This section establishes the precise location and scope of the proposed concrete pour. Accurate grid coordinate documentation is critical for as-built records, quality traceability, and structural verification against approved drawings.
Project Name
Project Number
Pour Identification Code
Physical Address or Site Location Description
Structural Grid Start Column Reference
Structural Grid End Column Reference
Structural Grid Start Row Reference
Structural Grid End Row Reference
Pour Area Dimensions & Elevation Data
Dimension Parameter | Length (meters) | Width (meters) | Thickness/Depth (mm) | Top of Pour Elevation (mASL) | Bottom of Pour Elevation (mASL) | |
|---|---|---|---|---|---|---|
Primary Pour Zone | 25.5 | 18 | 350 | 15.35 | 15 | |
Beam Integration Zone | 25.5 | 1.2 | 600 | 15.35 | 14.75 | |
Column Stub Zone | 0.8 | 0.8 | 750 | 15.35 | 14.6 | |
Scheduled Pour Date & Start Time
Estimated Pour Duration (hours)
Current Ambient Temperature (°C)
Weather Forecast for Pour Window
Are weather conditions within acceptable parameters per project specifications?
Concrete Delivery Access Route Description
Is the access route clear, stable, and rated for fully loaded mixer trucks?
Safety Exclusion Zone Perimeter & Barricading Details
This section documents the critical inspection of reinforcement steel and formwork systems. Any non-conformance must be rectified prior to pour authorization. Follow-up questions will capture defect details and corrective actions. Photographic evidence is mandatory for all inspection points.
Has the rebar placement been inspected and approved against the latest structural drawings?
Rebar Detail Verification Matrix
Component Type | Bar Size/Grade | Spacing (mm) | Design Cover (mm) | Actual Cover Min (mm) | Actual Cover Max (mm) | Within Tolerance? | |
|---|---|---|---|---|---|---|---|
Top Mesh | T16-200 | 200 | 35 | 34 | 38 | Yes | |
Bottom Mesh | T20-150 | 150 | 45 | 44 | 48 | Yes | |
Edge Beam | T25-100 | 100 | 50 | 49 | 53 | Yes | |
Are all rebar laps and splices positioned correctly with adequate overlap lengths?
Are rebar chairs, spacers, and supports adequate to maintain cover during pour operations?
Is the formwork system constructed from approved materials and in sound condition?
Formwork Deflection Under Load (measured in mm)
Is measured deflection within design limits?
Formwork Release Agent Application Details
Are all embedded items (conduits, bolts, plates) correctly positioned and secured?
Select all formwork inspection items that have been physically verified:
Dimensional accuracy within ±10mm
Levelness within ±5mm
Joint sealing prevents grout loss
Bracing and propping adequate
Walkway and access platforms secure
No visible damage or warping
Upload Rebar Placement Photographs (minimum 6 angles)
Upload Formwork Interior & Support System Photographs
Has a pre-pour inspection meeting been conducted with all trade supervisors?
This section captures the concrete mix parameters and quality control testing regime. Temperature differentials and slump consistency directly impact structural integrity and finish quality. All test equipment must be calibrated and ready.
Approved Mix Design Reference Number
Specified Concrete Strength Grade
Maximum Aggregate Size (mm)
Cement Type & Class
Specified Slump Range (mm)
Maximum Permissible Water-Cement Ratio
Select Admixtures Included in Mix Design:
Superplasticizer
Retarder
Accelerator
Air Entraining Agent
Corrosion Inhibitor
Fiber Reinforcement
None
Batch Plant Supplier Name & Facility Code
Maximum Transit Time from Plant to Site (minutes)
Current Substrate Temperature (°C)
Maximum Allowable Concrete Placement Temperature (°C)
Will ambient conditions require temperature-controlled delivery or ice addition?
