Attachment_24_FMD-42_and_FMD-67.pdf

FTC-FMD-42 (12/09) 1 of 2

CONTRACT NO. TITLE AND LOCATION DATE

REPORT NO.

CONTRACTOR (Prime or Subcontractor) NAME OF SUPERINTENDENT OR FOREMAN

WEATHER - A.M. TEMPERATURE - A.M. F

WEATHER - P.M. TEMPERATURE - P.M. F

EMPLOYER

DAILY REPORT TO INSPECTOR

LOCATION AND DESCRIPTION OF WORK

PERFORMED

(Use additional sheets if required)

PRIME CONTRACTOR / SUBCONTRACTOR WORKFORCE

NUMBER TRADE HOURS

INSPECTION AND / OR TESTING

PERFORMED TODAY - - FOLLOW

WITH REPORT

TOTAL WORK HOURS

ON JOB SITE THIS

DATE

CUMULATIVE TOTAL

OF HOURS FROM

PREVIOUS REPORT

TOTAL WORK HOURS FROM

START OF CONSTRUCTION

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?

REMARKS

RESULTS OF INSPECTIONS/

TESTING

LOCATION AND / OR

ELEMENT OF WORK

SPEC.PARA.

AND / OR

DRAWING NO.

EQUIPMENT / MATERIAL RECEIVED TODAY

TO BE INCORPORATED IN JOB

(Description, Sizes, Quantity)

SUBMITTAL NO. OR

CERTIFICATION

DATE

APPROVED

YES NO

ATTACHMENT 24 FMD-42 AND FMD-67

ATTACHMENT 24 FMD-42 AND FMD-67 Page 1 of 2

FTC-FMD-67 (12/09) 1 of 2

1. Contractor 2. Report No.

3. Contract No. Location 4. Sheet No.

A.M. Temper- A.M.

P.M. ature P.M.

7. CONTRACTOR

SUB-CONTRACTOR

CONTRACTOR'S QUALITY CONTROL DAILY REPORT

8. LOCATION & DESCRIPTION OF WORK PERFORMED THIS DATE

Short Title

Complete report in detail daily. If more space is needed, attach additional sheets. CQC REP to date and initial sheets. Attach test reports, delivery slips, references and Daily Report to Inspector per contract specification. Box 7 - Indicate contractor or trade responsible for work described in Box 8. Box 9 - as applicable. Box 11 - Note all deficiencies.

6. Date5. Weather

9. SPEC/PAR

AND/OR DWG. NO.

ATTACHMENT 24 FMD-42 AND FMD-67

ATTACHMENT 24 FMD-42 AND FMD-67 Page 2 of 2