Concrete Flooring Association

Project Name: _______________________________ Date: _______________
Location: _________________________ Engineer: ______________________
General: __________________________ Floor Finisher: __________________
Concrete Supplier: ________________ Testing Co.: _____________________

Submittals: (Approvals to be received prior to construction)
1. Materials literature approved (Y/N): _____
2. Concrete mix design reviewed (Y/N: _____
3. Sawcut and construction joint shop drawing approved? (Y/N):_____
4. Mock-up approved (Y/N): ____ Location: ____________________________

Safety:There are NO accidents !
Guardrails in place (Y/N): ___________ Safe access (Y/N): __________
Adequate lighting (Y/N): _____________ Traffic signallers by: ________
Adequate heat (Y/N): ____________ Adequate ventilation (Y/N): ________
Site safety rules: ______________________________________________
Emergency contact: ______________________________________________

Environmental Conditions:
Vented Temporary Heat (Y/N): _______ Roof Completed (Y/N): _______
Siding Completed (Y/N): _________ Openings sealed: ________________
Suitable lighting: _______________ Ambient Temperature: ____________
Temp. Power: ________________ Water Source: ______________________
Granular Material: ___________ Compaction checked by GC (Y/N): _______
Elevation Verified by GC (Y/N): _________ (CSA: +/- 10mm)

Mix Design: (All ingredients to be of a non-retarding nature)
Placement (check): Wheelbarrow __ Buggy __ Crane __ Pump __ Truck __
Strength: _____________ Air (Y/N): _____ W/C Ratio: ___________
Aggregate Size: _________ Slump at deposit: _________ ą _______
Cement Content: _____________ Slag %: ________ Flyash %: _______
Admixtures: ________________________ Travel Time: ______________
Concrete Temp: ________________ Load Sizes: _______________________
Pour Sizes: ___________________ Delivery rate (m3/hour): ___________
Super-P Added on Site (Y/N): ____ Single Plant Delivery? (Y/N): ____
Same sand, stone, admixtures, batch timing if no: ___________________

Floor Construction:
Reinforcing Type/Rate/Sub: _________________________________________
Fibre type: __________________________ Dosage rate: ________________
Elevations Checked by GC:____ Benchmark Location: ___________________
Smooth Dowels? (Y/N): _______Size & spacing: _______________________
Floor tolerances: __________________ To be measured ? _______________
Screed Method: ____________________ Highway Straightedge (Y/N): _____
Double pan Float (Y/N): ___________ Hardener type: _________________
Hardener Rate: _______________ Application method: ________________
Finish Type: _____________________ Sawcut Spacing/Depth: ____________
Curing Method: _______________________ Duration: ___________________
Sawcuts Filled? (Y/N): ________ Material: __________________________
Backer rod? (Y/N: ___________ Depth of sealant/filler: ___________
Time of Filling: _______ days after slab installation (120 minimum) Testing:
Maximum entrapped air content upon delivery: ____________ (verify)
Slump Prior to fibres: ______________ Slump at deposit: __________
Fibre washout test (Y/N): __________
Specified tolerances per CSA A23.1: _________________________________
Floor Measurement within 72 hours (Y/N): _______(cc: Finisher)
Sawcut filler depth cut test (Y/N): _________

Notes:________________________________________________________

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Concrete Floor Contractors Association of Ontario
70 Leek Crescent, Richmond Hill, Ontario, Canada, L4B 1H1
Tel: (905) 582-9825 Fax: (416) 981-3913
Internet: www.concretefloors.ca