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| Date: | 
| Name: | 
| License #: | 
| Job #.: | 
| # of Stories: | 
| 
 | Inspection Description | Frequency | Relevant Code, Section Or Standard | 
| 1 | General Tasks | ||
| 1.1 | Verify embedded fall-arresting systems have been inspected as it relates to use for concrete installation. Shop drawings. Contractor maintenance log | On-going | 3310.9 | 
| 1.2 | Maintain a concrete safety log book which lists activities that shall be conducted in coordination with the site safety manager or coordinator | Daily | 3310.8.4 | 
| 1.3 | Adequate lighting | Daily | 3310.9 | 
| 1.4 | Adequate ventilation | As required | 3310.9 | 
| 1.5 | Housekeeping | Daily | 3303.4 | 
| 1.6 | Pre-Storm planning, high winds | As required | BB2013-011 | 
| 1.7 | Concrete washout water, collection, containment, disposal | As required | 3303.15 | 
| 1.8 | Underpinning sequence/detail drawings on site | As required. | 3304.11 | 
| 2 | Site Safety Provisions | ||
| 2.1 | Monitor that required fall protection systems in place | On-going | 3308 | 
| 2.2 | Monitor workers using required fall protection systems | On-going | 3310.9 | 
| 2.3 | Monitor hoisting and rigging operations performed in a safe manner | As required | 3316 | 
| 2.4 | Extra shores or other material and equipment are available in the event of an emergency | Daily | 3305.3.6.2.1 | 
| 2.5 | Building materials properly piled and tied or contained | Daily | 3305.3.6.2.3 | 
| 2.6 | Emergency egress maintained | On-going | 3310.9 | 
| 2.7 | Escape hatches | As required | 3303.6 | 
| 2.8 | Handrails, mid-rails and kickboards in place and secure | Daily | 3310.9 | 
| 2.9 | Formwork erection and stripping signage clearly displayed | As required | 3310.9 | 
| 2.10. | Rebar ends capped to prevent impaling. | On-going | 3310.9 | 
| 3 | Installation of Formwork | ||
| 3.1 | Verify formwork drawings are available. Including shores, re-shores, foundations | Prior to formwork installation | 3305.3.1.5; ACI 318; 6.1.5 | 
| 3.2 | Verify formwork drawings are signed and sealed when required by Code | As required prior to formwork installation | 3305.3.2.1 | 
| 3.3 | Verify existing structure adjacent to concrete placement has been inspected and evaluated by a registered design professional prior to use as a form. Design drawings prepared | Prior to formwork installation | 3305.3.1.2.1 | 
| 3.4 | Verify formwork inspected by a competent person and shores are installed as per shop drawings | Prior to reinforcement placement | 3305.3.3.1 | 
| 3.5 | Verify visual observations of formwork were conducted by formwork designer at the minimum intervals | See 3305.3.3.2.1 | 3305.3.3.2; 3305.3.3.2.1 | 
| 3.6 | Verify any formwork discrepancies have been resolved | Prior to reinforcement placement | 3305.3.3.2.2 | 
| 3.7 | Unsafe conditions; notify contractor; contact DOB if required | Continuous | 3305.3.4.4 | 
| 3.8 | Monitor the required guardrail systems are in place on the forming and placement floors | On-going | 
 | 
| 3.9 | Ramps, runways and platforms comply with 3315. Designed by qualified person when buggies used | On-going | 3305.3.1.4 | 
| 3.10 | Inspection of concrete formwork by Concrete Safety Manager | On-going | RCNY 3310-02. e, 9. | 
| 4 | Placement of Reinforcement | ||
| 4.1 | Verify required shop drawings are available on site | Prior to reinforcement placement | 3310.9.1 | 
| 4.2 | Monitor that the workers performing reinforcement bending, cutting, welding and reinforcement placement operations on the working deck are working in a safe manner | On-going | 3310.9.1 | 
| 4.3 | Verify reinforcement placement operations are performed in a safe manner | Continuous | 3310.9.1 | 
| 4.4 | Verify concrete special inspector inspected and signed-off on final reinforcement placement | Prior to concrete placement | 1907.5 | 
| 5 | Placement of Concrete | ||
| 5.1 | Verify concrete special inspector is present for concrete placement. | Each placement | 3310.9.1 | 
| 5.2 | Verify DOB licensed concrete testing lab is present to sample and test. | Each placement | 3310.9.1 | 
| 5.3 | Pumping operations. | 
 | 3310.9.1 | 
| 5.4 | Verify pump operator and placement crew have participated in a preplanning meeting for pumping operations. Verify preplanning meeting for concrete pump operations occur at initial start-up of concrete pumping operations. | Prior to first pumping operation | 3310.9.1 | 
