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SPECIAL INSPECTION DAILY REPORT
Project Name:
Project Location:
SCO ID #:
Date of Inspection:
Inspector: SI Company Project No.
Inspector's Company:
Inspection Type(s):
Circle One: Continuous Periodic
Time Inspection Begun: Time Inspection Completed:
Area Inspected:
Describe Inspections Made:
List Tests Performed: 1
2
3
Discrepancy Notice #
Discrepancies Observed: (if applicable)
1 DN #
2 DN #
3 DN #
4 DN #
Corrections completed while on site:
1
2
3
4
Comments:
To the best of my knowledge, the work inspected was in accordance with the contract documents,
except as noted above.
Inspector's Signature: Date:
(A copy of this report is to remain at job-site. Use additional sheets if necessary.)
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Contractor's Initials:
(A copy of this report is to remain at job-site. Use additional sheets if necessary.)
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Date:
Project:
Contractor Initials:
Comments (Continued):
(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)
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(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)
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Date:
Project:
Contractor Initials:
Comments (Continued):
(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)
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(A copy of this report is to remain at job-site with the contractor for review by the building department's inspector upon request.)
Sequence No.
Truck No.
Cubic Yards Carried
F: (919) 380-8752
P: (919) 380-8750
Total Cubic Yards Delivered
Morrisville, NC 27560
Placement Location:
260 Town Hall Drive, Suite C
Stewart Engineering, Inc.
Ticket Number
Batch Time
Arrival Time
Final Placement Time
Elapsed Time
Concrete Mix Design:
Project :
No. Drum Revolutions
Concrete Placement Chart
Initial Slump
Date :
Final Slump
Air Percentage (%)
Material Temperature
Gallons of Water Added
Temperature :
Admixture Added (Y/N)
No. Samples Taken
Out of Specifications (Y?N)