PROJECT MANILA
: NEW OFFICE ANNEX
FORM NO. :
F-YLFCCS-QC-10-030
REQUEST FOR INSPECTION OF TORQUE TESTING
CONTRACTOR : _____________________________________________________________________________________________________________
NAME/POSITION : ________________________________________________________________
REQUEST NO. :_________________________
DATE PREPARED : ________________________________________________________________
SIGNATURE : __________________________
DEFINABLE FEATURE OF WORK : ___________________________________________________________________________________________
STRUCTURE: LEVEL: GRIDLINE / LOCATION:
AREA (Pls. enclose key plan) : INSPECTION TYPE: INSPECTION DATE/TIME: INSPECTION CLOSE OUT DATE:
Preliminary (INSTALLATION)
Final (INSPECTION)
NOTE : ALL SIGNATORIES SHOULD PRINT THEIR NAME AND SIGN TO IDENTIFY EACH SPECIMEN
The A&E Representatives certify to the CMG Representative that inspections were conducted by the subcontractor and verified by te CONTRACTOR'S-Project Engineers, and that the
(Pass/Fail) recommendations reflect the findings from those inspections.
Prepared By Checked By Inspected By REMARKS
TRADE
CONTRACTOR'S OPERATION CONTRACTOR'S QC ENGINEER YLFCCS REPRESENTATIVE YLFCCS TO FILL UP)
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
TELECOM
FDAS
BMS
MECHANICAL
SANITARY/PLUMBING
FIRE PROTECTION
SAFETY
OTHERS
ATTACHMENTS: Keyplan Inspection Checklist Test Reports (IF APPLICABLE) Material/s Inspection (IF APPLICABLE)
REMARKS / COMMENTS: ACTION
For Follow-up
Proceed to Succeeding Work
Do Not Proceed
Others _________________
CHECKED BY : APPROVED BY:
CONTRACTOR'S PROJECT/SITE ENGINEER YLFCCS REPRESENTATIVE
RECOMMENDING APPROVAL: NOTED BY:
CONTRACTOR'S QC ENGINEER YLFCCS - Project Manager
NOTED : THIS FORM MUST BE SUBMITTED TO THE CMGSI TEAM, DULY ACCOMPLISHED AND SIGNED BY THE CORRESPONDING CONTRACTOR'S PERSONNEL-IN-
CHARGE AT LEAST 24 HOURS BEFORE THE ACTUAL INSPECTION AND/OR INSTALLATION.
MANILA NEW OFFICE
Contract No.:ANNEX
MAKATI DEVELOPMENT CORPORATION SAQMMAA-07-C-0044
MANILA NEW OFFICE ANNEX PROJECT Form No.:
US EMBASSY, Manila City, Philippines F-MNOX-CQC-07-009
DEFINABLE FEATURE OF WORK INSPECTION TYPE
REQUEST FOR INSPECTION Preliminary (INSTALLATION)
Final (INSPECTION)
/INSTALLATION SITE LOCATION STRUCTURE GRIDLINE REQUEST NO.
REQUESTED BY : Name/ Designation :
Subcontractor : ____________________________________ Signature :
NOTE : ALL SIGNATORIES SHOULD PRINT THEIR NAME AND SIGN TO IDENTIFY EACH SPECIMEN
AREA (Pls. enclose key plan) LEVEL INSPECTION DATE/TIME INSPECTION CLOSE OUT DATE
The A&E Representatives certify to the CQC Representative that inspections were conducted by the subcontractor and verified by te MDC-Project Engineers, and that the
(Pass/Fail) recommendations reflect the findings from those inspections.
Prepared By Checked By Inspected By
TRADE
SUBCONTRACTOR MDC FIELD OPERATIONS MDC CQC OBO REPRESENTATIVE
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
TELECOM
FDAS
BMS
FE/BR
MECHANICAL
SANITARY/PLUMBING
FIRE PROTECTION
RED LINING
OTHERS
ATTACHMENTS: Keyplan Inspection Checklist Test Reports (IF APPLICABLE) Material/s Inspection (IF APPLICABLE)
REMARKS / COMMENTS: ACTION
For Follow-up
Proceed to Succeeding Work
Do Not Proceed
Others _________________
CHECKED BY : APPROVED BY:
JOEL C. DOMINGO
Site Superintendent MDC - CQC Manager
RECOMMENDING APPROVAL: NOTED BY:
RODELITO J. OCAMPO
MDC - CQC Representative MDC - Project Manager
NOTED : THIS FORM MUST BE SUBMITTED TO THE CQC TEAM, DULY ACCOMPLISHED AND SIGNED BY THE CORRESPONDING CONTRACTOR'S PERSONNEL-
IN-CHARGE AT LEAST 24 HOURS BEFORE THE ACTUAL INSPECTION AND/OR INSTALLATION.
