REQUEST FOR INSPECTION

ProjetConttact l'C03 Designand Construction oflwin uncl by Shicld T:M Tunnel by 'ut &
Cover. nderground Ramp at Rajcndra Nagar and Six Underground metro stations viz Raendra
Nagan, Mon U|asStadium, University, PMCH, Gandhi Maidan & Akashvani with ntry/Exits &
(onnecting subway including Architectural lFinishing. Water Supply, Sanitary Installation & Drainage
works on New ISBT to Patna Station of corridor-2 of Phase-l of Patna MRTS

Clicnt: DELHI METROO RAIL CORPORATION LIMITED

Contractor L&T CONSTRUCTION

REINo:
BOO Rcf:
LATIPCD3/As/12 Inspetion Date: 9 - t 4
Work
|Inspection Time:

Deseription: Ranp Baye ab oeintorr cernernttimalirt

Location of Work:
3.1X13.23s3)T 1 4
We request you to arrange for the inspection of activity mention above prior to strat of work.
For Contractor: For Client:
Requested by: Received by:
Name: Name
1l
3 e5|204

Date: Date:
Time Time

Enclosures Yes No
Comments/Recommendation of Client's Representative

Activity Inspection and Status: (Plcase tick the bos)

Approved
Approved
Approved as Noted
Approved as Noted
Revise & Resubmil
Revise k Resubmit

Contractor Representative
(lient Representative

Name:
Signature with Dae Name:
Signature with Date

Note RFL obe submitted atleast 24hrs puor to DSpecuon

L&TDMRCPCO3C2 PH-01FOTROLDated 24 0S 2022
 Remarks: Chainage/Structure
S.NO lD
:
Location: - CLIENT:
CONTRACTOR:
J6 15 14 13 11 10 9 8 7 6 4 1 Drawing
Date Sign Name
Check Check Whether condition.
Whether drawing
required WhetherWhether Whether BBS/Drawing.
Whether
Whether used
Whether WhetherWhether Whether Whether |Whether Whether
Representative
L&T No.
for
whether whether fabrication
with
Coupler Drainage water Coverspacing reinforcementapproved
reinforcement
correct properapproved approved
GI
binding Revision
the Couplers proofing Blocks access
arrangement No. relevant LARSEN METRO
DELHI
RAIL
missing Pipe provided
lengthlap work make Bar GFC
and wire (-y- p
are membrane of cutting. bars toBending PATNA
are of tools and site Drawing
rebar
required length &
found installed required are grade
such bending, is
is free availableSchedule TOUBRO
has within of is
missing/damaged. installed grade, rebar as of METRO
been as securelyand gauge mandrel, from available
Description
Date Sipn Name Reinforcement
tolerance per e
Representative
L.&TQA/QC anchored approved wherever
size is
as and
shape mud, is NSTw LIMITED)
CORPORATION
available
and per and rust, REINFORCEMENT
CHECK
LIST PC-03
quality bar
tightened/boundtiebyspacingapproved bending/cutting
nol5)14 D-Wall.
in MEP necessary fabrication
is
dust,
etc. bars -CONSTRUCTION PROJECT
drawings are used. are l3
BBS. used.
provided is (DMRC)
and as
in machine, per (Corridor-2
good as approved
wires. per
Level/Layer |Date (HEAVY
GFC etc
are
Dale Sign Name of
CIVIL Phase-I)
Yes
INFRA
Represenative
DNIRC
No IC)

Status
NA

|Count
No,NI
= |Count
SubiiLaT
No Remarks

=
NIL
 Remarks:
16 15 |4 13 12 11 10 8 7 6 4
SL.No
Chainage/Structure
Drawing lD:
Location: JCLIENT:
CONTRACTOR:
Date Sign Name
|tightened
WhetherWhether Whether
Cover of Whether
Whether
WhetherWhetherWhetherdrawing, Whether Whether
GFC Cover
drawing, Whether
drawing. certificates,
Whether colour
Whether
WhetherWhether
Whether
Representative
L&T No. -
sufficient all with Cu
as Adequate proper shuttering reinforcement
HolesAdequateformwork/shuttering approved
machineriesproperlabours
GFC
per joints
drawing
Revision
and Blocksof
specification/drawingjointing areconcrete
around
supporting
lap support Workcoding,etc
access are
gaps material
properly and in
between
in cutting,Method tO
proper is CoN
PC DELIHI
LARSEN &
required Tools site available PATNA
materials provided
shutter arrangement 03-SY-ONC-sT-wG2gis
sealed alignment, as isPPEs,
formwork
per bending wherever available& METRO
reinforcement closed grade, statement Tackles Description ono CHECK
like and to GFC have TOUBRO METRO
Name
formwork for level andapplicable
Date Sign bolts, made to and size ID RAIL
prevent drawing/specifications.
shuttering is have
QA/QC
L&T previously and and placing
available SHUTTERING/FORMWORK
card, LIST
FOR
etc water calibration, (ONSTRUCTION
LIMITED -
CORPORATION PC-03
steel as
are slurry per verticality spacingare as ctc. 2an
is
provided tight
maintained is done per
PROJECT
formwork
cast done SHE
Representative using leakage
asTPT/itness
concrete. as is providedperas per
codnditions
and foam,
as per done
drawing approved (DMRC)
properly specified. GFC
correctly.
putty, |Level/Layer: (Corridor-2
|Inspection
date&
time:
etc.
(EAVY
Sign Name of
Date Yes
Phase-)
INFRA
CIVILIC)

