FOR BUILDING WORKS PART-I WORK INFORMATION - (TO BE FILLED-UP BY PROJECT) Work is

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KARNATAKA RURAL INFRASTRUCTURE DEVELOPMENT LIMITED (FORMERLY KARNATAKA LAND ARMY CORPORATION LIMITED) "GRAMEENABHIVRUDDHI BHAVAN", 4TH & 5TH FLOOR, ANANDA RAO CIRCLE, BANGALORE 560 009 Annexure - 1 Format 1 - Part 1 FOR BUILDING WORKS PART-I WORK INFORMATION - (TO BE FILLED-UP BY PROJECT) Work is Ongoing Completed 1. GENERAL: 1. Date of Inspection : 2. Name of District/ State Quality Monitor : 3. District: Taluk: 4. Work code: 5. Name of work: 6. Technically Sanctioned Date & Amount: No. Dt: Rs. Lakhs 7. Adm. Approval Date & Amount: No. Dt: Rs. Lakhs 8. Date of Commencement: 9. Stipulated Date of Completion: 10. Actual Date of Completion (if work is completed): 1. STAGE OF WORK: Stage of work Financial progress Remarks / Reasons for delay in construction (if any) 2. QUALITY CONTROL : 1. Location of Field Laboratory (if any) : 2. Quality Control Register Part-I is maintained by : JE/AE 3. Quality Control Register Part-II is maintained by : AEE 4. Location of works... 1

3. INSPECTIONS BY DQM/SQM AND ACTION TAKEN: Sl. No Date of Inspection Inspected by Stage of work at the time of Inspection Whether observations have been attended to Date of submission of compliance 4. SUITABILITY TESTS CONDUCTED ON MATERIAL PRIOR TO CONSTRUCTION Sl. No Item of Work Type of Test Test conducted Test reports enclosed Remarks a. SBC of Soil...kN/m 2 1. Foundation 2. Materials (Tests for relevant properties of all materials as per Standards) b. Min. Depth of Excavation (m) a. Cement: (OPC/PPC grade).53/43/33 b. Seting time c. Soundness d. Steel:Grade :Fe415/500/550 e. Coarse/Fine aggregates f. Metal:20mm/40mm/ 100mm g. Stones/Rubble h. Bricks i. Solid block/ Size8 /6 /4 j. Flooring/Stone/Tiles 3 4. Mixed design of concrete Concrete Work k. Joineries Mixed design of concrete for M20/ M25/ M30 a. Plinth beam/roof beam M20/M25/M 30 b. Columns(M20/M25/ M30) c. Staircase/lintel etc (M20/M25/M3) d. Roof slab (M20.M25/M30) 2

5. Superstructur e For BBM/SBM/SS M 1. Shape and dimension of bricks/stone/blocks 2. Water absorption 3. Dressing of stones 4. Compressive strength of mortar cubes 5. Gradation of sand 6. Finishing work 7. Flooring Work 6. Deleterious materials and organic impurities a. Plastering (CM1:3/1:4/1:6/1:8) b. strength of mortar cubes a. Flooring b. dadooing 8. 9. 10. Electrification work Water Supply & Sanitation Non destructive test conducted (if any) a) Electrical cable type 1.5/2.5/4.00/6.00 etc ISI Mark b) Brand Switches & sockets ISI Mark c) Brand Distribution board d) Brand Lighting fixtures ISI Mark e) Brand Submersible pump ISI Mark f) Earthing g) Cable termination LT power & control Diameter of pipe GI/PV/UPVC/other * Brand material for WC pans/water supply materials * Diameter/ Thickness of pipes SWR/PVC for sanitary a) Rebound hammer test b) Ultrasonic pulse velocity c) Other tests AE/JE Date... ASSISTANT EXECUTIVE ENGINEER 3

