7/24/2019 IR format

1/1

INSPECTION REQUEST FORM

IR no: Rev.no: 0 Date:

Contract no.: Contractor:

Originator : Submitte to:

In!"ection Date#Time:

Sub$Contractor:

Di!ci"%ine: &rea: Land Scape

T'"e o( )or* Permanent#E+terna%#Ot,er Site: Onsite/Offsite

-ocation E%evation :$ Document Re(erence No. Rev No.

MST:

ITP:

IFC Drawing:

Other: egSpec

Item to be in!"ecte T'"e o( in!"ection

Witness

Hold

Contractor Re"re!entativeSub$Contractor Initiator: Sign.: Date:

Sub$Contractor Qua%it' : Sign.: Date:

Contractor Initiator: Sign.: Date:

Contractor Qua%it' : Sign.: Date:

Engineer In!"ection comment!In!"ection

ateDe!ignation Comment! Signature

Site Surve'or

Site In!"ector#Engineer

Materia%In!"ector#Engineer

Remar*!:FIN&-

ST&TUSCODE

EngineerRe"re!entative

Name:

Date:

Signature:

Note!:ngineer inspection shall onl! occ"r after the Inspection File is signed off #! the Contractor $C %epresentati&econfir'ing the acceptance of the wor()ST&TUS CODE:&$*ppro&ed : /$*ppro&ed with co''ents : C$%e+ected : $Witness