Slump Test & Sampling Location Plan
Test Location ID | Grid Reference | Scheduled Test Time | Sample Batch Number | Target Slump (mm) | Critical Control Point? | |
|---|---|---|---|---|---|---|
LOC-01 | C-D/8-9 | 9:30 AM | 1 | 140 | Yes | |
LOC-02 | E-F/10-11 | 10:15 AM | 2 | 140 | ||
LOC-03 | G/12 | 11:00 AM | 3 | 140 | Yes | |
Is calibrated slump test equipment available on-site and ready for use?
Minimum Frequency of Slump Testing (per cubic meters)
Are standby test cylinders, cube molds, and curing facilities prepared?
Contingency Plan for Out-of-Specification Slump or Temperature Results
This section verifies the operational readiness of placement equipment and confirms the pour sequence strategy. Proper vibration prevents voids and ensures consolidation, while a clear sequence minimizes cold joints and structural weaknesses. Communication protocols are essential for coordination.
Pour Sequence Description (start point, direction, section breaks)
Maximum Allowable Time Between Adjacent Pour Sections (minutes)
Will construction joints be required? If yes, are they at approved locations?
Primary Concrete Placement Method
Concrete Pump - Boom Type
Concrete Pump - Line Type
Mobile Crane & Skip
Tower Crane & Skip
Direct Chute from Truck
Conveyor Belt System
Estimated Concrete Pour Rate (cubic meters per hour)
Vibration Equipment Inventory & Readiness Check
Equipment ID | Type/Model | Vibration Frequency (Hz) | Tip Diameter (mm) | Equipment Condition | Tested & Operational? | |
|---|---|---|---|---|---|---|
VIB-01 | High-Frequency Poker | 200 | 50 | Yes | ||
VIB-02 | High-Frequency Poker | 200 | 60 | Yes | ||
VIB-03 | Surface Vibrator | 150 | 300 | Yes | ||
Is backup vibration equipment available on-site in case of primary equipment failure?
Vibrator Spacing Plan (maximum distance between insertion points in mm)
Maximum Vibration Duration Per Insertion (seconds)
Are vibration operators trained and certified for proper technique?
Communication Protocol Between Pour Crew, Pump Operator, and Testing Team
Is adequate lighting available for the entire pour area if operation extends beyond daylight hours?
Curing Materials & Method Ready for Immediate Application After Screeding
Is emergency wash-down and spill containment equipment positioned nearby?
This final section constitutes the formal authorization to proceed with the concrete pour. The Site Structural Engineer and Quality Control Manager must independently verify all preceding sections and provide digital signature confirmation. Any conditions or reservations must be explicitly documented. This sign-off represents acceptance of responsibility for structural integrity and quality compliance.
Site Structural Engineer: Have you physically inspected the rebar and formwork and verified compliance with structural drawings?
Site Structural Engineer Full Name
Professional Registration Number
Engineering Discipline & Jurisdiction
Site Structural Engineer Digital Signature
Engineer Sign-Off Timestamp
Quality Control Manager: Have all quality control pre-checks been completed and documented?
Quality Control Manager Full Name
Quality Certification Number
Quality Control Manager Digital Signature
QC Manager Sign-Off Timestamp
Do both signatories unconditionally authorize the pour to proceed?
Final Authorization Comments & Hold-Point Release Statement
Final Authorization Issue Time
Has this form been reviewed and acknowledged by the Concrete Foreman?
This supplementary section ensures all supporting documentation is attached and establishes the schedule for post-pour quality verification activities. Proper closure of the pre-pour process includes planning for subsequent inspections.
Attached Supporting Documents (select all that apply):
Structural Drawings (latest revision)
Rebar Bending Schedules
Formwork Design Calculations
Concrete Mix Design Certificate
Batch Plant Delivery Schedule
Equipment Calibration Certificates
Weather Forecast Report
Risk Assessment & Method Statement
Traffic Management Plan
Spill Response Plan
Upload Consolidated PDF of All Supporting Documents
Scheduled Post-Pour Surface Finish Inspection
Scheduled Concrete Strength Test (Cube/Cylinder Break)
Special Monitoring Requirements During Initial Curing Period
Is a follow-up structural survey required after formwork removal?