QATAR DESIGN CONSORTIUM

ARCHITECTS, ENGINEERS, PROJECT MANAGERS & CONSULTANTS

Ref. No: INSPECTION REQUEST FOR BACK FILLING Date:

PROJECT:
CLIENT:
CONTRACTOR:
AREA PREPARED FOR BACK-FILLING
BACK-FILLED
GRID REFERENCE: STATUS CHECKED BY
NAME SIGNATURE
a. Necessary protection for concrete done as per Yes/No
specifications and inspected.
b. Complete area cleared of debris. Yes/No
c. Backfilling material is approved. Yes/No
d. Compaction method as per specification Yes/No

Layer thickness : __________________________Weight of roller: ________________

No. of passes : __________________________No. of tests : _______________

Inspection Date requested:

Inspection Time requested:

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CONTRACTOR
QDC’S REMARKS:
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Approved Approved with comments Not Approved

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CIVIL ENGINEER MECH ENGINEER ELEC ENGINEER
Note : Minimum time / notice to be given for inspection –48 hours

Doc. No: F 321 Rev. No: 00 Dated 30th March 2005 Page 1 of 1