Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Specimen ID Date CastRequired Date
TestGrade of Concrete Mix
Cement used
Kg/m3 By Product Name By Product Used Kg/m
3 Chemical Used Name
L/m3
رقم املراجعة/ رقم إلاصذار
رقم النمورج
Sample Required : 3 - Specimens are required for each test:
Water Absorption
BS 1881:P122:83 Amd 6108:89
Rapid Chloride Permeability ASTM C1202 -
97
Initial Surface Absoption Test BS
1881 Part 208:96
Depth of Water Under Pressure
BS EN 12390-8:2000
Specified limit : Specified limit: Specified limit: Specified limit:
نمورج طلب اختبار ديمومة الخرسانة
DURABILITY TEST REQUEST
Test Required / Method:
Mix Reference Mix Source Cement Type
By Product Type-1
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
Cement Source
SourceSource By Product Type-2
1
DUR / Project No. : Bill No. :
w/c Ratio
تاريخ إلاصذار
صفحة
(2) (1)
QC-LAB-CF16
04/01/2018
1/4/2018 تاريخ إلاصدار (2)/(1) /رقم املراجعةإلاصداررقم
(1) صفحة QC-LAB-CF1 رقم النموذج:
نموذج طلب تصميم الخلطة الخرسانية
CONCRETE MIX DESIGN REQUEST
Project املشروع
Consultant الاستشاري
Contractor املقاول
Booking Date Email :
Tel: Mobile No :
For Lab. Use : MDT/ Date Received
Project No Bill No
Please give the following details.
Specified Cube Str.: ____________ MPa
Cement Type:_____________ OPC/SRC
Cement Kg/ m3
:___________________
Kg Mini. _________________Kg Max.
Cement Source: ___________________
Free W/C __________________ (Max.)
By Product Kg/m3: ________________
Slump:_____________________ mm
Type of Admixture :________________ Slump : ____________________ mm
Mix Design based on : BS 5328 :1991
Criterion for acceptance of test results: For example,
1. Average strength of 4 test specimens shall be equal to or more than the specified strength and no
specimen shall have strength less than 85% 0f the specified strength.
OR
2. The strength of 95% test specimens to exceed the specified strength.
OR
3. Any other, please specify.
Materials required for each mix design is as follows. Mix design will be carried out only if the materials
supplied conform to relevant specification as proved by their test results.
1. Cement - One bag; 2. Fine Aggregate-each sample Mini. 90 kg; 3.Coarse Aggregate-each sample Mini. 90 kg
Consultant Signature: Sign verified by Lab. Personal
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
INFORMATION TO BE FILLED CAREFULLY:
Concrete Temperature at the time of Placing _____________________°C
S. NO.
Consultant Signature Sign verified by Lab. Personal
ثاريخ إلاصدار
صفحة QC-LAB-CF2
04/01/2018
1
Received Date
CCU No. : Project No. : Bill No. :
(1) (2)رقم املراجعة/ رقم إلاصدار
نموذج طلب اختبار املكعبات الخرسانية
C O N C R E T E C U B E T E S T R E Q U E S T
Mobile No
Date Cast Actual Date TestNeed Curing in
the lab.
Chem. Admixture:________________________________________
Curing Condition:Done on the site as per standard / Not Done___________________________________
Total No. of Cubes:_______________________________________
Compression Test Method: BS 1881 : 116 & 111 : 1983 AMND 1991-( Cubes from each bach is required for 7 & 28 days test.)
Date to be Tested
For Lab Use Only
Cement Type:_________________________________
W/C ratio:____________________________________Cement Source: _________________________________________
Cement Content:_________________________________________
رقم النموذج
Source:______________________________________Mix Reference:___________________________________________
Specified Strength:_________________________MPa
Nominal Cube size:____________________________
Slump Obtained at Site:_________________________
Mark On Cube
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
تاريخ إلاصدار
صفحة
Test Required & Method:Compressive Strength(BS-6073 P2:1981-AMND4508:84) +Water Absorption(ASTM-C140-09a) +Sulfate &
Chloride(BS-1881- P124:88)
For Lab Use Only
رقم النموذج
SIZE OF SPECIMENS
Thermal
Telephone :
1. Masonry Block (15 specimens of each batch or every 10000 Blocks are required.)
نموذج طلب اختبار الطابوق
M A S O N R Y B L O C K T E S T R E Q U E S T
Mobile No
Contractor:
Received Date
CMB No. : Project No. : Bill No. :
(1) (2)رقم املراجعة/ رقم إلاصدار
Length xThickness x Height mmLength xThickness x Height mm Length xThickness x Height mm
QC-LAB-CF3
04/01/2018
1
TYPE OF SPECIMENS
Solid
Hollow
Source: Specified Strength:
Consultant Signature Sign verified by Lab. Personal
Hourdi
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
تاريخ إلاصدار
صفحة
Consultant Signature Sign verified by Lab. Personal
QC-LAB-CF4
04/01/2018
1
INFORMATION TO BE FILLED CAREFULLY:
Name of person taking core.
