F.F. CRUZ & CO., INC.

Civil & Geodetic Engineers • Constructors WORK INSPECTION REQUEST

800 EDSA, West Kamias, Quezon City

Construction Process: Concrete Pouring for WIR No.: FFC-WI-QA-0572

Location/Stationing: ATI-EIB Reclamation Area Date: November 15, 2019
Pay Item No. Pay Item Description Inspection Request Date/Time
4001 Temporary Terminal Fencing November 16, 2019/ 9:00 AM

DETAILS OF WORK TO BE DONE:

Inspection for the installation and fixing of formworks, pipe sleeve and concrete pouring of moveable concrete base barrier.

Numbers of moveable concrete barriers with dimensions of 1.m L X .4 m W x 0.3m H : 20 numbers

Compressive strength of concrete : 3,000 psi

Notes:
1) Work Inspection Request (WIR) shall be valid 24 hours past the work inspection request date/time upon approval of client.
2) Works associated with this WIR will be checked by Contractor's Quality Control/Assurance Team and Supervisor-in-Charge prior to the requested
inspection time to ensure that works are in accordance with the drawings and specifications.
3) WIR is subject to disapproval once (site) circumstances will not enable the activity to proceed.
Requested by: Noted by: Received by:

Don Villanueva/Raymond JoeyAlbert S. Cipriano Rochelle Dela Vega

Fruto Contractor’s Representative Project Secretary (AECOM)
Project Engineer Date/Time

WITNESS / REMARKS / OBSERVATION

Remarks Signatures
ESH:

LINES AND ELEVATIONS:

NOE PENDON/ KATHERINE A.

CABANIG

QA/QC:

CIVIL WORKS / FOE / NON-FOE:

APPROVED DISAPPROVED RESUBMIT APPROVED WITH COMMENTS/

FOR INFORMATION OTHERS FOR REFERENCE INSUFFICIENT ATTACHMENTS

Employer’s Comments Concurred by: Noted by:

Joey Albert S. Cipriano Noe Pendon/Katherine A. Cabanig

Contractor’s Representative/DATE Employer’s Representative/DATE

| FFC-F-CST-002 Revision: 2 Effective: 06-21-2019