQUEST FOR INSPECTION
Project Name: __________________________________________________________ Submission Date:
Location of Inspection: __________________________________________________________
Grid No.s & Level: __________________________________________________________ Check Request No:
Type of Work: __________________________________________________________
Previous NCR # (if any):
Concrete Class & Quantity: __________________________________________________________
Inspection Date / Time:
Inspection related to:
Excavation Re-inforcement Plaster
Backfil Concrete Others (plz specify)
Formwork Block Masonry __________________________
Site Engr. Name: ___________________________________________________________________ Time: ______________________
Date: ___________________________________________________________________ Signature: ______________________
Site Supervisor Name: ___________________________________________________________ Time: ______________________
Date: ___________________________________________________________________ Signature: ______________________
ACTION BY QA / QC ENGINEER AGAINST INSPECTION REQUEST
QA/QC Enigneer Remarks: ________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Sign: _______________
__________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
Date: _______________
Non-Conformity and/or reference to attached Non-Conformity Report (NCR) NCR#: Date: _______________
Accepted Rejected
Date: ______________
QA/QC Manager Signature:
______________________________________________ Time: ______________
Note: QA/QC department no objection doesn't relieve the respected site staff of his responsibilities.