Use this record for
Field identity, sampling/test method reference, custody transfer, laboratory report transcription, project-specific review and exception closeout for ordinary cast-in-place concrete tests.
Outside this record: Prescribing test operations or sampling rates; generic acceptance criteria; laboratory certification; structural interpretation; lot acceptance; curing of the constructed member or early-load authorization.
Blank record. Use the actual adopted test method and project criteria; transcribe results only from the issued laboratory report. It does not certify a test or concrete lot.
Collect these project inputs first
- Project specification and sampling plan
- Defines sample/test type, frequency, age, required specimens, report route and acceptance basis.
- Adopted test method and laboratory assignment
- Names actual method edition, sampling/testing party and their responsibilities.
- Delivery ticket and pour-location records
- Trace sample to batch and the element represented.
- Sample labels and custody/transport forms
- Preserves identity across each handover to the laboratory.
- Review criteria and failed-result procedure
- Names the project decision authority and response for anomalous or nonconforming results.
How to use the checklist
- Confirm exact project sampling plan, method edition, report route and result reviewer.
- Link sample and specimen IDs to actual docket, batch, pour lot and location.
- Record tester/equipment and custody evidence only as required by adopted method; preserve contemporaneous forms.
- Transcribe actual results and units exactly from issued report; retain amendments and laboratory comments.
- Compare to the stated project criterion and record assigned reviewer decision; leave any unresolved result open for written disposition.
- Use the specimen register for repeat entries; continue on another blank copy when needed and retain the linked original evidence.
Checks and the records they need
Fill project criteria from approved documents before inspection. The fields below show what the downloaded form asks you to record; the web page does not save or approve site results.
Specimen register for repeat entries
Use one row per specimen/result entry. Keep sample-set and batch links when several specimens represent one sample. Enter laboratory results only from the issued report; preserve the original report, amendments and custody evidence. This register indexes the evidence and does not replace it.
- Sample / specimen ID
- Docket / batch ref
- Element / pour location
- Sampling date / time
- Custody / lab receipt ref
- Method / test age and unit
- Report / revision
- Actual result / unit
- Review / disposition / role ref
The files provide 6 blank entry rows. Continue on another blank copy as needed; the web page does not record site entries.
CT-01 · Sample identity and concrete traceability
Unique sample/set and specimen IDs, docket/batch/mix, date/time, lot, pour, element/grid and represented location.
- How to check
- Match labels and sampling log to docket and pour diary at sampling; preserve the defined link if a sample represents several specimens or locations.
- What defines acceptance
- The sample and specimen IDs are legible and traceable through source batch/docket and represented element/location under the project sampling plan. Duplicate or unmatched identity remains unresolved rather than assigned by assumption.
- Project document to cite
- Approved project sampling plan, sample/label register, source delivery docket and pour-location record; cite the actual identity and mapping references.
If a discrepancy is found: Resolve duplicate, illegible or unmatched identity with sampler/lab; never assign by assumption.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Sample / specimen IDs
- Docket / batch / mix
- Date/time and sampled location
- Pour / lot / element ref
- Result, inspector and date; issue and recheck reference
CT-02 · Test purpose and method reference
Requested test type, purpose, method clause/edition, requested age or occasion and sampling/testing role.
- How to check
- Transcribe from project test plan and laboratory request; reconcile with report headers when issued.
- What defines acceptance
- Test purpose, method/edition and requested occasion agree with the project test plan and laboratory request. A missing or conflicting method, age or sample basis requires clarification before the affected result is assessed.
- Project document to cite
- Project concrete specification/test plan, adopted test-method identifier and edition, and laboratory test request defining purpose and test occasion.
If a discrepancy is found: Ask the project engineer or laboratory to resolve a missing or conflicting method and mark result review Pending.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Test type / purpose
- Method / clause / edition
- Requested age / date basis
- Sampler / tester role and request ref
- Result, inspector and date; issue and recheck reference
CT-03 · Tester and equipment evidence
Sampler/tester role; actual equipment identifier and calibration/verification reference where required by adopted method.
- How to check
- Link equipment and competence evidence to the actual sample/test record without assuming credentials or intervals.
- What defines acceptance
- The actual performing role and any required equipment/competence records can be traced to the sample/test under the adopted procedure. Missing required evidence is referred for technical review, without assuming a credential or interval.
