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:
SAMWOH CORPORATION PTE LTD SK E&C ER296-CONSTRUCTION AND COMPLECTION OF SENTOSA
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 Request Rejected

*delete where appropriate

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 No.

Date/Time: Location: Chainage:

S/No Description of Works Checked by Confirmed by

Contractor QP(S)
1 Check for proper signing

2 Check cleanliness of road surface or graded stone layer

3 Check level of graded stone layer

4 Removing loose stones and blind with quarry dust

5 Machinery requirement:
5.1 Paver (equipped with sensor)

5.2 Tandom roller

5.3 Three-wheelled roller

5.4 Pneumatic roller

6 Apply tack coat

7 Check temperature of premix

8 Take premix samples at site or at plant

9 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
17 Others