(1) (2)رقم املراجعة/ رقم إلاصدار
Admixtures used.
ConcreteDirection
Project No. :
Comprisive StrengthDrilled. V/H/D
Telephone:
Specimen to
be drilled on
نموذج طلب اختبار القالب الخرساني
CORE DRILLING TEST REQUEST
Mobile No
Contractor:
For Lab Use Only
رقم النموذج
TEST METHOD BS 1881 : Part 120 : 1983
Specimen
Location
Test Required
Received Date
CCO No. : Bill No. :
Date cast
Specified concrete Strength MPa.
Concrete mix details.
Condition of storage.
تاريخ إلاصدار
صفحة
Other details
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
Length Width Height
3
4
5
6
تاريخ إلاصدار
صفحة
Specimen
No
1
2
Test required
Chemical
Test Required
Physical
INFORMATION TO BE FILLED CAREFULLY:
Consultant Signature Sign verified by Lab. Personal
7
Bill No. :
(1) (2)رقم املراجعة/ رقم إلاصدار
QC-LAB-CF5
04/01/2018
1
هموذج طلب اختبار الكريبستون
KERB STONE TEST REQUEST
Mobile No
Received Date
For Lab Use Only
رقم النموذج
8
Sample Required : 8 Specimens required for conformity from the factory , 4 specimens required from batch or each 1000 m
TEST METHOD BS EN 1340 : 2003 ANNEX C & F / BS-1881 Pt 124:1988
Specimen Dimension mm
KSN No. : Project No. :
Number of Specimens.
Name of Supplier of Specimen.
Specified Strength MPa.
Other details
Date of Sampling.
Time and place of Sampling.
Time and place of Making Specimen.(Source)
Method of Compaction (Hand or Vibration).
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
Length Width Height
3
4
5
6
تاريخ إلاصدار
صفحة
Other details
Date of Sampling.
Time and place of Sampling.
Time and place of Making Specimen.(Source)
Method of Compaction (Hand or Vibration).
INFORMATION TO BE FILLED CAREFULLY:
Number of Specimens.
Name of Supplier of Specimen.
Specified Strength MPa.
For Lab Use Only
رقم النموذج
TEST METHOD BS 7263 P1 : 2001/BS 1881-Pt 124* Sample Required : 6 Specimens for Batch of up to 1000 paving flags .
Specimen Dimension mm
FLG NO : Project No. : Bill No. :
رقم املراجعة/ رقم إلاصدار
نموذج طلب اختبار البالط الخرساني
PAVINGN FLAGS TEST REQUEST
Mobile No
Received Date
(2) (1)
QC-LAB-CF6
04/01/2018
1
Consultant Signature Sign verified by Lab. Personal
Specimen
No
1
2
Test required
Chemical
Test Required
Physical
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone
Booking Date
تاريخ إلاصدار
صفحة
Others if any
T E S T R E Q U I R E D
Breaking Strength
CERAMIC/ CONCRETE TILE
Dimension Water Absorption
TEST METHOD: BS EN ISO 10545
نموذج طلب اختبار بالط السيراميك
T E S T R E Q U E S T F O R M F O R CERAMIC TILE
Mobile No
Received Date
CTL : Project No. : Bill No. :
For Lab Use Only
(1) (2)رقم املراجعة/ رقم إلاصدار
QC-LAB-CF7
04/01/2018
1
TILE TYPE
SOURCE
Note: 15 Specimens are required for the tests.
Consultant Signature Sign verified by Lab. Personal
رقم النموذج
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Source
Cr.Gravel 20 mm Cr. Gravel 10 mm Sieve Analysis Dust Content Water Absorp.
