Standard Forms

AnnexB:StandardForms
# Reference Title
1. Communication Forms
1-1 CF-01 Monthly Progress Meeting Minute
Weekly Coordination Meeting Minute Among the Consultant’s
1-2 CF-02
Team
1-3 CF-03 Telephone Massage Receiving Pad
2. Site Instruction, Inspection and Request Forms

2-1 SI-01 Site Instruction Form (SIF)
2-2 SI-02 Site Clarification Request (SCR)
2-3 SI-03 Confirmation of Verbal Instruction (CVI)
2-4 SI-04 Request for Work (RFW)
2-5 SI-05 Request for Inspection & Testing (RFIT)
2-6 SI-06 Request for Inspection (RFI)
3. Site Record and Report forms

3-1 SR-01 Daily Log Book
3-2 SR-02 Weekly Report
3-3 SR-03 Monthly Progress Report Summary
3-4 SR-04 Incident/Accident Report
3-5 SR-05 Variation Order
3-6 SR-06 Labor Summary for Day Work
3-7 SR-07 Equipment Summary for Day Work
3-8 SR-08 Structural Inspector’s daily Report
3-9 SR-09 Sub-Base Data Registration Sheet
3-10 SR-10 Sub-Grade Data Registration Sheet
3-11 SR-11 Super Elevation Data Registration Sheet
3-12 SR-12 Surveyors Daily Report Format
4. Topographic and Measurement Report forms

4-1 TM-01 Traverse Field Book
4-2 TM-02 Traverse Computation Sheet
4-3 TM-03 Differential Leveling Field Book
4-4 TM-04 Differential Leveling Computation Sheet
4-5 TM-05 Cross Section Leveling Sheet
4-6 TM-06 Clearing and Grubbing Measurements
4-7 TM-07 Stockpile Material on Site
4-8 TM-08 Material on Site
5. Test Forms
5-1 TF-01 Sampling Tag
Draft Quality Assurance Manual (QAM)
Sodo Junction (Dimtu)-Bilate Military Training
Center Road Project Section 3: Site Record and Report forms
# Reference Title
5-2 TF-02 DCP
5-3 TF-03 Determination of Sand Density (Calibration of Field Density Sand)
5-4 TF-04 Density of Soil In-Place by Sand-Cone Method
5-5 TF-05 Density of Soil and Soil-Aggregate by Nuclear Method
5-6 TF-06 Determination of Specific Gravity of Fine Aggregate
5-7 TF-07 Determination of Specific Gravity of Coarse Aggregate
5-8 TF-08 Determination of loose Unit Weight Aggregate
5-9 TF-09 Determination of Aggregate Crushing Values
5-10 TF-10 Determination of Flakiness Index
Determination of liquid Limit, Plastic Index & Classification of
5-11 TF-11
Soils and Soil-Aggregate Mixtures
5-12 TF-12 California Bearing Ratio Test (Data)
5-13 TF-13 California Bearing Ratio Test (Graphs)
5-14 TF-14 Compressive Strength of Cylinder cal Concrete Specimens
5-15 TF-15 Aggregate Crushing Value Test
5-16 TF-16 Aggregate Impact Value Test
5-17 TF-17 Application Rate (Bitumen) Test
5-18 TF-18 Clay Content Test
5-19 TF-19 Coating and Stripping Test
5-20 TF-20 Dray Roded Unit Weight of Aggregate Test
5-21 TF-21 flakiness Index Test
5-22 TF-22 Free Swell Test
5-23 TF-23 Wet Sieve Analysis (Grading) Test
5-24 TF-24 Los Angeles Abrasion
5-25 TF-25 Linear Shrinkage Test
5-26 TF-26 Cement Concrete Mix Design
5-27 TF-27 Sieve Analysis of Sand (Grading) Test
5-28 TF-28 Soundness Test of Coarse Aggregate
5-29 TF-29 Specific gravity Test of Soil
5-30 TF-30 Ten Percent Fines Value (TFV)Test
5-31 TF-31 Unit Weight Test
Gondwana Engineering, PLC

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1. COMMUNICATION FORMS

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Monthly Progress Meeting Minute

Date of Meeting/ Venue :
Time of Meeting :
Monthly Meeting No :
Attendants
Item Action
Topic Discussed Remark
No by
Date of Next Meeting :

Next Meeting Venue :
Form No: CF/01

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Weekly Coordination Meeting Minute Among the Consultant’s Team

Date of Meeting /Venue :
Time of Meeting :
Monthly Meeting No :

A. Attended by
B. Agenda/Summary
C. Progress/Schedule/Corrective Action Remark Action by
D. Anticipated Delays/Claims/Variations Order:
E. Other Outstanding Issues:
Form No: CF/02

Page 5 of 68
Telephone Massage Receiving Pad
Name of Caller : Date of Calling :

Receiver By : Time of Calling : Telephone
Number :
 Incoming
 Outgoing
Tele Message No : ___________

Message:
Action by:
Copies to:
Note: Pad shall preferably be prepared with A5 size
Form No: CF/03

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2. INSTRUCTION, INSPECTION AND REQUEST FORMS

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Site Instruction Form (SIF)

Site Instruction No: ______
Location/Work Item :
Subject:
Sketch
Name Position Signature Date
Consultant
Prepared By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Contractor
Received By: _______________ _______________ _______________ _______________
Form No: SI/01

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Site Clarification Request (SCR)

Site Clarification Request No: _______
We herewith request clarification of the following
………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………….…………………
………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
Submitted by Contractor_______________ _______________ _______________ _______________

………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………….…………………
………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
Clarification Given By:_______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: SI/02

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Confirmation of Verbal Instruction (CVI)

Verbal Confirmation No: _______
In accordance with _______________, we hereby confirm that the below described and/or
detailed verbal instruction is given by the Supervisor’s Staff named below:
Submitted by Contractor:______________________________ _______________ _______________
Instructed by Consultant:______________________________ _______________ _______________
Description and/or details:
We here by confirm this Oral Order as being given by the supervisor under _____________
_________ and/or other conditions of contract, and request the supervisor’s confirmation, and if
required issue of an Administrative Order/Variation Order in accordance with ________________
Engineer’s Rep.: _______________ _______________ _______________ _______________
Contractor’s Rep.: _______________ _______________ _______________ _______________
Distribution: Original: Consultant Green: File Yellow: Originator
Form No: SI/03

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68
Request for Work (RFW)