12/15/2023 F-MNOX-CQC-07-009 REV-3
MANILA NEW OFFICE
Contract No.:ANNEX
MAKATI DEVELOPMENT CORPORATION SAQMMAA-07-C-0044
MANILA NEW OFFICE ANNEX PROJECT Form No.:
US EMBASSY, Manila City, Philippines F-MNOX-CQC-07-009
DEFINABLE FEATURE OF WORK INSPECTION TYPE
SECTION 09622; 09638; 09651 - STONE
REQUEST FOR INSPECTION PAVING AND FLOORING
Preliminary (INSTALLATION)
Final (INSPECTION)
/INSTALLATION SITE LOCATION STRUCTURE GRIDLINE REQUEST NO.
REQUESTED BY : Name/ Designation :
Subcontractor : ____________________________________ Signature :
NOTE : ALL SIGNATORIES SHOULD PRINT THEIR NAME AND SIGN TO IDENTIFY EACH SPECIMEN
AREA (Pls. enclose key plan) LEVEL INSPECTION DATE/TIME INSPECTION CLOSE OUT DATE
The A&E Representatives certify to the CQC Representative that inspections were conducted by the subcontractor and verified by te MDC-Project Engineers, and that the
(Pass/Fail) recommendations reflect the findings from those inspections.
Prepared By Checked By Inspected By
TRADE
SUBCONTRACTOR MDC FIELD OPERATIONS MDC CQC OBO REPRESENTATIVE
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
TELECOM
FDAS
BMS
FE/BR
MECHANICAL
SANITARY/PLUMBING
FIRE PROTECTION
OTHERS
ATTACHMENTS: Keyplan Inspection Checklist Test Reports (IF APPLICABLE) Material/s Inspection (IF APPLICABLE)
REMARKS / COMMENTS: ACTION
For Follow-up
Proceed to Succeeding Work
Do Not Proceed
Others _________________
CHECKED BY : APPROVED BY:
JOEL C. DOMINGO
Site Superintendent MDC - CQC Manager
RECOMMENDING APPROVAL: NOTED BY:
RODELITO J. OCAMPO
MDC - CQC Representative MDC - Project Manager
NOTED : THIS FORM MUST BE SUBMITTED TO THE CQC TEAM, DULY ACCOMPLISHED AND SIGNED BY THE CORRESPONDING CONTRACTOR'S PERSONNEL-
IN-CHARGE AT LEAST 24 HOURS BEFORE THE ACTUAL INSPECTION AND/OR INSTALLATION.
12/15/2023 F-MNOX-CQC-07-009 REV-2
MANILA NEW OFFICE ANNEX
Contract No.:
MAKATI DEVELOPMENT CORPORATION SAQMMAA-07-C-0044
MANILA NEW OFFICE ANNEX PROJECT Form No.:
US EMBASSY, Manila City, Philippines F-MNOX-CQC-07-009
Date Prepared Request No. Page No.
REQUEST FOR INSPECTION / 1 of 1
INSTALLATION Location
MNOX-1
REQUESTED BY : Name/ Designation :
Subcontractor : ____________________________________ Signature :
Note : All signatories should print their name and sign.
AREA (Pls. enclose key plan) GRIDLINE/AXES LEVEL STRUCTURE
DEFINABLE FEATURE OF WORK INSPECTION DATE/TIME INSPECTION CLOSE OUT INSPECTION TYPE
Preliminary
Final
The A&E Representatives certify to the CQC Representative that inspections were conducted by the subcontractor and verified by te MDC-Project Engineers, and that the (Pass/Fail)
recommendations reflect the findings from those inspections.
Prepared By Checked By Inspected By
TRADE
SUBCONTRACTOR MDC FIELD OPERATIONS MDC CQC OBO REPRESENTATIVE
ARCHITECTURAL
CIVIL/STRUCTURAL
MECHANICAL
ELECTRICAL
SANITARY/PLUMBING
FIRE PROTECTION
OTHERS
REMARKS : ACTION
For Follow-up
Proceed to Succeeding Work
Do Not
Proceed Others
_______________
CHECKED BY : APPROVED BY:
JOEL C. DOMINGO
SITE SUPERINTENDENT CQC MANAGER
RECOMMENDING APPROVAL: NOTED BY:
RODELITO J. OCAMPO
MDC CQC REPRESENTATIVE PROJECT MANAGER
NOTE : This form must be submitted to The CQC TEAM, duly accomplished and signed by the corresponding
Contractor's Personnel-in-charge at least 24 hours before actual installation.
F-MNOX-CQC-07-009 REV-0
REQUEST FOR INSPECTION/INSTALLATION