Representative
DMRC No

Status

NA

sutniecRA.Remarks
LT
()
 Remarks: Chainage/Structure
No. S. Draw ID:
0catton:
14 13 12 11 10 5 4 3
CONTRACTOR: CLIENT:
9 7
Name
Date Sign ing
rainwater,
Whether Whether etc. checked
Whether WhetherWhether Whether Whether Whether |Whether Whether Whether
Whether Whether Whetherconcrete No.
with
Representalive
L&T
before SufficientCondition
Concreting
sufficient Lifting sufficient level
member alignment, Survey checking
labours proper approved WG-02283
C-3-SY-ONC-ST- GFC Revision
is drawing
Hooks placing marked to are is access
testing materials Transit of done. of Work
Equipment be in width reinforcement TOUBRO
LARSIEN &
concrete. Tools concreted, proper to is METRO
DELII
/Stiffeners
equipments Mixers & site Method available
like & depth
PPEs, is
tarpaulin,(Concrete Equipments available statement PATNA
provided are is
free have are is
are available within done Description
available of ID RAILCORPORATION
(DMRO
etc Pumps/ PRE-POUR
at are all is METRO
Name the card,etc.tolerance. available
Date Sign are in foreign LIMITED
Representative
QA/QCL&T predetermined available Boom good
to
test PC-03
condition, materials
concrete Placer CONCRETE
-CONSTRUCTION
to
RANIRoy location
prevent
pipe and PROJECT
at TPI
site required
entry etc.) done.
condition CHECK
of finished (Corridor-2
(IEAVY
is
|Date LIST
Yes Level/Layer
CIVIL of
Date Sign Name Phase-[)
INFRA
No
Result
Representative
DMRC
IC)

NA

Remarks
Date SignDesignation
Name REMARKS: lnspection
|DateCasting
ofDateDrawng
of
Comonen Strucure
Strucure
ltem
STEAOCAON
No.SI.
13 12 1 10 4 2
(ONTRACTOR:
3 (LIENT:
No
Representative
L&T ith
Whether|WhetherWhetherWhetherConcrete all WhetherWhether WhetherWhether Whether WhetherWhether
WhetherWhether Description
Revison
Structuredrainage any any debris. Proper Deshuttering Concrete Lifting Center Concrete All
All DELW
concrete over materials
foreign the suvey ARSEN
hessain Curing Shear sleeves/lnserts line
ldentification spout run surfaces Top
coordinates
offsets/defects marked METRO&
of keys done level
openings slurryclothes method TOURRO PATNA
are after are
removed properly as
Date Name
SignDesignation availablecleared structures
on etc
is in in
locations per are RAL
adopted goodattaining good
darwing correct
obsrved above LIMTED METIRO
C
like, condition condition
are ORIORATION
Inserted required POST-IPOUR
Representative
QA/QC
L&T & in insert
required inposition
plates -(ONSTRUTION PC-03
PVC strength
to pipe, if
be Applicable PROJECT(Corridor-2
repaired foam, CONCRETE
CIIECK
LIST

Mastic
(1|EAVYIVI
tape,

Date Name
SignDesignation
Bareo
YES of
INFRA
Phase-)

