EI-CON-CIV-23-Mortar Screed

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Mortar Screed / Grout Authorization

Report and Performance Check


No: EI-CON-CIV-23 Rev.: 0 Date: 23.01.2023 Page: 1

PROJECT: CONTRACTOR:
DRAWING: RFI No:
DESCRIPTION:
REPORT No.:
REPORT Date:
This certificate does not exempt the Subcontractor from the Terms of the Contract, Project Specifications or Quality Procedures but confirms that all these Tests have been performed according to them.
Description of item/items to be grouted Steel Structure
Static Equipment
1. GROUT AUTHORIZATION

Rotary Equipment
Others: ____________________
Description of grouting phase:

Installed Items are released for grouting.

IPMT/EMPLOYER STEEL STRUCTURE/MECHANICAL SUPERVISOR (signature and date):

Mortar / Grout type:

Verification check list YES NO N/A

Surface of foundation chipped, wetted and cleaned.

Clearance between base plate and foundation

Formwork is leak proof. Formwork position, level, shape, chamfers, cleanliness.


2. GROUT PERFORMANCE CHECK

Check mixing ratio according to data sheet

Check ambient temperature ( _______ºC)

Check grout temperature ( _______ºC)

Mixing and pouring method according to data sheet with proper equipment and tools for mixing

Thickness of grout according to drawing / specification

Cube Samples taken for Grout Testing

Check base plates full contact with grout

Curing time respected

Grout finishing acceptable

Crack or damage repair completed

Released for next activities

N/A=NOT APPLICABLE

REMARKS

WITNESSED / MAIN
SUBCONTRACTOR EPC CONTRACTOR OWNER/PMC
REVIEWED BY: SUBCONTRACTOR

SIGNATURE:

PRINT NAME:

DATE:

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