Attachment__6_-_Sample_Report_Forms.pdf

SAMPLE

KEYES CONSTRUCTION COMPANY, INC.

DAILY QUALITY CONTROL REPORT

Daily Report No.: Date:_______ Contract No.:_________

Project Title & Location:___________________ Weather: ______ Precipitation: ________ in. Temp: _______ Min. _______ Max.

1. Contract/Subcontractors and Area of Responsibility:

NUMBER: TRADE : HOURS : EMPLOYER : LOCATION/DESCRIPTION WORK

2. Operating Plant or Equipment. (Not hand tools)

Date of Date of Hours Hours Hours Plant/Equipment Arrival/Departure Safety Check Used Idle Repair

3. Work performed today: (Indicate location and description of work performed by prime and/or subcontractors by letter in table above).

4. Results of control activities: (Indicate whether P - Preparatory, I - Initial, or F - Follow-up Phase. When a P or I meeting is conducted, complete attachment 1-A or 1B, respectively.

When network analysis system is used, identify work by use of I-J numbers.)

5. Test performed as required by plans and/or specifications:

6. Material received:

7. Submittals Reviewed:

(a) Submittal No. (b) Spec/Plan Reference (c) By Whom (d) Action

8. Offsite surveillance activities, including action taken:

9. Job Safety: (Report violations; corrective instructions given; corrective actions taken).

10. Remarks: (Instructions received or given. Conflict(s) in Plans and/or specifications).

Contractor's Verification: On behalf of the Contractor, I certify this report is complete and correct, and all materials and equipment used and work performed during this reporting period are in compliance with the contract plans and specifications, to the best of my knowledge, except as noted above.

Authorized QA Mgr at Site Date

Preparatory Phase Checklist

Contract No.: ________________________ Date: _____________

Definable Feature: ____________________ Spec Section: _____________

Government Rep Notified _______________ Hours in Advance Yes _______ No _______

I. Personnel Present:

Name Position Company/Government

1. _________________________________________________________________________

2. _________________________________________________________________________

3. _________________________________________________________________________

4. _________________________________________________________________________

5. _________________________________________________________________________

6. _________________________________________________________________________

7. _________________________________________________________________________

(List additional personnel on reverse side)

II. Submittals

1. Review submittals and/or submittal log 4288. Have all submittals been approved?

Yes __________ No _____________

If No, what items have not been submitted?

a. ______________________________________________________________________

b. ______________________________________________________________________

c. ______________________________________________________________________

2. Are all materials on hand? Yes __________ No ___________

If No, what items are missing?

a. ______________________________________________________________________

b. ______________________________________________________________________

c. ______________________________________________________________________

3. Check approved submittals against delivered material. (This should be done as material arrives.)

Comments _______________________________________________________________

III. Material storage

Are materials stored properly? Yes _________ No ___________

If No, what action is taken? _____________________________________________________

IV. Specifications

1. Review each paragraph of specifications.

2. Discuss procedure for accomplishing the work.

3. Clarify any differences.

V. Preliminary Work and Permits

Ensure preliminary work is correct and permits are on file.

If not, what action is taken? ____________________________________________________

VI. Testing

1. Identify test to be performed, frequency, and by whom.

2. When required?___________________________________________________________

3. Where required?___________________________________________________________

4. Review Testing Plan._______________________________________________________

5. Has test facilities been approved?_____________________________________________

VII. Safety

1. Review applicable portion of EM 385-1-1._______________________________________

2. Activity Hazard Analysis approved? Yes ________ No ________

CQC REP

Initial Phase Checklist

Contract No.: _______________________ Date:_____________

Definable Feature: _________________________

Government Rep Notified ________________ Hours in Advance Yes _____ No _____

I. Personnel Present:

Name Position Company/Government

1. ________________________________________________________________________

2. ________________________________________________________________________

3. ________________________________________________________________________ 4 ________________________________________________________________________

5 ________________________________________________________________________

6. ________________________________________________________________________

(List additional personnel on reverse side)

II. Identify full compliance with procedures identified at preparatory. Coordinate plans, specifications, and submittals.

Comments: ________________________________________________________________

III. Preliminary Work. Ensure preliminary work is complete and correct. If not, what action is taken?

IV. Establish Level of Workmanship.

1. Where is work located? _____________________________________________________

2. Is a sample panel required? Yes _______ No ________

3. Will the initial work be considered as a sample? Yes _______ No ________

(If yes, maintain in present condition as long as possible).

V. Resolve any differences.

Comments:

VI. Check Safety.

Review job conditions using EM 385-1-1 and job hazard analysis.

Comments: _________________________________________________________________

CQC REP