Cr. Stone 20 mm Cr.Stone 10 mm Flakiness Bulk Density 10%FineValue
Wadi Gra. 20 mm Wadi Gra.10 mm Soundness Chloride Sulfate
Source
Dune Sand Beach Sand Sieve Analysis Dust Content Water Absorption
Wadi Sand Cr. Gravel Sand Bulk Density Chloride Sulfate
Cr. Stone Sand Soundness
تاريخ إلاصدار
صفحة رقم النموذج
Spec.Gravity
Test Required - BS-812:P-1,2,103,105,111,117&118 / ASTM:C88
Test Required - BS-812:P-1,2,103,,117&118 / ASTM:C88
(1) (2)رقم املراجعة/ رقم إلاصدار
QC-LAB-CF8
Organic Matter
For Lab Use Only
AGGR. (Mini 90 Kg. each Sample)
Bill No. :Agg No : Project No. :
Fine Aggregate
Specific Gravity
04/01/2018
1
Coarse Aggregate
Consultant Signature Sign verified by Lab. Personal
نموذج طلب اختبار للركام
T E S T R E Q U E S T F O R M F O R AGGREGATE TEST
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Rebend Sulphur Carbon Nitrogen Phosphorus
رقم املراجعة/ رقم إلاصدار
رقم النموذج
نموذج طلب اختبار الحديد
S T E E L T E S T R E Q U E S T
Note: Test Certificate from the manufacturer is required
Consultant Signature Sign verified by Lab. Personal
Sample Required: 60 cm.Length 3 bars &
30 cm. Length 2 bars from each Diameter
Local Supplier:
T E S T R E Q U I R E D
Source:
For Lab Use Only
DIAMETER (mm)
BoltsRe-bar
As per standard a fresh sample should be submitted every "100" tonnes use of steel.
Bill No. :
As per standard a fresh sample should be submitted every "100" tonnes use of steel.
Test Method: BS 4449:1997 & BS EN 10002:1:2001
Tensile Bend
STEEL TYPE : Others
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF9
04/01/2018
1
STL / Project No. :
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
CEMNT TYPE
GRADE
TESTS REQUIRED
TEST METHOD
SOURCE
CHEMICAL ANALYSIS
BS EN 196 P-2:2005
PHYSICAL TESTS
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF10
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
OPC/SRC/MSRC
32.5N/ 42.5N/52.5N
04/01/2018
1
CEM NO / Project No. : Bill No. :
DETAILS TO BE FURNISHED
Note: One full packet of 50 kg sample is required for the tests.
نموذج طلب اختبار إلاسمنت
C E M E N T T E S T R E Q U E S T
BS EN 196 P1 & P-3 :2005
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
04/01/2018 تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF11
PAINT TYPE
BATCH NO.
Pigment Content
QUANTITY
****
TESTS REQUIRED (As per ASTM D4451,1644 &1475 )
1
PNT / Project No. : Bill No. :
DETAILS TO BE FURNISHED
SOURCE
Binder Content
Non Volatile Matter
COLOUR
نموذج طلب اختبار ألاصباغ
P A I N T T E S T R E Q U E S T
Sample required : Min.2 litre sample . Technical data sheet should be provided.
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
Specific GravityVolatile Matter
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
Sample required : Min. 2Kg.Sample Bitumen.Technical Data sheet should be provided
هموذج طلب اختبار البيتومين
B I T U M E N T E S T R E Q U E S T
T E S T R E Q U I R E D
Colour Drying Time
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
BITUMEN
Solid Content
Specific Gravity
Bill No. :
TEST METHOD: As per ASTM D244,D2939
SOURCE
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF12
SAMPLE DESCRIPTION
GRADE
QUANTITY
04/01/2018
1
BIT / Project No. :
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Sample used as
Point No. Test Location
رقم املراجعة/ رقم إلاصدار
صفحةرقم النموذج
(2) (1)
QC-LAB-CF13
04/01/2018
1
ISDT NO / Project No. : Bill No. :
تاريخ إلاصدار
Soil Description
Thickness Layer
Consultant Signature Sign verified by Lab. Personal
TEST METHOD BS 1377 : Part 9 : 1990
Test Level cm
(إختبار الدمك باملوقع )نموذج طلب اختبار كثافة التربة
IN- SITU DENSITY T E S T R E Q U E S T
For Lab Use Only
Source:
COMPACTION Specification Limit
Refer:
Proctor Reference
MDD:
OMC:
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
نموذج طلب اختبار البالط
TERRAZZO TILE T E S T R E Q U E S T
TEST METHOD: BS EN 13748 PART 1 & 2 : 2004
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
Others if anyWater Absorption
QC-LAB-CF14
Breaking Strength/Breaking Load
T E S T R E Q U I R E D
DIMENSIONS
04/01/2018
1
TTL / Project No. : Bill No. :
Requirement of Specimen: 10 Specimens each 1000m2
SOURCE
تاريخ إلاصدار
صفحة
(2) (1)
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
نموذج طلب اختبار العازل املائي
WATER PROOFING MEMBRANE TEST REQUEST
Test Method: UEAtc
WATER PROOFING MEMBRANE
QUANTITY
For Lab Use Only
SOURCE
GRADE
Tear Resistance(L&T)
Thickness
Consultant Signature Sign verified by Lab. Personal
Mass/Unit Area
Elongation(L&T)
Sample required : Min.1Roll(Membrane).Technical Data sheet should be provided (1 test every 10000m2 or less)
Heat stability
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF15
T E S T R E Q U I R E D
1
SAMPLE DESCRIPTION
04/01/2018
Reinforcement Tensile Strength(L&T)
Water Absorption
WPM / Project No. : Bill No. :
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
رقم املراجعة/ رقم إلاصدار
رقم النموذج
Grass Block
Rondo
TYPE OF SPECIMENSIZE OF SPECIMEN (THICKNESS)
COLOR OF SPECIMENS
Uni Block
Uni Décor
Source: Specified Strength:
Decor Block
Behaton
Cercle Block
Florendo
1
CPB NO / Project No. : Bill No. :
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF17
04/01/2018
Paving Block (15specimens of each batch & color are required) or 1000 m2
نموذج طلب اختبار إلانترلوك
PAYVING BLOCK (Interlock ) TEST REQUEST
Test Required & Method:Compressive Strength(BS-6717- P1:1993) + Water Absorption(ASTM-C140-09a) + Sulfate & Chloride(BS-1881-P124:1988)
Other
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
80 mm 60 mm
Rectangular Block
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
WATER
Minimum 1Lit.
