INSPECTION REQUEST FORM FOR ASPHALTIC PREMIX NO:

Unless otherwise approved,this inspection request form shall be submitted during

the daily morning meeting among LTA,Contractor and QP(S)
Contractor:
Project:
ER296-CONSTRUCTION AND COMPLECTION OF SENTOSA
SAMWOH CORPORATION PTE LTD SK E&C

GATEWAY TUNNEL FROM TELOK BLANGAH ROAD TO KEPPEL

ROAD / KAMPONG BAHRU ROAD/ LOWER DELTA ROAD AND
ASSOCIATED ROAD WIDENING WORKS INTERCHANGE

To:

Date:
LTA

Time:

The work described below has been inspected by our Site Engineer and is complete
and ready for your inspection. A checklist is attached overleaf.
Location
Checked and Requested By:
Chainage
Type of asphaltic premix
Drawings Used for Construction
Other Description

Contractor's PM Name & Signature

The Meeting noted that the information provided by the Contractor is adequate/not adequate*
QP(S) may proceed
*delete where appropriate

Request Rejected

INITIAL INSPECTION DECISION BY QP(S)

We have inspected the above referenced works and found them acceptable. You may proceed.
However, please return the completed checklist upon completion of the remaining work.
You cannot proceed. Please carry out corrective works as noted on the checklist and
submit a fresh request for inspection.
Other comments:

RTO/RE Name & Signature/ Date

FINAL INSPECTION DECISION BY QP(S)

___________________________________
QP(S) Name & Signature/Date
work approved to start:___________________

work completed on:__________________________

LTA
The above process for request for inspection of work by Contractor and approval by QP(S) is noted.
_____________________________________
LTA's Representative/Date/Time

CHECKLIST FOR ASPHALTIC PREMIX

Date/Time:
S/No

Location:
Description of Works

Check for proper signing

Check cleanliness of road surface or graded stone layer

Check level of graded stone layer

Removing loose stones and blind with quarry dust

Machinery requirement:
5.1 Paver (equipped with sensor)
5.2 Tandom roller
5.3 Three-wheelled roller
5.4 Pneumatic roller

Apply tack coat

Check temperature of premix

Take premix samples at site or at plant

Check and endorse on the Delivery Orders

10

Check compaction of premix laid with nuclear density tester

11

Check thickness of premix

12

Ensure critical road lines to be painted

13

Ensure existing manholes to be demarcated

14

Ensure samples properly labelled and kept

15

Send samples for testing

16

Check sufficient temporary traffic devices if lane

closure is required
Others

17

No.

Chainage:
Checked by
Contractor

Confirmed by
QP(S)