Requisition No.: - _____________________
Date: - _________________
We request the commencement/Execution of the following works.
BOQ Pay item &/or Work item___________________________________________________________
Location _________________________________________________________________
Brief status of preceding work. ________________________________________________
_________________________________________________________________________
Submitted by Contract Name & Signature: - __________________________________
Date:/Time: - _________________________________
Received for Consultant Name & Signature: - ____________________________
Date:/Time: - __________________________________
Consultant comment
Position Supervisor’s Remarks Signature/Date
Quantity Surveyor
Surveyor
Lab. Technician
Work Inspector
Structural Inspector
Material Inspector
Others
Engineer's (RE/ARE) Comments: _____________________________________________

________________________________________________________________________
________________________________________________________________________
The works are: -
Permitted Permitted as noted Not Permitted
Signature: _________________ ___________________ ____________________
Date: _________________
Received for contractor; Name & Signature: _________________________ ______________
Date/Time: _________________________
Form No: SI/04

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68
Request for Inspection & Testing (RFIT)

Requisition No.: - _____________________
Date: - ________________
1. Contractor: - We request your attendance of the following works.
Activity Group: Earthworks Pavement Structure Surveying
Material Production Others
Date/Time of
Sr.No. Description of Activities Location(Change) Inspection
1
2
3
4
5
6
7
8
9
10
11
12
Submitted by Cont’r; Name & Signature: -_______________________Date:/Time: ____________

Submitted by Consul’t; Name & Signature: -____________________Date:/Time: ____________
2. Consultant
Supervision Attended by: Name/Position _______________________________________
Remarks: _________________________________________________________________________
_________________________________________________________________________
Forwarded to: -
1. Name/Position: __________________________ 2. Name/Position: _____________
Date/Time: ___________________________ Date/Time: ______________
Action taken_______________________________ Action taken________________
_________________________________________ __________________________
_________________________________________ __________________________
Engineers (RE/ARE/ME) Comments __________________________________________
_________________________________________________________________________
________________________________________________________________________
The works are: - Accepted Accepted as Noted Rejected
Name/Signature: ___________________________________________ Date: _________________
Received for contractor; Name & Signature:
_________________________________________
Date/Time: ________________________________
Form No: SI/05

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68
Request for Inspection & Testing (RFI)
Request Date: _____________________ Inspection Request No: ______________

We request your attendance for the following works: Item No._______________
1. Type:  Concrete  Soil  Pavement  Others
2. Inspection Date: 3. inspection Time:
4. Location:
5. Inspection  First  Second  Third

6. Purpose of the Inspection:
Roads  Structures 
Settings out capping Traffic Settings out Reinforcement
Earth works signs Excavation Concreting
Sub grade/Road bed  Sub-Base Form work
Improved Sub grade Road base
Surfacing
Others (Specify)
Particular Details
________________________________________________________________________________________
______________________________________________________________________________________
Requested by Contractor Received for Engineers Representative

Name & Sign________________________ Name & Sign. _____________________
Date_______________________________ Date_____________________________
Time_______________________________ Time_____________________________
Position Remarks Signature
 Work Inspector
 Surveyor
Material Eng.
Structural Eng.
 Laboratory Material Technician
 Material Inspector
 Structural Inspector
 Quantity Surveyor
Engineers Representative's Comments and instruction:

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
____________________________________________________________________________________
The works are:  Approved  Approved as noted  Rejected

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68
Form No: SI/06

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68
3. SITE RECORD AND REPORT FORMS

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68
Daily Log Book

Daily Log No: ______
1. Work Section ____________________________________________ Date: - ____________________
2. Weather Condition _______________________________________________________
3. Activities on Progress
Activity Type___________________________ Activity Type__________________________________
Location ______________________________ Location ______________________________________
4. Resource Deployed
Material ______________________________ Material ______________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
Manpower ____________________________ Manpower ______________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
Equipment ____________________________ Equipment ___________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
_____________________________________ _____________________________________________
5. Documents (Instruction/Drawings etc.)
Received _____________________________ Received ________________________________________
_____________________________________ _____________________________________________
Required _____________________________ Required ________________________________________
_____________________________________ _____________________________________________
Requested ____________________________ Requested ___________________________________
_____________________________________ _____________________________________________
6. Action Taken (testing, sampling, inspection, Instruction, checking, approvals e.t.c)
_____________________________________ _____________________________________________
_____________________________________ ______________________________________________
_____________________________________ ______________________________________________
7. Problems and incidences encountered
_____________________________________ ______________________________________________
_____________________________________ ______________________________________________
_____________________________________ ______________________________________________
Prepared By: _______________ _______________ _______________ _______________

Checked By: _______________ _______________ _________________
Form No: SR/01

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68
Weekly Report
Week Ending :
Weekly Report No :
Location Construction Activity

R
B
C
O
A
Prepared By: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Form No: SR/02

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68
Monthly Progress Report Summary

Section: ____________________ Reporting Month: _________________ Date: _________________ Report No: ___________
Ite Accomplishment (Qty.)

Unit of Planed activities
m Item Description Remarks
Meas. Previous months This month To date for the month
No
Prepared By: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Form No: SR/03

Incident/Accident Report
Incident/Accident Report No __________
Date of Occurrence: Time of Occurrence:
Location
Description of Damages
Engineer’s Employee Badly Injury Minor: ……....Major…………Fatal………….

Contractor’s/Construction Employee Badly Minor: ……....Major…………Fatal………….
Injury
Private Citizen Badly Injury Minor: ……....Major…………Fatal………….
Engineer’s Property Damage Minor: ……....Major…………
Contractor’s Property Damage Minor: ……....Major…………
Diagram
Note
a) The Resident Engineer shall be notified immediately of all injuries and accidents
b) Accident diagram should include all traffic control devises present at the time of
accident and the vehicles involved.
Prepared By: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Form No: SR/04

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68
Variation Order
Variation Order No: ________________
Omission Addition
Unit of
Item Description Estimated Estimated Estimated Estimated
Meas.
Qty. Amount Qty. Amount
Net addition/Omission
Continued
Add/Omit the sum of:
Prepared By: _______________ _______________ _______________ _______________
Checked & Approved By:_______________ _______________ _______________ _______________

Note: Any objection to this order should be received in writing by the Engineer within
fourteen days from the date of issue of this order to the contractor.
Distribution: Contractor, Engineer and ERA

Form No: SR/05

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68
Labor Summary for Day Work

