MISSOURI DEPARTMENT OF TRANSPORTATION

CONCRETE POUR CARD

Work and inspection shall be completed and initialed by the responsiuble party, prior to placing concrete in a column cap.

CONCRETE POUR LOCATION AND ID #

Item # Work or Inspection Reference Completed By: Date Completed

1 Reinforcing Subcontractor Reinforcement Spec 706

2 Carpenter Foreman Formwork Specification 703

3 Subcontractor

4 Other

Reinforcement and formwork,

5 Process Control
Specs 706, 501, 703

Pour card complete, end of

shift before the next day's
6 Verification Assurance
scheduled pour (or 12
hours)

Ready to Place Concrete

Supervisor Date