SampleSulfate TDS pH Value
رقم املراجعة/ رقم إلاصدار
رقم النموذج
Test Required (AS PER BS 6068:2/ BS 1377:3)
04/01/2018
1
WAT/
تاريخ إلاصدار
صفحة
(2) (1)
QC-LAB-CF18
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
نموذج طلب اختبار املاء
WATER T E S T R E Q U E S T
Chloride
Source
Project No. : Bill No. :
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Source
Liquid Limit Plastic Limit Proctor
Chloride Sulfate Organic Matter
رقم املراجعة/ رقم إلاصدار
رقم النموذج
Consultant Signature Sign verified by Lab. Personal
FIL / Project No. : Bill No. :
هموذج طلب اختبار الدفان
F I L L I N G T E S T R E Q U E S T
Filling Material
Mini.120 Kg.
Sample
Test Required -As per BS-1377:P-2,3&4 :1990/ BS 812:P103:1985
(2) (1)
QC-LAB-CF19
CBR
Sieve Analysis
04/01/2018
1
تاريخ إلاصدار
صفحة
For Lab Use Only
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Beach Sand Natural Sand Dust Content B.Density Spec.Gravity
Chloride Sulfate Organic Matter
رقم املراجعة/ رقم إلاصدار
رقم النموذج
نموذج طلب اختبار رمل البالستر
P L A S T E R S A N D T E S T R E Q U E S T
Test Required - BS-812:P-1,2,103,,117&118 /BS 1377:3:1990
Sieve Analysis
W. Absorption
Plaster Sand
Mini. 60 Kg. Sample
For Lab Use Only
Consultant Signature Sign verified by Lab. Personal
Source
Project No. :PLA /
QC-LAB-CF20
تاريخ إلاصدار
صفحة
Bill No. :
04/01/2018
1
(2) (1)
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Source
Dust Content B.Density Spec.Gravity
Chloride Sulfate Organic Matter
رقم املراجعة/ رقم إلاصدار
QC-LAB-CF21رقم النموذج
04/01/2018
1
Bill No. :
تاريخ إلاصدار (2) (1)
صفحة
Consultant Signature Sign verified by Lab. Personal
Project No. :MOR /
نموذج طلب اختبار رمل الطابوق
M O R T A R S A N D T E S T R E Q U E S T
Test Required - BS-812:P-1,2,103,,117&118 /BS 1377:3:1990
Sieve Analysis
W. Absorption
Mortar Sand
Mini. 60 Kg. Sample
Natural Sand
Cr. Stone Sand
For Lab Use Only
Project املشروع
Consultant الاستشاري
Contractor املقاول
Telephone Mobile No
Booking Date Received Date
Liquid LimitPlastic
LimitProctor
Chloride Sulfate Organic Matter
رقم املراجعة/ رقم إلاصذار
1رقم النمورج
(2) (1)
QC-LAB-CF22
Bill No. :
تاريخ إلاصذار
صفحة
04/01/2018
Consultant Signature Sign verified by Lab. Personal
Project No. :ROB /
Source
نمورج طلب اختبار الرودبيز
R O A D B A S E T E S T R E Q U E S T
Test Required -As per BS-1377:P-2,3&4 :1990
Sieve Analysis
CBR
Road base
Mini. 120 Kg. Sample
Cr. GravelWadi Gravel
For Lab Use Only