Period _____________________ Day work Order No: _______ Report Date: ___________
Total
Hourly
Category Name Date/Hour Hour Amount
Rate
s
Total Amount
I hear by certify that the above listed Labors were used on the dates and for the hours shown
above for the Day work Order No._________
For Contractor;
Name: _______________ Signature: ______________ Date: _____________
For Consultant;
Name: _______________ Signature: ______________ Date: _____________
Form No: SR/06

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68
Equipment Summary for Day Work

Period: ______________________ Day work Order No: _______ Report Date: _________
Total Hourly
Category Name Date/Hour Amount
Hours Rate
Total Amount
We hear by certify that listed equipments were used on the dates and for the hours shown above
for the Day work Order No._________
Contractor : Name: _______________ Signature: ______________ Date: _____________
Consultant : Name: _______________ Signature: ______________ Date: _____________
Form No: SR/07

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68
Title Sub Base Data Registration Sheet

Ô”Éª“ ›=”Í=’]”Ó ኃ .የተ . የግል ኩባንያ
Document No.: Revision No.: Effective Date:
Gondwana Engineering PLC.
SR/09 0 ____________
Project: ____________________________
Employer: _______________
Contractor: ________________
Consultant: ________________
MEASUREMENT SHEET
ITEM DESCRIPTION:
SUB BASE DATA SHEET
LEFT SIDE CENTER RIGHT SIDE

A B C D E F G
STATION OffElev. OffElev. OffElev. OffElev. OffElev. OffElev. OffElev.
Prepared By: ________________ Signature/Date: _________________
Checked By: ________________ Signature/Date: _________________
Form No: SR/09

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68
Sub Grade Data Registration Sheet

Ô”Éª“ ›=”Í=’]”Ó ኃ .የተ . የግል ኩባንያ
Title
Revision No.: Effective Date:
Gondwana Engineering PLC. Document No.:
0 ___________
SR/10
Project:
_________________________
Employer:
_______________
___
Contractor:
________________
Consultant:
________________
MEASUREMENT SHEET
ITEM DESCRIPTION:
SUB GRADE DATA SHEET
LEFT SIDE CENTER RIGHT SIDE
A B C D E F G H I J K L M
STATION
OffElev. Back Slope OffElev. OffElev. Side Slope OffElev. OffElev. OffElev. OffElev. OffElev. OffElev. OffElev. Side Slope Elev. OffElev. Back Slope OffElev.
Prepared By: ________________ Signature/Date: _________________
Checked By: ________________ Signature/Date: _________________
Form No: SR/10

Page 24 of
68
Form No: SR/09
Ô”Éª“ ›=”Í=’]”Ó ኃ
.የተ . የግል ኩባንያ Title Super Elevation Data Registration Sheet
Gondwana Engineering PLC. Document No.: Revision No.: Effective Date:
SR/11 0 _____________
Normal
Curve crown slope
e%
No Radius Spiral in Spiral Out % TR X Y SR
Prepared By: ________________Signature/Date
Checked By: ________________Signature/Date
Form No: SR/11

Page 25 of
68
Title SURVEYOR DAILY REPORT FORMAT

Ô”Éª“ ›=”Í=’]”Ó y .¾}.¾ÓM Ÿ<v”Á
Gondwana Engineering PLC. Document No.: Revision No. : Effective Date:
SR/12 0 __________
Station Approval
No Description Remark
From To Yes No
1 Topograpic Surveying center line alignment
2 Traverse Control points BM to BM
3 Bench marck leveling run
4 Set -out Centre line stacking
5 As built-subgrade carriage way
6 As built-subgrade shoulder
7 As built -Sub-base carriage way
8 As built-Sub-base shoulder
9 As built base course
10 Invert elevation and foundation layout checking
11 Invert elevation checking for class C slab concrete
12 excavation layout for minor structure
13 excavation layout for major structure
14 Rock excavation
15 Under cut for unclassified soil
16 Right of way,list of obstruaction measurment
17 O. G. L. cross section data callecting
18 Others
Reported by: Ckecked by ARE:-
Form No: SR/12

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68
4. TOPOGRAPHIC AND MEASUREMENT REPORT FORMS

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68
TRAVERSE RECORD BOOKS

From____________ to______________ Sheet: ______of ________ Date: ____________
TRAVERSE FIELD BOOK
Observation Average Average
Inst. Sat. Sat. Face Angle Distance Angle Distance Remarks
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Dir.
Indir.
Contractor Consultant
Name & Sign. Name & Sign. ___________________
Date Date
Form No: TM/01

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68
TRAVERSE COMPUTATION SHEET

Horizontal Ang. Horizonta Actual Corrected Adj. Coordinate
l
Min Corrected Azimut Lat
Point Deg. . Sec. (Decimal) Correction Hori. Angle h Distance Radian Depa. . Depa. Lat. NORTHING EASTING Remarks
Name
&
Name & Sign. Sign.
Date Date
Form No: TM/02

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68
LEVELING RECORD BOOKS
From____________ to_____________Sheet: ________of________Date:_________________
DIFFERENTIAL LEVELING FIELD BOOK
STATION B.S H.I F.S ELEVATION STATION B.S H.I F.S ELEVATION
Name & Sign. Name & Sign.
Date Date
Form No: TM/03

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68
From____________ to______________ Sheet: ______of ________ Date:____________

DIFFERENTIAL LEVELING COMPUTATION SHEET
Adjusted Actual Absolute

Station First run Average Check back Devation Correction Average elevation elevation Remarks
Name & Sign. Name & Sign.
Date Date
Form No : TM/04

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68
Cross Section Leveling Record Sheet
From__________ to__________ Sheet: ________of________Date:_________
Height of Reduced Ref

Chainage Offset B.S. I. S F.S. Remark
Instrument. Level No.
Contractors Surveyor Consultant Surveyor Resident Engineer
Name: _______________ Name: ______________ Name: _______________
Signature: _____________ Signature: ___________ Signature: ____________
Form No: TM/05

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68
Clearing and G rubbing Measurement

Date:__________________
Item Station Width Area (Length

Length Remark
No x Avg. width
From To Left Right Total Avg
Contractors Surveyor Consultant Surveyor Resident Engineer
Name: _______________ Name: ______________ Name: _______________
Form No: TM/06

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68
Material on Site
Payment is requested for materials we purchased for future incorporation into the project
works. In requesting payment for the material quantities listed on the attached Stockpiled
Material worksheet, we certify, by signature, the following:
1. The quantities as indicated, have in fact been delivered to, or stored at, the location
as designed. They have been stockpiled in a way that makes them readily available.
2. The material will be retained at the location for exclusive use on this project: they
will not be removed from the site.
3. The amount requested are the actual amounts expended for the purchase and
transport of materials
4. All materials meet applicable contract specification
5. The Resident Engineer will be notified in writing prior to utilization of material in
actual installation /construction operations.
For Engineer For Contractor Checked and Approved
Name: _______________ Name: ______________ Name: _______________
Engineer acknowledges review, inspection, and acceptance of the above-referenced material
Remarks
Form No: TM/07