| 5.4.1 | For concrete pumping operations which involve lubricating grout (e.g. concrete pumped though a placement boom). | Each placement | 3310.9.1 | 
| 5.4.1.2 | Verify the contractor supplied sufficient grout discharge boxes on-site to receive 100% of the volume of the lubricating grout actually placed in the boom (and hoses, etc.), regardless of the volume indicated on delivery ticket(s). | Each placement | 3310.9.1 | 
| 5.4.1.3 | Verify the contractor provided the special inspector of the concrete pour with sufficient notice | Each placement | 3310.9.1 | 
| 5.4.1.4 | Confirm the special inspector is on site to perform the required special inspections | Each placement | 3310.9.1 | 
| 5.4.1.5 | Confirm that the special inspector has observed the concrete exiting the hose and that he has identified it as concrete exhibiting a uniform matrix of aggregate before commencement of placement of the structure | Each placement | 3310.9.1 | 
| 5.5 | Verify pump equipment has been inspected | Prior to each use | 3310.9.1 | 
| 5.6 | Verify hoses and connections have been inspected | Prior to each use | 3310.9.1 | 
| 5.7 | Monitor pumping operations performed in a safe manner | On-going | 3310.9.1 | 
| 5.8 | Monitor concrete buckets, hoppers, chutes and buggies are inspected, cleaned and in proper working order | Prior to each placement | 3310.9.1 | 
| 5.9 | Monitor concrete placement is performed in a safe manner | On-going | 3310.9.1 | 
| 5.10. | Monitor power buggies operated in a safe manner | On-going | 3310.9.1 | 
| 5.11 | Monitor formwork is inspected during concrete placement for potential problems | On-going | 3310.9.1 | 
| 5.12 | Verify the designated signalmen are in place when a crane is being used for lifting | As required | 3310.9.1 | 
| 5.13 | Cold weather requirements | As required | 1905.12 | 
| 5.14 | Hot weather requirements | As required | 1905.13 | 
| 5.15 | Verify rate of placement not exceeded per drawings | On-going | 3305.3.2.3 | 
| 6 | Stripping Operations | ||
| 6.1 | Monitor that the horizontal netting conforms to Code before commencing stripping operations | On-going | 3310.9 | 
| 6.2 | Verify formwork removal procedure | Prior to stripping | 3305.3.5.1 | 
| 6.3 | Monitor that in-place concrete strength has been evaluated and accepted in accordance with removal schedule | Prior to stripping | 3305.3.5.1.3 | 
| 6.4 | Verify structural members have acquired sufficient strength to safely support their own weight and external loads | Prior to stripping | 3305.3.5.5 | 
| 6.5 | Monitor stripping operations are performed in a safe manner | On-going | 3305.3.5.4 | 
| 6.6 | Debris contained and removed at reasonable intervals | On-going | 3305.3.6.6 | 
| 6.7 | Stripping not performed more than three stories below the story being formed | On-going | 3305.3.6.6 | 
| 6.8 | Special considerations for prestressed members | As required | 3305.3.5.3 | 
| 7 | Reshoring Operations | ||
| 7.1 | Verify reshoring plan is available | Prior to stripping | 3305.3.6.8 | 
| 7.2 | Monitor reshores within 10 feet of building edge are secured, banded and tied to the structure | Daily | 3305.3.6.1.2 | 
| 7.3 | Monitor wedges are not used for reshores within 10 feet of building edge | Daily | 3305.3.6.1.3 | 
| 7.4 | Monitor appropriate number of floors have been reshored. | Daily | 3305.3.6 | 
| 7.5 | Verify reshores were inspected by competent person designated by the contractor | Prior to forming next level | 3305.3.3.1 | 
| 7.6 | Verify visual observations of formwork were conducted by formwork designer at the minimum intervals | Prior to forming next level | 3305.3.3.2 | 
| 7.7 | Stresses. Ensure shores not located improperly causing stress reversals or inducing tension at unreinforced portion of structural member(s) | On-going | 3305.3.6.1.4 | 
| 7.8 | Reshores perpendicular to surface they are supporting | On-going | 3305.3.6.1.5 | 
| 7.9 | Reshores braced and plumb | On-going | 3305.3.6.3 | 
| 8 | Material Handling | ||
| 8.1 | Monitor safe handling of shores, reshores, formwork and reinforcement | As required | 3310.9.1 | 
| 8.2 | Monitor proper storage of shores, reshores, formwork and reinforcement on working floors | Daily | 3310.9.1 | 
| 8.3 | Monitor floors not overloaded by excessive storage | Daily | 3310.9.1 | 
| 8.4 | Monitor fall protection methods employed at edges left exposed for hoisting are in place | Daily | 3310.9.1 |