KARNATAKA RURAL INFRASTRUCTURE DEVELOPMENT LIMITED (FORMERLY KARNATAKA LAND ARMY CORPORATION LIMITED) "GRAMEENABHIVRUDDHI BHAVAN", 4TH & 5TH FLOOR, ANANDA RAO CIRCLE, BANGALORE 560 009 Format 1 - Part II REPORT OF DISTRICT QUALITY MONITOR (DQM)/STATE QUALITY MONITOR (SQM) FOR BUILDING WORKS PART-II- Observations of DQM/SQM for Ongoing/Completed Work (To be filled-up by DQM/SQM, use additional sheets, if required) Stage of Work : (Tick only one appropriate box) I II III Foundation/basement and plinth is in progress. Superstructure/roof is in progress. Finishing Work is nearing completion 1. QUALITY ARRANGEMENTS AND ATTENTION TO QUALITY: For all stages of Work - (Visual observations) : a.field test # Visual observations Remarks 2. Observations about Mandatory Tests: # Item of work executed Total number of Mandatory QC tests required Total number of Test conducted by the agency Name of the Test conducted by DQM at a designed location Result of the test conducted by DQM Pass/Fail Test result as per Q.C register at the same location (Mention the page No. of Q.C Reg.) Pass/Fail Whether the test recorded in Q.C register found correct. 4

3. Observations - Maintenance of QC Registers (Examination of record and verification of QC Register Part 1 & 2) # Based on executed quantities whether all mandatory tests conducted Whether QC Register Part I maintained properly Whether QC Register Part II maintained and NCR issued whether necessary Yes Partly No Yes Partly No Yes Partly No Grade : S RI U If this item is graded RI/U, write clear reasons a suggestions for improvement. 4. Field tests to be reviewed by DQM/SQM: # Item of work executed GF/ FF/ SF Total number of Mandatory QC tests required Total number of Mandatory QC tests conducted by the agency Whether quality of the material is acceptable Remarks Earthwork 1 excavation Foundation & 2 Basement RCC footing, 3 column, 4 Superstructure RCC roof, 5 beam 6 Joineries 7 Plastering 8 Flooring Water supply 9 & Sanitation Electrification 10 11 12 Grade : S RI U If this item is graded U, write clear reasons and suggestions for improvement: 5

5. Observations-Quality of Construction: In all stages # Item of work Dimensions Thickness/wi dth are as per sanctioned estimate 1 Earthwork excavation 2 Foundation & Basement 3 RCC footing, column, 4 Superstructure 5 RCC roof, beam 6 Joineries 7 Plastering 8 Flooring 9 Water supply & Sanitation 10 Electrification 11 12 Whether the sizes constructed is acceptable Whether quality of the material is acceptable Whether quality of workmanship is acceptable Remarks Observations - Tests reports on mortar or Concrete ingredients, Design mix, Storage of cement and stacking of aggregates, Cement consumption, workability, W/C ratio, Mixing, Transporting, Placing and Compaction, form work, centering scaffolding, Bracing etc., casting of cubes and 28 days strength etc., Honeycombing and finishing, Tests on steel, bending, splicing or welding and placing of reinforcement. Dressing of stones and its sizes, Height of course, consumption of mortar, line, plumbness, Horizontality and Vertically of course, staggering of joints, Physical tests on stones and bricks, Bond stones, weep holes. Tests on Hume pipes, alignment and joining of pipes, cushions, backfill material and its compaction, longitudinal slopes, keying of face walls above HFL, Protective works, clearing of valley approach and exit etc., Comments about adequacy of face/main walls, wings and retaining walls. Write comments: Grade : S RI U If this item is graded U, write clear reasons and suggestions for improvement: 6

6. General Observations of DQM/SQM (including the observations made during the interaction with PIU staff and Contractor s/consultant s Engineers) : 6.1 Observations about deficiency in project preparation (Give detailed observations about deficiencies in general items which have been left but are required as per site condition): 1. 2. 3. 4. 6.2 Whether the work, has been completed/is in progress as per work programme or the delay has occurred is attributable to the contractor, whether the liquidated damages have been withhold or recovered: 6.3 Clearly offer comments about the action taken on the observations of Departmental Officers, District Quality Monitors and State Quality Monitor. 1. 2. 3. 4. 5. 6. 6.4 Comments about difference in observations made by DQM/SQM in earlier inspections (the DQM/SQM shall study the earlier inspection reports of DQM/SQM any and offer his clear comments about the differences in observations, in any). 7. Other observations if any: 7

8. Overall Grading of Work: The overall grading calculated on the basis of item and sub-item wise grading is given below. Item No. Sub item for observation Awarded Grade 1 Earthwork excavation 2 Foundation & Basement 3 RCC footing, column, 4 Superstructure 5 RCC roof, beam 6 Joineries 7 Plastering 8 Flooring 9 Water supply & Sanitation 10 Electrification 11 12 13 14 Overall Grading * S - Satisfactory Signature : * RI-Required improvement Name : * U-Un-satisfactory Date : 8