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68
Stockpile Material on Site
To: Date:
From (Contractor):
In accordance with the provisions of the General Conditions of the Contract request is made
for payment of material on hand for the following materials
Item Material Description Unit Quantity Value Where stored

Number
AFFIDAVIT
The materials listed above have been purchased exclusively for use on the above
referenced project. The material is separate from the like material and is physically
identified as our property for use only on the project. The owner may inter up on the
premises for inspection, checking or auditing or for any other purpose as considered
necessary. It is expressly understood and agreed that this information and affidavit is
furnished for the purpose of obtaining payment for the above materials before they are
delivered to, or incorporated into, the project described above, and that the storage
thereof at the location shown shall not relieve the contractor of full responsibility for the
security and protection of all such materials until incorporated in the works of the project.
Contractor: Name and Signature: ______________ Title: _____________ Date: ___________

To Contractor; Forward original and one copy to the Project Resident Engineer. Attach
evidence of purchase (and warehouse receipt when required) to the original.
To Resident Engineer; Retain original in your files with supporting documents for progress
payment.
Form No: TM/08

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68
5. TEST FORMS

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68
Sampling Tag
LABORATORY TEST ORDER

Project:
Test ordered by: Date Sampled:
Station Sampled: Sample I.D. No.:
Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Material Description:
Sample Quantity [Bags]:
Test for: 1 4
2 5
3 6
Remarks/Notes:

Project:
Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Test for: 1 4
2 5
3 6
Remarks/Notes:

Project:
Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Test for: 1 4
2 5
3 6
Remarks/Notes:

Project:

Page 37 of
68

Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Test for: 1 4
2 5
3 6
Remarks/Notes:

Project:
Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Test for: 1 4
2 5
3 6
Remarks/Notes:

Project:
Depth Sampled
Offset from C.L:
[cm]:
Intended use:
Test for: 1 4
2 5
3 6
Remarks/Notes:
Form No: TF/01

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68
Dynamic Cone Penetration (DCP) Test
Chainage: DCP zero reading:

Offset from proposed centerline: Test No.:
Represents from km ________ to km _________
R
R
B
B
o
o
P
P
N
N
C
SUMMARY OF CORRELATION (For Office Use)

Fro Dept
To DCP CBR
m h Str. Subg.
Layer Type S.N
[mm [mm [mm/blo Cof. Mod.
[mm] [%]
] ] w]
Layer 1
Layer 2
Layer 3
Layer 4
Purpose for testing:
Remarks
Analyst: _______________ _______________ _______________ _______________

Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF02

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68
Determination of Sand Calibration (Field Density Sand)
Lab Test No :__________ Sample Date :__________

Sample from :__________
Determination of volume of the container:
Description Test - 1 Test - 2 Test - 3 Test - 4 Test - 5

Mass of the cylinder container, g
Mass of container + Water + Glass, g
Mass of glass, g
Mass of Water in container, g
Volume of container, cm3
Average Volume of container, cm3
Determination of sand in cone:

Mass of cylinder + sand before pouring, g
Mass of cylinder + sand after pouring, g
Mass of sand in the cone, g
Average Mass of sand in the cone, g
Determination of sand in cone:

Mass of can, g
Mass of can + sand, g
Mass of sand in can, g
Density of sand, g /cm3
Average Density, g /cm3
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/03

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68
DENSITY OF SOIL IN-PLACE BY SAND-CONE METHOD , AASHTO T-19 1
Project : ____________________________ Required Compaction

Wt of Sand in Cone Wsc
Layer Description: _______________________
(gr)
Date of Testing : ________________________ Density of Sand Ds (gr/cc)
Test Ref. No
ecnerefeR
Depth of Hole cm
Max. Dry Density ( MDD) gr/cc
Opt. Moisture Content (OMC) %
tseT
Chainage Km
Test Location (offset from cl) m
Wt. of wet soil = Wws gr
Initial Wt. Sand in Bottle = Wsb1 gr
noitanimreteD
Final Wt. Sand in Bottle = Wsb2 gr

ytisneD
Wt. Sand in Hole & cone = Wsbc=Wsb1-

gr
Wsb2
kluB
Wt. Sand in Hole =Wsh=Wsbc-Wsc gr

Volume of Sand in Hole = Vsh=Wsh / Ds cc
Bulk Density of Wet Soil = WD=Wws / Vsh gr/cc
Container No
noitanimreteD
Wt. of Wet Soil + Container = A gr

Wt. of Dry Soil + Container = B gr
Wt. of Water = A - B gr
Wt. of Container = C gr
erutsioM
Wt. of Dry Soil = B - C gr

Moisture Content = Mc = (A-B) / (B-C) %
Density of D. Soil = DD=WDx100 /
noitcapmoC
gr/cc
(Mc+100)
Degree of Compaction = DDx10 0 / MDD %
Remarks :

Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/04

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Density Of Soils And Soil - Aggregate By Nuclear Method (AASHTO T– 238 )

Type of construction: _____________________ Date of testing::__________________
No Sample Station Offset Dept Laboratory Density Moisture Comp
No from C.L h (gr/cc) content % Remar
(M) (M) MDD OMC Wet Dry % k
(g/cc (%)
)
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/05

Page 42 of
68
Determination of Specific G ravity of Fine Aggregate (AASHTO T 8 4 – 9 4)
Lab No :__________ Sample source :__________

Sample from :__________ Sampling Date :__________
Type of Aggregate :__________ Test Date :__________
Size of Aggregate :__________
No of Trails Trial - 1 Trial - 2 Trial - 3 Trial - 4 Average
A Weight of surface dry sample
Weight of pycnometer containing

B
sample and water
Weight of pycnometer containing water

C
only
D Weight of oven dry sample
Calculation
S.G. on oven dry bases (Bulck S. G.) =

E
D(A+C-B)
F S.G. on S. S. D. bases = A(A+C-B)
G Apparent S.G.= D(D+C-B)
Remarks: …………………………………………………………………………………………………
………………………………………………………………………………………………………………
………………………………………………………………………………………………………………
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/06

Page 43 of
68
Determination of Specific G ravity of Coarse Aggregate (AASHTO T 8 5 – 9 4)
Lab No :__________ Sample Source :__________