IC

Representative
DMRC NO

NA

Remarks
 PATNA METRO PC-03 PROJECT (Corridor-2 of Phase-I)
CLIENT: DELHI METRO RAIL CORPORATION(DMRC)
CONTRACTOR: LARSEN& TOUBRO LIMITED - CONSTRUCTION (HEAVY CIVIL INFRA IC)
COUPLER BAR POSITION & TIGHTENING REPORT
Location:
Chainage/Structure ID: JInspecetion date:13Sl24
Pannel No:
BASE SLAB
49, 78
Drawing number: PCssys- NlsT-wb22r3
No of Coupler as Bars inserted in Tightness of
bars &
D-Wall Sketch Layer per drg/ No of Coupler available No of Drilled couplers upto Bars/Couplers Remarks
Nos requirenment spacing
required threading checked physicalty
Top
NA
Bottom NA
Top 16O3|Nopl6e31 No NA
Bottom l6e3 No: 2TQ3INo NA
Top l6e37No l6@ 37Ne NA
-33 Bottom
ølGe3No l6D3No
2 0 3 No037No NA
Top IG3INo 6 3 | No. NA
Bottom

Main
NA
Dia Top
Reiforcem
ent Dia Bottom

Dia Top
Distributio
n Bars
Dia Bottom

Remarks : -

L&TRepresentative L&T QAVÌCRepresentative DMRC Representative

Name Name Name

Sign Sign Sign

Date Date
|8eS| 24 Date
 PATNA METRO PC-03 PROJECT (Corridor-2 of Phase-I)

|CLIENT: DELHI METRO RAIL CORPORATION (DMRC)

CONTRACTOR: LARSEN &TOUBRO LIMITED - CONSTRUCTION (HEAVY CIVIL INFRA IC)
COUPLER BAR POSITION& TIGHTENING REPORT
|Location: |Inspection date:
Chainage/Structure lD: R'ASE SLAB
Pannel No:
Drawing number: P-s-SyS-NO-ST -
No of Coupler as Bars inserted in Tightness of
No of Drilled bars &
D-Wall Sketch Layer per drg/ No of Coupler available couplers upto Bars/Couplers Remarks
spacing
Nos requirement required threading checked physically

Top l6a3Nol6@34No3No- 35 ye
Bottom 163tNoT603No NA
Top le3No \6@3 No
34Nol6a3t
Bottom
NA
Top

Bottom

Top
Bottom

Main
Reiforcem
Dia Top
16m
ent Dia Bottom

Dia Top
Distributio
n Bars
12nm
Dia Bottom
2m 12mm
RemarKS :

L&T Representative L&T QAÌC Representative DMRC Representative

Name Name Name
RANI Po
Sign Sign Sign
Date
18lesj2 Date
185/29 Date
 96/

KJN
SIGN UL8095.775BASE
TO
020+2
-CJ(UL8079.623)
OF 46.490
L&T 5-6(B)
ZONE ASBUILT
SLAB
SURVEYOR

46.597

AT
969
CUT
46.716 AND

090+8 COVER

SIGN RAMP
AREA
46.855
93-oS-
Do24 OF
DMRC

|6669

REPRESENTATIVE FROM

46.994
UL8079.623

LL60N 2

PC01
cJ(ULIJL8095.775)
47.152 N
 PATNA METRO PC03 PROJECT(Corridor-2 of Phasc-1)

(LIENT: DEHIMEIRO RAIL CORPORATION (DN1RC)

CONTRACTOR: IARSEN& TOUBRO LIMITED -CONSTRUCTION (IEAVY CIVIL INFRA IC)

CIIECKLIST FOR SURvEY

Location: -
|Inscpection date:
18:0s. 2024
Chainage Structure ID Level/Layer: Rasl Level-0530
Basc slab ct Ramp alca
Date of snrver
I8.o5. 2024
Work descrintion

Referencc drawing No.

Base slab arca chekg fom s09. 623 to LBA ?5-725
PCo3- SYS-CNC- ST-Dwao2254 -(R-E
Reference survev station
GPSID LT63
|Instrument used
Leica TS - 04
Theorctica/ Required Co-ordinates Actual Co-ordinates
Difference in mm
Description of check
Easting Northing Casting Northing

28323S21S4 3149836SY 28323S2 |SS

221celayat 31491.926 28323 40. 818 314521 938 2832340-819
3 ce 314983.322 2832B40.608 314583.3 20 2832340. 6o3
4
21492 622 283233600 314482·62 2832336 ¢22 -m2my
314968962 2832338(6]_ 314468 963 2832338l6
2832342·6&ò 3i4969.G46 2832242682 2 m
2832242 49o 3149030 2832 34241
Renarks
314992. 762 2232353 896 3(4922963 2832 2S3 9
UL
BO9S75 PeO1,
L&I Representative DMRRepresentativ
|:xecution Lngneer SuryVOr Fnginer
Surveyor
ame:
kertick cl ando Nae

