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Foundation & Grout Record
Grout product, batch and cure conditions, and a void check that names its method.
MILLWRIGHT QC
Precision Maintenance QC
millwrightqc.com
Project
Job No.
Client
Sheet ____ of ____
Equipment Tag
Foundation ID
Date
Grout Type
Epoxy
Cementitious
None
Grout Product
Batch / Lot No.
Pour Date
Ambient Temp (F)
Foundation Temp (F)
Cure Time (hrs)
Void Check Method
Hammer sounding
Ultrasonic
Core sample
Not checked
Voids Found
Yes
No
Surface Preparation and Anchor Bolt Condition
Result
Accept
Reject
Repaired
Notes
Checked By
Witnessed By
Checked by / Date
Witnessed by / Date
QA/QC Acceptance / Date
MW-GR-01 | Rev 0
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MILLWRIGHT QC
— millwrightqc.com