Size of Aggregate :__________
No of Trails Trial - 1 Trial - 2 Trial - 3 Trial - 4 Average
Weight of Saturated Surface Dry sample

A
in air
Weight of Saturated Surface Dry sample

B
in water
C Weight of Oven Dry sample in air
Calculation
S.G. on Oven Dry bases (Bulck S. G.) =
E C(A-B)
F S.G. on S. S. D. bases = A(A-B)
G Apparent S.G.= C(C-B)
Remarks:……………………………………………………………………………………………………
………………………………………………………………………………………………………………
………………………………………………………………………………………………………………
………………………………………………………………………………………………………………
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/07

Page 44 of
68
Determination of Loose Unit Weight of Aggregate, Test Method: AASHTO T-19
Lab No :__________ Sample Source :__________

Size of Aggregate :__________ Purpose: :__________
Description Test - 1 Test - 2 Test - 3
Weight of Agg. + Weight of Container
Weight of Container
Weight of Aggregate
Volume of Container
Loose Unit Weight of Aggregate
Average loose Unit Weight of Aggregate
Remarks:………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/08

Page 45 of
68
Determination of Aggregate Crushing Values Test Method: BS 8 12 Part 110 , 19 9 0
Lab No :__________ Sample source :__________

# Description Test - 1 Test - 2 Test - 3
A Test No.
Mass of aggregate before test, passing 14 mm

B
and retain 10 mm sieves, M1(g)
Mass of aggregate after compression, passing

C
2.36 mm sieve, M2(g)
D ACV (%) = ( M2/M1 ) x 100
Average ACV (% ) = ( M2/M1 ) x 10 0 =
Remarks:…………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
……………………………………………………
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/09

Page 46 of
68
Determination of Flakiness Index Test Method : BS 8 12 Section 10 5.1,19 8 9
Lab Test No :__________ Sample source :__________

%
Weight
Sieve Size Proportion Weight Weight FI = Wt. Pass
Sample Retain
( mm ) in the mix taken(g) Pass (g) Total Wt. (% )
(g)
(P)
A 63 - 50
B 50 - 37.5
C 37.5 - 28
D 28 - 20
E 20 - 14
F 14 - 10
G 10 - 6.3
Weighted Average FI (%) = PA*FIA + PB*FIB + PC*FIC * (1/100)
Remarks: … … … … … … … … … … … … … … ..… … … … … … … … … … … ..… … … … … … ...............

....................................................................................................................................................
… … … … … … … … … … … … … … … … … … … … … … … … … … .… … … … … … … … … … … … … … …
… … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … … .…
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/10

Page 47 of
68
Determining Liquid Limit, Plastic Limit, Plastic Index & Classification of Soils and Soil
-Aggregate Mixtures. Test Method : AASHTO T:8 9 , T9 0 & M145
Lab Test No : ______________ Sample Taken From: : _____________

Sampling : ______________
: ______________ Represented Section
Station:
Source Station : _____________ Date Sample: : _____________
Visual Description : ______________ Date Tested: : _____________
Offset : ______________ Depth: : _____________
Purpose : ______________
LIQUID LIMIT PLASTIC LIMIT

Test No. 1 2 3 4 1 2
Number of blows
Container No.
Wet Soil + Cont (g)
Dry Soil + Cont (g)
Mass Container (g)
Mass Moisture (g)
Mass Dry Soil (g)
Moist Content (% )
Ave. PL
Cumm. % Liquid Limit Determination
Size Wt. Ret. % Ret 45
Pass
44
4.75
43
2.00
42
0.425
Moisture Content (%)
41
0.075
40
0.075
39
Liquid Limit: ……………………………… 38
Plastic Limit: ……………………………… 37

36
Plasticity Index: ………………………………
35
AASHTO Classification: …….…………… 10 25 100
Number of blows
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/11

Page 48 of
68
California Bearing Ratio – G raphs Test Method: AASHTO T 19 3
Lab Test No : ______________ Sample Taken From : _____________

Sampling Station : ______________ Represented Section : ______________
Source Station : _____________ Date Sample : _____________
Visual Description : ______________ Date Tested : _____________
Offset : ______________ Depth : _____________
Purpose : ______________
MOISTURE DENSITY CURVE
2.2
2.1
2.0
1.9
1.8
1.7
1.6
5 7 9 11 13 15 17 19 21 23 25
Moisture Content ( %)
MODIFIED PROCTOR : T 180, METHOD D

MDD (g/cc) : __________________
OMC (%) : ___________________
Before Soaking After Soaking

Blows DD Moisture DD Moisture
(g/cc) (%) (g/cc) (%)
10
30
60
LOAD-PENETRATION CURVE DENSITY - CBR CURVE

100
24
80
20
16 60
Load (KN)
Percent CBR
12
40
8
20
4
0 0
0 2.54 5.08 7.62 10.16 12.7 1.7 1.8 1.9 2.0
Penetration (mm) Dry density (g/cc)
LOAD (KN) CBR(% ) Swell Blow Dry density CBR%

Blow
2.54mm 5.08mm 2.54mm 5.08mm % 10
10 30
30 65
65 CBR at ____ MDD (% ): _____

Page 49 of
68
Analyst: _______________ _______________ _______________ _______________
Checked By: _______________ _______________ _______________ _______________
Approved By: _______________ _______________ _______________ _______________
Form No: TF/12

Page 50 of
68
California Bearing Ratio – Data Test Method: AASHTO T 19 3

Lab Test No : ______________ Sample Taken From : _____________
Sampling Station : ______________ Represented Section : ______________
Source Station : _____________ Date Sample : _____________
Visual Description : ______________ Date Tested : _____________
Offset : ______________ Depth : _____________
Purpose : ______________
DENSITY DETERMINATION
10 Blows 30 Blows 6 5 Blows
SOAKING CONDITION BEFORE AFTER BEFORE AFTER BEFORE AFTER
MOLD NUMBER
WEIG HT OF SOIL + MOLD, g
WEIG HT OF MOLD, g
WEIG HT OF SOIL, g
VOLUME OF MOLD, g
WET DENSITY OF SOIL, g/cc
DRY DENSITY OF SOIL, g/cc
MOISTURE DETERMINATION
SOAKING CONDITION AFTER AFTER AFTER AVG