- Project document to cite
- Adopted procedure and project testing-provider requirements, actual sampler/tester record and any required equipment calibration/verification record.
If a discrepancy is found: Hold affected result for assigned technical review if a required evidence item is absent; do not backfill a claim.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Sampler / tester name and role
- Equipment ID / type
- Calibration / verification ref + date
- Deviation / query ref
- Result, inspector and date; issue and recheck reference
CT-04 · Specimen preparation and field handling
Observed specimen count/type and labels, sampling/casting time, initial storage/handling entry and any deviation required by the method.
- How to check
- Record contemporaneously from actual sampler log and labels; point to the exact method clause for details.
- What defines acceptance
- Recorded specimen type/count, preparation and initial handling evidence can be reconciled with the adopted procedure. A recorded departure is retained for method-based disposition; this form supplies no preparation parameters or validity judgement.
- Project document to cite
- Adopted specimen preparation/handling procedure and its clause, sampling/label log, initial storage record and any deviation instruction.
If a discrepancy is found: Document and notify deviations promptly; request method-based decision before treating specimens as valid.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Specimen IDs / type / count
- Sampling/casting time
- Initial condition / storage record
- Method clause / deviation ref
- Result, inspector and date; issue and recheck reference
CT-05 · Custody transfer and laboratory receipt
Date/time and transferring/receiving roles, specimen IDs at each handover, dispatch record and lab receipt/condition acknowledgment.
- How to check
- Follow actual custody forms; reconcile ID at collection, delivery and receipt. Attach chain-of-custody or dispatch evidence.
- What defines acceptance
- Specimen identity remains traceable across the recorded transfers and laboratory receipt, with condition or custody exceptions identified under the applicable procedure. Missing acknowledgement or mismatched IDs remain Pending.
- Project document to cite
- Actual project/laboratory chain-of-custody or dispatch form, specimen labels, transfer record and laboratory receipt acknowledgement.
If a discrepancy is found: If identity or custody is uncertain, preserve the full trail and ask lab/project reviewer whether result is usable.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Handover times and roles
- Specimen IDs at transfer
- Lab receipt / condition
- Custody form / dispatch ref
- Result, inspector and date; issue and recheck reference
CT-06 · Issued laboratory report and actual results
Report ID/revision; specimen IDs; actual value and unit; test date/time/age; reported method, comments, invalid/omitted marks.
- How to check
- Transcribe exactly from issued lab report; do not convert or average unless adopted method directs. Keep report with record and flag amendments.
- What defines acceptance
- Each transcribed value, unit, method, test date/age and comment agrees with the identifiable issued report and specimen. Amendments and invalid/omitted result marks are retained; transcription alone does not establish project conformity.
- Project document to cite
- Original issued laboratory report and amendment/revision, sample/specimen register and the project test request or method used for reconciliation.
If a discrepancy is found: Query mismatched IDs, missing unit/method, amendments or anomalous outcome with laboratory and project reviewer; retain originals.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Report no. / revision
- Specimen ID
- Actual result / unit
- Test date and age / unit
- Method / comments / amendment ref
- Result, inspector and date; issue and recheck reference
CT-07 · Project criterion and assigned result review
Exact criterion, source document/revision/clause, actual result comparison/calculation if required, named assigned reviewer and recorded status.
- How to check
- Compare issued report against project test plan; show criterion and report side by side and have the assigned role record conclusion.
- What defines acceptance
- The assigned reviewer uses the actual governing criterion and original report to record a supported comparison and decision. An unavailable criterion or anomalous result remains open; no default strength, age or acceptance rule is set.
- Project document to cite
- Governing project result-acceptance clause/test plan and its approved revision, original report and assigned result-review/decision arrangements.
If a discrepancy is found: Keep status Pending or follow project Fail action and escalate to named project role; preserve exact criterion and report reference.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022).
- Criterion + unit / exact clause
- Source document / revision
- Review outcome / status
- Reviewer role / date
- Result, inspector and date; issue and recheck reference
CT-08 · Failed, missing or disputed result closeout
Affected sample/batch/element, lab query or NCR, investigation, written disposition, further evidence/retest reference and closeout status.
- How to check
- Carry issue into concrete delivery/placement records; link original and revised reports, instructions, action and recheck in date order.
