Formats  › Geotechnical  › Lab Test Request
Form · FMT-GEO-005
Lab Test Request Form
9 fields across 3 sections. Standard lab request — drives lab workflow + result tracking + acceptance.
9 Fields
3 Sections
Per sample
QC Engineer, Geotech Engineer

Format Preview

S.No.Field / CheckpointReferenceStatus
A. SAMPLE DETAILS
A1Project + sample ID + collection date + by whom
Acceptance: Cross-referenced
Per project + sampling plan
OK
NC
NA
A2Sample type (soil / aggregate / cement / steel / etc.)
Acceptance: Per type
Per material
OK
NC
NA
A3Sampling location (BH no., chainage, element)
Acceptance: Per drawing
Traceable
OK
NC
NA
B. TESTS REQUESTED
B1Test list per material — sieve, consistency, shear, CBR, compression, etc.
Acceptance: Per spec
Per project QA/QC plan
OK
NC
NA
B2Standard references (IS / IRC / ASTM)
Acceptance: Per spec
Per material spec
OK
NC
NA
B3Urgency — normal / urgent / immediate
Acceptance: Logged
Per project schedule
OK
NC
NA
C. LAB INFO + RESULTS
C1Lab name + NABL accreditation + report date
Acceptance: Cert attached
NABL preferred
OK
NC
NA
C2Results — per test + acceptance criteria
Acceptance: Per IS / IRC
Per spec
OK
NC
NA
C3Pass / Fail + recommendations
Acceptance: Acted upon
Per QC
OK
NC
NA
A. SAMPLE DETAILS
A1Project + sample ID + collection date + by whom
Per project + sampling plan
Cross-referenced
OKNCNA
A2Sample type (soil / aggregate / cement / steel / etc.)
Per material
Per type
OKNCNA
A3Sampling location (BH no., chainage, element)
Traceable
Per drawing
OKNCNA
B. TESTS REQUESTED
B1Test list per material — sieve, consistency, shear, CBR, compression, etc.
Per project QA/QC plan
Per spec
OKNCNA
B2Standard references (IS / IRC / ASTM)
Per material spec
Per spec
OKNCNA
B3Urgency — normal / urgent / immediate
Per project schedule
Logged
OKNCNA
C. LAB INFO + RESULTS
C1Lab name + NABL accreditation + report date
NABL preferred
Cert attached
OKNCNA
C2Results — per test + acceptance criteria
Per spec
Per IS / IRC
OKNCNA
C3Pass / Fail + recommendations
Per QC
Acted upon
OKNCNA
Approval / Sign-Off
APPROVED
HOLD — REVISIONS REQUIRED
REJECTED
Overall Verdict
Name / Sign / Date
Prepared By — Name / Sign
Name / Sign / Date
Reviewed By — Name / Sign
Name / Sign / Date
Approved By — Name / Sign
Name / Sign / Date
Date & Time
Name / Sign / Date
Remarks
Name / Sign / Date