BEFORE AVG BEFORE AVG BEFORE
(TOP 1in). (TOP 1 in.) (TOP 1 in.)
CONTAINER NUMBER
WET SOIL + CONTAINER, g
DRY SOIL + CONTAINER, g
WEIG HT OF WATER, g
WEIG HT OF CONTAINER, g
WEIG HT OF DRY SOIL, g
MOISTURE CONTENT
AVG . MOISTURE CONTENT, %
PENETRATION TEST DATA

PENETRATION DIAL LOAD COR. CBR DIAL LOAD COR. CBR DIAL LOAD COR CBR
(mm) RDG (kn) LOAD(kn) % RDG (kn) LOAD(kn) % RDG (kn) LOAD(kn) %
0
0 .6 4
1.27
1.9 6
2.54
3.18
3.8 1
4.45
5.0 8
7 .6 2
10 .16
12.7
SWELL
No.OF BLOWS 10 30 65
RDG (BEFORE SOAKING)
RDG (AFTER SOAKING)
PERCENT SWELL
AVERAGE PERCENT SWELL:

Analyst: _______________ _______________ _______________ _______________

Page 51 of
68
Checked By: _______________ _______________ _______________ _______________
Form No: CL/13

Page 52 of
68
Compressive Strength Of Cylindrical Concrete Specimens Test Method: BS 18 8 1; Part

116
Lab No: Date of Casting: Date of Testing:
Submitted by :__________ Source of C.A. :__________
Identification station :__________ C.A. ACV % :__________
Class of concrete :__________ C. A. Unit Wt :__________
Slump :__________ Source of F.A. :__________
Quantity represented :__________ F. A. Fineness :__________
Modules
W/C Ratio :__________ Clay Content % :__________
Cement content (Kg)/ 1m3 :__________ Sampling Date :__________
Sieve Analysis F.A. Sieve Analysis C.A.

Sieve size Cumulative Specification Sieve size Cumulative Specification
(mm) pass (% ) limit (% ) (mm) pass (% ) limit (% )
Sample No
Cylinder Size Height

Diameter
Weight of sample g
Volume of sample cm2
Crushing area cm2
Hardening period days 3 7 28
Reading KN
Strength MPa
Average strength MPa
Type of Failure (rough

sketch)
Remarks:……………………………………………………………………………………………………………………………………………………
…………………………………………
Analyst: _______________ _______________ _______________ _______________

Page 53 of
68
Checked By: _______________ _______________ _______________ _______________
Form No: CL/14

Page 54 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Aggregate Crushing Value Test

Gondwana Engineering PLC. Document No.: Revision No. Effective Date:
TF/15 0 ___________
Project:- Date Sampled:-

Client:- Date Tested:-
Contractor:- Sampled by
Station:- Sampled From
Sample of:- Lab.No _______________
Description Intended Use _______________
of Material
TEST METHOD : BS 812 Part 110 : 1990
SAMPLE NO. 1 2
SIZE OF AGGREGATES, mm. 12.5 - 9.5 12.5 - 9.5

MAXIMUM LOAD APPLIED , KN 400 400
DURATION OF TESTING, min. 10 10
WEIGHT OF SAMPLE TESTED, gm.
Wt. OF SAMPLE Ret. ON 2.36mm SIEVE, gm.
AGGREGATE CRUSHING VALUE, %
AVERAGE AGG. CRUSHING VALUE, %
Remark:-
Consultant Consultant's SP
Tested by:- contructor's PME:- Representative:- Material Engineer
Date:- Date:- Date:- Date:-
Form No: TF/15

Page 55 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Aggregate Impact Value Test

Revision No.
Gondwana Engineering PLC. Document No.: Effective Date:
TF/16 0 ____________

Contractor:- Tested by
Station:- Lab.No:-
Sample of:-
Sampled by:-
Material Descri.:-
SAMPLE NO. 1 2
NO OF BLOWS
WEIGHT OF SAMPLE BEFORE TESTED, gm.
WEIGHT OF SAMPLE AFTER TESTED, gm.
AGGREGATE IMPACT VALUE, %
AVERAGE AGG. IMPACT VALUE, %
Remark:-
Tested by:- contructor's PME:- Consultant Repre'tive:- Consultant's Material Engineer
______________________ ______________________ ______________________

Form No: TF/16

Page 56 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Application Rate Test

TF/17 0 _____________
Station:- Tested on:

Material Type:- Date spray:-
Material Description :- Truck speed ;
Primed stretch :- Tested By :-
Intended use:- Job No.
Spraying Tem. Time :
APPLICATION RATE OF PRIME ( MC 30 ) OR TACK COATS ( TRAY TEST )
TEST NUMBER 1 2 3 4
A. Weight of Tray g.
B. Weight of Tray +Prime Coat g.
C. Weight of Prime Coat C=B-A/1000 kg
D. Area of Board 2
m
E. Specific gravity of Prime Coat g/cm³
2
F. Rate of Spray F =( C/D)/1000))/Sp.G l/m
Average Rate of Spray l/m²
Note : Specification Requirement is ( ) lts/m²
Remarks :-
Consultant
Consultant's SP
Tested by:- contructor's PME:- Representat
Material Engineer
ive:-
Form No: TF/17

Page 57 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Clay Content

TF/18 0 _________________
Project:-
Client:-
Contractor:-
Station:-
Sample of:-
Sampled by:-
Tested by
Type of test:-
Date Sampled:-
Date Tested
Lab. Number:-
TEST METHOD : AASHTO T - 176
Mass of Sample Mass of Sample After Clay Content

Sir No W 1-W 2X100
before Test (W1) Test gm (W2)
w1
Remark:-
Form No: TF/19

Form No: TF/18

Page 58 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Coating and Stripping

TF/19 0 __________________

Contractor:- Test by
Station:- Lab.No:-
Sample of:-
Sampled by:-
TEST METHOD : AASHTO : T 182-84
Weight of Result
Sir No Weight of Bitumen
Aggregate Abave 95% Below 95%
1
2
3
Remark:-
Consultant Consultant's SP Material

contructor's PME:- Representative:-
Tested by:- Engineer
Form No: TF/20

Page 59 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title DRY RODED UNIT WEIGHT OF AGGREGATE
TF/20 0 _________________
Project:-
Client:-
Contractor:-
Station
Sample of
Sampled by:-
Tested by
Material Type:-
Date Sampled:-
Date Tested
Lab. Number:-
TEST METHOD : AASHTO T 19
Test No. 1 2 3 4
Weight Mould + Aggregate (gm)
Weight of Mould (gm)
Volume of Mould (cm³)
Dry roaded Unit Weight of Aggregate (gm/cm³)
Avg Dry roaded Unit Weight of Aggregate (gm/cm³) .
Remark:-
Tested by:- Checked by:- Approved by:-
Date:- Date:- Date:-