- What defines acceptance
- The affected sample/batch/element, written disposition and required follow-up evidence are linked, and the project-assigned role records closure or remaining conditions. This entry grants no structural or early-work release.
- Project document to cite
- Project nonconformance/technical-review procedure, laboratory query or amended report, written disposition and follow-up/retest evidence references.
If a discrepancy is found: Leave affected issue open until documented disposition and required recheck are filed.
Topic references: Cavoren cast-in-place concrete baseline; Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022); Hutchies 040 Concrete Place Report (public Word report template).
- Affected sample / batch / element
- NCR / lab query ref
- Written disposition / authority ref
- Follow-up evidence and closeout date
- Result, inspector and date; issue and recheck reference
When a check cannot be closed
| Situation | What to record or resolve |
|---|---|
| Specimen ID or report does not match field sample/custody records. | Keep result unlinked and Pending; reconcile original labels, transfer log, lab receipt and any amended report. |
| Method, test age, unit or project acceptance criterion is absent. | Identify exact missing document/clause and request assigned technical decision. Do not invent a generic value or rate. |
| Report is invalid, anomalous or outside the cited project criterion. | Preserve report, map affected batch/element and use project NCR/technical review process before closeout. |
| Someone asks the test record to authorize stripping or loading. | Refer to separate written design/project criteria and named release role. This sheet cannot authorize that activity. |
| Laboratory qualification or equipment status is assumed. | Check only the current project/method requirement and evidence; record the verified scope and reference. |
Concrete test evidence handover
This status covers traceability and report review. The laboratory reports a test; the project-assigned role reviews it against adopted criteria. Neither this sheet nor the recorder certifies concrete or authorizes early work.
Record handover status options in the blank record:
- Record completed; evidence filed
- Action or recheck remains open
- Project / technical disposition required
Record the assigned roles: Field sampler / recorder name / role / date; Laboratory receiving role / date; Assigned result reviewer role / date; Open NCR / lab query / disposition ref.
Fictional specimen-to-report trace example — no result shown
Fictional teaching example only. These are illustrative document references, not a real project, engineering values or completed inspection results.
Teaching-only IDs: docket DKT-0007, batch B-04, sample S-02, specimens S-02-A / S-02-B, element P1, report LAB-R-18. All identifiers are invented.
- Requirement to carry into the record
- Trace each identifier across docket, site log, sample label, custody handover, laboratory receipt and issued report. Review only after the actual project method and acceptance clause are entered.
- Illustrative reference
- Fictional IDs only. No test value, unit, age, frequency, test procedure or result is provided.
- What the site record should capture
- Map the fictional trace using the blank fields. Result, criterion, custody condition, review and disposition remain blank because no work/test evidence exists.
Source notes and limits
- Cavoren cast-in-place concrete baseline
Scope context only; not independent technical authority or project acceptance criteria. Read: Original proposed sampling and result-review topics CON-10 and CON-14. Checked 2026-10-07.
- Queensland Department of Transport and Main Roads, MRTS70 Concrete (July 2022)
Topic guidance only. MRTS70 is for Queensland road/bridge infrastructure contracts (or other specified elements). Its values, timing limits, test frequencies, qualifications, H/W points, project roles and release rules are not generalized into these records. Read: July 2022, Clauses 12.2–12.3 (batch/location, reports and testing records); 15.2.1–15.2.5 (in-situ sampling, specimen identity and handling, and early-age interface). Requirements apply only within the adopted TMR contract scope. Checked 2026-10-07.
- Hutchies 040 Concrete Place Report (public Word report template)
Contractor-specific example of report layout and handover, not universal criteria. No Hutchies text is reproduced. Read: Public 040 Concrete Place Report: header and closeout fields, rows 6–13 on discharge, placement, protection, curing and final records review. Contractor example only; no technical acceptance conditions are adopted. Checked 2026-10-07.
Continue the work sequence
- Concrete ITP template
- Pre-pour inspection
- Concrete delivery record
- Concrete curing and protection record
- How to write a concrete ITP
- ITP vs inspection checklist
This field record documents checks after they are carried out. An ITP sets the work sequence, project criteria, responsibilities and required records before the work starts.
Need an ITP prepared for your project?
Send your drawings, specifications and contractor requirements. Receive a project-specific ITP and matching blank site records in Excel, Word and PDF.
USD 99 per defined work package · Within 24 hours after the required project files are complete.