CHECKLIST NUMBER DATE RFI NUMBER

INSPECTION CHECKLIST
Fill, Backfill and Compaction Inspection QCL-A-004 CIVIL-
PROJECT TITLE CONTRACTOR / SUBCONTRACTOR

UMM WU'AL PHOSPHATE PROJECT SEG

ITP NUMBER ACTIVITY NUMBER WORK PERMIT REQUIRED?
CV-ITP-0001 N/A
JACOBS INSPECTION LEVEL CONTRACTOR INSPECTION LEVEL YES
W H

ITEM
ACCEPTANCE CRITERIA REFERENCE PASS FAIL N/A RE-INSP DATE
No.

A Fill and backfill Inspection

MD-101-SMEM-
A1 Fill material shall be placed in lifts not exceeding 200mm in loose depth. EG-CV-SPC-
0001

MD-101-SMEM-
Fill material shall be placed in lifts not exceeding 100mm in loose depth
A2 EG-CV-SPC-
for hand-operated compaction.
0001

MD-101-SMEM-
Granular fill material shall be compacted in 300mm in loose depth using
A3 EG-CV-SPC-
vibratory compactor
0001

MD-101-SMEM-
Fill material shall be placed in lifts not exceeding 230mm in loose depth
A4 EG-CV-SPC-
for hand-operated compaction.
0001

Fill and backfill adjacent to any type of structure shall not be compacted MD-101-SMEM-
A5 with heavy equipment; Hand operated equipment shall be used within EG-CV-SPC-
1.2 meters of any structures. 0001

MD-101-SMEM-
Area to be filled or backfilled shall be free from vegetarian, debris, loam.
A6 EG-CV-SPC-
snow, ice,standing water or frozen ground.
0001

Place backfill simultaneousely on both sides of installed work to equalize MD-101-SMEM-

A7 loading.difference in fill height shall not exceed 300mm for structural EG-CV-SPC-
components or 150mm for pipes. 0001

MD-101-SMEM-
Excavation, fill, backfill and finished grading shall be to the lines,grades
A8 EG-CV-SPC-
shown on the drawing.
0001

MD-101-SMEM-
Grading shall be done in such way that surface drainage is maintained
A9 EG-CV-SPC-
in all areas.
0001

B Compaction Inspection

Compaction shall begin only after the fill or backfill has been properly MD-101-SMEM-
B1 placed and the material to be compacted is at the proper moisture EG-CV-SPC-
content within +/-2% of the optimum moisture content. 0001

Fill or backfill placed below area paving, levees,site area fill shall be
compacted to 90% of the maximum Modified Proctor density as MD-101-SMEM-
B2 determined by ASTM D1557.for cohesionless free draining EG-CV-SPC-
soil,compaction shall be 70% of the relative density as determined by 0001
ASTM D 4253 and ASTM D 4254.

Fill under foundation shall be 95% of the modified proctor density as

MD-101-SMEM-
determined by ASTM D 1557.for cohesionless soil,fill shall be compacted
B3 EG-CV-SPC-
to 80% relative density as determined by ASTM D 4253 and ASTM D
0001
4254.

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 MD-101-SMEM-
In no case compaction is allowed on slope steeper than 1(V) to 5(H)
B4 EG-CV-SPC-
(20%).
0001

Compaction by water jetting or flooding not permitted for most fill MD-101-SMEM-
B5 material.however,flooding may be used if the fill material is cohesionless EG-CV-SPC-
freely draining sand. 0001

Construction of new slopes shall be accomplished by compacting MD-101-SMEM-

B6 horizontal fill layers at least 1 roller width beyond the design edge of the EG-CV-SPC-
slope and then trimming back to achieve the final slope dimensions 0001

REMARKS:

REFERENCE DOCUMENTS:

Contractor Jacobs
Construction Department
Work is Complete and Ready for Inspection:
Name, Initials and Date:

QC Inspector Jacobs Representative

Performed Inspection Work / Rework May Proceed T&I Witnessed QC Record Reviewed Work Verified
Name, Initials and Date: Name, Initials and Date:

QC Supervisor
Quality Record Approved:
Name, Sign and Date:

*Person Responsible for Completion of Quality Work / Test Y = YES N = NO F = FAILED

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