Page 60 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Flakiness Index

TF/21 0 _____________
Station:- Lab.No:-
Sample of:- Intended Use
Sampled by:-
Material Descri :-
TEST METHOD : BS 812:Section 105.1:1989
SieveSieve
Size / Analysis
RetainedRecord Flakiness Index Calculation
Nominal Size Sample % Retained
(mm) (gm)
Sieve Size (mm) Mass
50 Mass Passing
Retained (gm)
100% 100%
37.5 Passing Retained (gm)
26.5 37.5 26.5
19 26.5 19
13.2 19 13.2
9.5 13.2 9.5
6.7 9.5 6.7
Sum Total ----
Take Mass Retained in gm for FI Calculation only that of % Retained >5%.
FI=Total Mass Passing / Total Mass Retained * 100
FI=
Remark:-
Form No: TF/21

Page 61 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Free Swell

TF/22 0 ____________

Client:- Date Tested
Sample of:- Lab.No:-
Sampled by:-
TEST METHOD : BS 1377
Sr Initial Final Free Avareage

No
Station Depth Material Description
Volume Volume Swell% F.S%
1
2
3
4
5
6
7
8
Free Swell Final Volume - Initial Volume x 100%

Initial Volume
Remark:-
Form No: TF/22

Page 62 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}. ¾ÓM Ÿ<v”Á Title Wet Sieve Analysis (Grading)
TF/23 0 _____________
Project:-
Client:-
Contractor:-
Station:-
Description of Sample:-
Sampled by:-
Tested by
Date Sampled
Date Tested
Lab. Number:-
Weight Before Washing gm Weight After Washing gm
ASTM SIEVE (MM) CUMULATIVE WT. RETAINED (gm) CUMULATIVE % RETAINED % PASS
75
63
50
37.5
25
19
12.5
9.5
6.3
4.75
2.36
2
1.18
0.85
0.6
0.425
0.3
0.15
0.075
100.0
80.0
% Pass
60.0
40.0
20.0
0.0
100 10 1 0.1 0.01
Particle Size, mm
Remark:-
Form
FormNo:
No:TF/24
TF/23

Page 63 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Los Angeles Abrasion

TF/24 0 _____________

Contractor:- Tested by:-
Station:- Sampled by
Sample of:- Lab.No:- ____________
Material Descri.:-
TEST METHOD : AASHTO T 96 - 77
Weight of Indicated Sizes, g

Sieve Size
Grading
Passing Retained
A B C D
(mm) (mm)
37.5 25.0 1250±25 … … …
25.0 19.0 1250±25 … … …
19.0 12.5 1250±10 2500±10 … …
12.5 9.5 1250±10 2500±10 … …
9.5 6.30 … … 2500±10 …
6.30 4.75 … … 2500±10 …
4.75 2.36 … … … 5000±10
Total 5000±10 5000±10 5000±10 5000±10
No. of Spheres 12 11 8 6
Weight of Surcharge, g 5000±25 4584±25 3330±20 2500±15
Sieve Size Weight of

Weight of Weight of
No. of sample Weight loss Percent loss
Surcharge sample
Passing Retained Spheres before, gm. %
gm. after, gm.
(mm) (mm) gm.
37.5 25.0
25.0 19.0
19.0 12.5 2500
12.5 9.5 2500
9.5 6.30
6.30 4.75
4.75 2.36
Total 11 4592.5 5000
Remark:-

Page 64 of
68
Title
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Linear Shrinkage
TF/25 0 ____________________

Client:- Date Tested
Sampled by:-
Wt. of Wt. of dry Moisture

Sr Mould Wt. Of Lo, Ld, (1-Ld/Lo)x 100,
Station Depth Material Description wet soil soil + Content,
No. No. Mould mm mm %
mould mould %
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Remark:-
Form No: TF/25

Form No: TF/26
Page 65 of
68
Title Cement Concrete Mix Design

Ô”Éª“ ›=Í=’]”Ó 
.¾}.¾ÓM Ÿ<v”Á Revision No.
Gondwana Engineering PLC. Document No.: Effective Date:
TF/26 0 _____________
TEST METHOD : AASHTO M - 85
Project:-
Client:-
Contractor
Location:-
Parameters Requirements Reference
Required Ave. Compressive Strength
Required Cement Content
Water/ Cement Ratio
Standared Deviation
Slump Required
C/AGG. SAND
3
Loose unit weight (kg/m ) Loose unit weight (kg/m 3)
Maximum Size (mm) SP. Gravity
SP. Gravity Rodded unit Weight (kg/m 3)
Rodded unit Weight (kg/m 3) Finess Modules
NMC (%) NMC (%)
W. absorption (%) W. absorption (%)
Batch Mix
Mix Proportion
W/C Ratio Cement Sand Coarse Aggregat
Slump
3
Batch Weight (kg) Per M Box Size (cmxcmxcm)
Cement
Water
Sand
Coarse Aggregate
Compressive Strength Values in Mpa (Cube Concrete)
3 days =
7 days =
28 Days =
Remark:-
Form No: TF/27

Page 66 of
68
Title
Ô”Éª“ ›=Í=’]”Ó .¾}. ¾ÓM Ÿ<v”Á Sieve Analysis of Sand (Grading)
TF/27 0 ________________
PARTICLE SIZE DISTRIBUTION

Project:- Sampled by:-

Client:- Tested by
Contractor:- Date Sampled
Station:- Date Tested
Description of Sample:- Lab. Number:-
Weight Before Washing gm Weight After Washing gm
ASTM SIEVE (MM) WT. RETAINED (gm) % RETAINED % PASS

10
4.75
2.36
1.18
0.6
0.425
0.3
0.15
0.075
Dry weight before washing
100.0
Sample preparation : Oven-dried sample
80.0 Method of sieving:
% Pass
60.0 Wet sieving

40.0 Dry sieving
20.0
0.0
10 1 0.1
Particle Size, mm
Fineness Modulus :
Remark:-
Form No: TF/28

Page 67 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Soundness Test of Coarse Aggregate

TF/28 0 ________________
Project:-
Client:-
Contractor:-
Sample of
Sampled by:-
Station
Type of test
Material Type
Lab. Number:-
Date Sampled
Passing Retained Grading Wt. Of Wt. Of Percent

Sieve On Sieve Of Test Container Specimen Specimen passing Corrected
Size Size Sample, No. before test after test finer sieve % Loss
% ret. (gm) (gm) after test
63mm 50mm
50mm 37.5mm
37.5mm 25.0mm
25.0mm 19.0mm
19.0mm 12.5mm
12.5mm 9.5mm
9.5mm 4.75mm
Total
Soundness Loss =
Remark:- Solution used is anhydrous Sodium Sulphate Na2SO 4 .