GUNIESH kuAR
Sign
Geoje}l kims
Date:
(8.0S-02A 12-05-} Date
18-oS-224
 -CJ(UL8079.6231
RJNT
PCC AS-BUILT LEVEEFROM UL8079.623 TO UL8095.775OF RAMP SLAB P

CU;8095.775)

ZONE 5-6(B) ZONE 6-7(A)

24.185 14.705

$.918 46.98
439159
NWDO9
AOHI
aIS &

Z8r0 too EVOEIHI

WWO09 F6. 05 Y6. 73 V6 757
6.61
6. 72 K6.7.74z43 36.985
6.619 \46 731 N6812 46 937
46. 17 k6. 92 Y623 \46.94 446.69.695
\60219 9219 H64.6.2119 6. 93 46.7 4
T8089 ¬9+9 X6. 72 6.776
6.462. 25 352 46.948 47 0 1
928S Ot6G Lt2L9 SLA9
9
6 72 6.735
45.807 45.886 45.965 46.045 46.124 46.203 46.282 46.461 46.540 46.620 46.699 46.778 46.857 46.936 47.110/47.010

O
SIGN. OF L&T SURVEYOR
SIGN. OF DMRC REPRESENTATIVE

konhek charda chalolels

isfos/2024 S-oS-2024
 LARSEN & TOUBROLIMITED
HEAVY CIVIL INFRASTRUCTURE IC
PATNA METRO PC-03 PROJECT (Corridor-2 of Phase-1)
Metros Business Unit
CLIENT: DELHIMETRO RAIL CORPORATION (DMRC) L&T/ DMRC/ PC-3/ R00
CONTRACTOR: LARSEN &TOUBRo LIMITED -CONSTRUCTION (HEAVY CIVIL INFRA IC)
CONCRETE POUR CARD
Structure:
BASE SLAR sidNo 6totASoAB Date:
215|244
ocation: Ambient

Drawing No. with Revision

Temp: 275'c
Grade of concrete: M- 4o
Transit Mixer
Pouring Time Slump
Qty in Cum.Qty in At Plant At Site in mm
Temp.°C No of
S) No Vehicle No
M³ M3 Cubes Remarks
Batch
Start
Batch End In Time Out Time Start End At Plant Site At Plant Site Taken

3025 So2-427:s3+3
24677
6o3 t-o21 ISo24:4sS
4 933 |oo;slGO)34I: lo2302: l o 2 25 |45A-2

to42-oee:4o:S2:3s323oo 31S |3S 42

93S o49-o |:31:a2:43s3:2s|3:459e I 4 S t o 1
305 +ol S6o2:2s333:osl4:1s| 3:SS44: lo 1s 26-626-7 3
t-o63239 247|3:4544 4:204:3s13o 13s6426-s
353s *oZo o25333: SS:es 4:45So|SIso 26s266
o 1o3:s3:|44:cS:3 S:l5:25to 4o 64 26s
Go37 +og4 4:o4:215:1o5:ss| 5:355:5o1?s ISo 2622633
3
Remarks 7iel91.o4:18\4:27|5:136:2o 6toe6:slol4o 6924

I81 Represcntative L&TQA/QC Representative DMRCRepresentative

Name Name
Ravi Roy Chanchal Name

Sign Sign Sign

Date Date
21/o5/24 Date
 LARSEN & TOUBRO LIMITED
HEAVY CIVIL INFRASTRUCTURE IC
PATNA METROPC-03 PROJECT (Corridor-2 of Phase-I )
Metros Business Unit
CUENT: DELHI METRO RAIL CORPORATION (DMRC)
L&T/ DMRC/ PC-3/ RO0
CONTRACTOR: LARSEN & TOUBRO LIMITED-CONSTRUCTION (HEAVY CIVIL INFRA IC)

CONCRETE POUR CARD

Structure
BASE SLAR Date:
Location: Ambient
Temp:
Drawing No with Revision
Ds S-N C-ST W- 0223
Grade of concrete:

Transit Mixer Slump

At Plant Pouring Time Temp.°C
SI No Vehicle No Qty in Cum.Qty in At Site in mmn No of
M M Batch Cubes Remarks
Start
Batch End In Time Out Time Start End At Plant Site At Plant Site Taken

to9o4:z42S:36:4s|6:2S 6:4o||to|3s26 4 26-s3

Tolo5o5l S:96:lols6So:lo 120|4S 26-8 269
to|20S:265:o6:37:sT2040 1sSo 263 26-9 3

|Remarh

L&1 Representative L&TQA/QC Representative DMRC Representative

Name Name Ravi Roy Chanchal Name

Sign Sign Sign

Date Date
21/05/24 Date