DPWH | Project Implementation Forms Job Control Form A-07

Work Permit No. 1

CONCRETE POURING
(ITEM 311 - PORTLAND CEMENT CONCRETE PAVEMENT)

Date: May 20, 2016

Sectio STA. 109+604.18 STA.
n: 109.679.18 R/S

PROJECT TITLE/LOCATION : 16H00027 Road Upgrading (UNPAVED TO PAVED) based on

Gravel Road Strategies, Traffic Benchmark for upgrading to Paved Road Standards
(HDM -4 Project Analysis) (Intermittent Sections) Tertiary Roads, Dalaguete
Mantalongon Badian Road
Description: ITEM 311 Volume: 70.35 cu.m Length: 75 meters

DESCRIPTION REMARKS PERSON RESPONSIBLE

A. GEOMETRIC CONTROL
1. Lines
2. Grades
3. Elevation
B. Pre-requisite Test
1. FDT OK A.B.S MERTALLA / R. JUMAMOY
2. Pavement Thickness (Form
setting)
C. MATERIAL REQUIREMENT
1. Portland Cement, Bags=
703.5 OK A.B.S MERTALLA / R. JUMAMOY
2. Fine Aggregates, Vol.=
35.18 kgs OK A.B.S MERTALLA / R. JUMAMOY
3. Coarse Aggregates, Vol.=
35.18 kgs OK A.B.S MERTALLA / R. JUMAMOY
4. Water OK A.B.S MERTALLA / R. JUMAMOY
5. Admixture N/A
6. Batching Plant Capability N/A
7. Beam Mold OK A.B.S MERTALLA / R. JUMAMOY
8. Curing Compound N/A
D. CONSTRUCTION CONTROL
1. EQUIPMENT:
a. Concrete Vibrator
b. Vibratory Screeder/Paver
c. Transit Mixer/Bagger Mixer
d. Template
e. 3-meter straight edge
f. Protective covering
materials
2. STEEL FORMS (LEVEL AND
ALIGNMENT)
3. TRAFFIC SIGNS, BARRICADES
AND TRAFFIC AIDE
Notes:

REQUESTED BY: (Contractor)

JULIUS D. DAMOLE ANTONIO AGUILAR

Quantity
Materials Engineer Engineer Project
DPWH | Project Implementation Forms Job Engineer
Control Form A-07
APPROVED/DISAPPROVED:
(DPWH)
 ALMA BELLA S.
MERTALLA EVANGELINE CUADRASAL
Quantity
Materials Engineer Engineer Project Engineer

PROJECT TITLE/LOCATION :____________________________________________________________________________

Item No.: ______________________

Description: __________________________

DESCRIPTION
A. GEOMETRIC CONTROL
1. Lines
2. Grades
B. Pre-requisite Test/Measurement
1. Dimensions
2. RSB, sized and spacing
C. MATERIAL REQUIREMENT
1. Portland Cement, Bags=_______
2. Fine Aggregates, Vol.=________
3. Coarse Aggregates, Vol.=______
4. Water
5. Admixture
6. Batching Plant Capability
7. Cylinder Mold
8. Curing Compound
D. CONSTRUCTION CONTROL
1. EQUIPMENT:
a. Concrete Vibrator
b. Chute, Crane Bucket, etc.
c. Transit Mixer/Bagger Mixer
d. Template
e. Protective covering materials
2. FORMS and SCAFFOLDS (Vertical & Horizontal)
3. TRAFFIC SIGNS, BARRICADES
Notes:

REQUESTED BY: (Contractor)

Materials Engineer

APPROVED/DISAPPROVED: (DPWH)

Materials Engineer

DPWH | Project Implementation Forms Job Control Form A-07