Page 68 of
68
Title
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Specific Gravity of Soil
TF/29 0 _____________

Contractor:- Tested by .:-
Station:- Lab.No:-
Sample of:-
Sampled by :-
Material Descri.:-
TEST METHOD : AASHTO T - 100-93
Sample No 1 2
Weight of bottle + stoper gm. M1
Weight of bottle + stoper + soil gm. M2
Weight of bottle + stoper + soil + full water gm. M3
Weight of bottle + stoper + full water gm. M4
Specific gravity gm./cm3 M2 - M1
Av. Specific gravity gm./cm3 (m4-m 1)-(m 3-m 2)
Remark:-
Form No: TF/29

Page 69 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Ten Percent Fines Value (TFV)
TF/30 0 ________________

Station:- Sampled From
Sampled by:-
Material Descri.:-
Material Condition DRY WET

Sample No. 1 2 3 1 2 3
Size of aggrgate, mm. 10-14 10-14 10-14 10-14 10-14 10-14
Load achived at required penetration of plunger (f), KN

Duration of testing, min 10+30sec 10+30sec 10+30sec 10+30sec 10+30sec 10+30sec
Penetration of plunger, mm
Weight of sample tested, gm
Weight of sample retaind on 2.36 mm sive gm
% of material passing 2.36 mm
Force required to produce 10% fine (TFV) IN KN
AVERAGE FORCE TFV IN KN,
WET/DRY relationship %
Remark:- Percent passing 2.36mm should be between 7.5 and 12.5%

F= 14xf/ (m+4)
Penetration of pinuger
15mm for rounded or partially rounded aggregate
20mm for normal crushed aggregate
24mm for vesicular (honeycombed) aggregate
Form No: TF/30

Page 70 of
68
Ô”Éª“ ›=Í=’]”Ó .¾}.¾ÓM Ÿ<v”Á Title Unit Weight

TF/31 0 __________________
Project:-
Client:-
Contractor:-
Station
Sample of
Sampled by:-
Tested by
Material Type:-
Date Sampled:-
Date Tested
Lab. Number:-
TEST METHOD : AASHTO T 19M - 93
Sr. No 1 2
Specimen number
MC = Mass of empty, clean can + lid (grams)
MCMS = Mass of can, lid, and moist soil (grams)
MCDS = Mass of can, lid, and dry soil (grams) .
MS= Mass of soil solids (grams)
MW = Mass of pore water (grams)
W = Water content, w%
Remark:-
Form No: TF/31

Page 71 of
68

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AnnexB:StandardForms

2. Site Instruction, Inspection and Request Forms

3. Site Record and Report forms

4. Topographic and Measurement Report forms

Gondwana Engineering, PLC

Gondwana Engineering, PLC

Monthly Progress Meeting Minute

Date of Next Meeting :

Form No: CF/01

Gondwana Engineering, PLC

Weekly Coordination Meeting Minute Among the Consultant’s Team

C. Progress/Schedule/Corrective Action Remark Action by

D. Anticipated Delays/Claims/Variations Order:

E. Other Outstanding Issues:

Form No: CF/02

Gondwana Engineering, PLC

Telephone Massage Receiving Pad

Name of Caller : Date of Calling :

Tele Message No : ___________

Note: Pad shall preferably be prepared with A5 size

Form No: CF/03

Gondwana Engineering, PLC

2. INSTRUCTION, INSPECTION AND REQUEST FORMS

Gondwana Engineering, PLC

Site Instruction Form (SIF)

Name Position Signature Date

Prepared By: _______________ _______________ _______________ _______________

Approved By: _______________ _______________ _______________ _______________

Received By: _______________ _______________ _______________ _______________

Form No: SI/01

Gondwana Engineering, PLC

Site Clarification Request (SCR)

Name Position Signature Date

Submitted by Contractor_______________ _______________ _______________ _______________

Name Position Signature Date

Clarification Given By:_______________ _______________ _______________ _______________

Approved By: _______________ _______________ _______________ _______________

Form No: SI/02

Gondwana Engineering, PLC

Confirmation of Verbal Instruction (CVI)

Submitted by Contractor:______________________________ _______________ _______________

Instructed by Consultant:______________________________ _______________ _______________

Description and/or details:

Engineer’s Rep.: _______________ _______________ _______________ _______________

Contractor’s Rep.: _______________ _______________ _______________ _______________

Distribution: Original: Consultant Green: File Yellow: Originator

Form No: SI/03

Gondwana Engineering, PLC

Request for Work (RFW)

Position Supervisor’s Remarks Signature/Date

Engineer's (RE/ARE) Comments: _____________________________________________

Form No: SI/04

Gondwana Engineering, PLC

Request for Inspection & Testing (RFIT)

Submitted by Cont’r; Name & Signature: -_______________________Date:/Time: ____________

Form No: SI/05

Gondwana Engineering, PLC

Request for Inspection & Testing (RFI)

Request Date: _____________________ Inspection Request No: ______________

5. Inspection  First  Second  Third

Prepared By: _______ _ _ _______

Approved By: _______ _ _ _______

Received By: _______ _ _ _______

Submitted by Contractor_______ _ _ _______

Clarification Given By:_______ _ _ _______

Approved By: _______ _ _ _______

Submitted by Contractor:______________________ _ _________

Instructed by Consultant:______________________ _ _________

Engineer’s Rep.: _______ _ _ _______

Contractor’s Rep.: _______ _ _ _______

Submitted by Cont’r; Name & Signature: -___________Date:/Time:

Request Date: _______ Inspection Request No:

Prepared By: _______ _ _ _______

Prepared By: _______ _ _ _______

Checked By: _______ _ _ _______

Prepared By: _______ _ _ _______

Checked By: _______ _ _ _______

Prepared By: _______ _ _ _______

Checked By: _______ _ _ _______

Prepared By: _______ _ _ _______

Checked & Approved By:_______ _ _ _______

Contractor : Name: _ Signature: Date: _

Consultant : Name: _ Signature: Date: _

Prepared By: Signature/Date: _

Checked By: Signature/Date: _

Prepared By: Signature/Date: _

Checked By: Signature/Date: _