Field ITP Civil

SI-ITP(CIVIL) (1)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksSOIL INVESTIGATION and SURVEYING (1/1)Sub-ContractorContractorOWNERRegulatoryActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignDate/SignISOIL INVESTIGATION and SURVEYING1SURVEYINGa)Survey of location protection of coordinates and benchmarkElevation and CoordinateVisual & Dimensional100%AFC drawingsSurvey ReportIWsWs2SOIL INVESTIGATIONa)Location of Soil InvestigationCorrect LocationDimensional & Survey100%AFC drawingsSub-cont. reportIHWsb)Check of EquipmentsAppearanceVisual100%correct functionSub-cont. reportIRRc)BoringCorrect dimension and depthVisual & Dimensional100%BS 1377Sub-cont. reportIWsWsd)Standard Penetration Test (SPT)DepthTesteach 1.5 m depth of soilBS 1377Sub-cont. reportIWsWse)Undisturbed SamplingSampleVisual100%BS 1377Sub-cont. reportIWsWsf)Dutch Cone Sounding ( if required )DensityTestMeasuring interval less than 20 cmBS 1377Sub-cont. reportIRRg)Laboratory Soil TestSoil characteristicTestas specifiedBS 1377Sub-cont. reportIWsWsh)Unconfined Compression TestCompressionTestas specifiedBS 1377Sub-cont. reportIRRi)Consolidation TestLoadTestas specifiedBS 1377Sub-cont. reportIRRj)Chemical analysis of SoilChemical propertiesTestas specifiedBS 1377Sub-cont. reportIRRk)Method of Storing SamplesMethodVisualeach 1.5 M of boring hole (SPT sample)RequisitionSub-cont. reportIWsWsl)Boring LogsRecordVisualeach LogRequisitionBoring LogsIRRPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008HC-T-&C/2010/00088

SP-ITP(CIVIL) (2)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksSITE PREPARATION (EARTH WORK) (1/2)Sub-ContractorContractorOWNERRegulatoryActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignDate/SignIISITE PREPARATION (EARTH WORK)1SURVEYINGa)Location, number, stability and protection of coordinates and BenchmarkCorrect LocationDimensional & Survey100%AFC drawingsQI-S.0.01, QI-S.0.02IWWsb)Topography Survey After Completion of Clearing, Striping , Removal of VegetationCorrect LocationDimensional & Surveyeach protection coordinate and BMAFC drawingsQI-S.0.01, QI-S.0.02IWWs2CLEARING, STRIPPING, AND REMOVAL VEGETATIONCleaning AreaVisual100%AFC drawingsQI-C-0.01IWWs3TEMPORARY DRAINAGE AND SLIT TRAPDrainage & Slit TrapVisual100%AFC drawingsQI-C-0.01IWWs4EXCAVATIONAPreparation1)Set out location, based on shop drawing and endorsed BenchmarkCorrect LocationSurvey100%AFC drawingsQI-C-0.01IWWs2)Demolition or Protection of Existing FacilityProtection of Existing FacilitiesVisual100%AFC drawingsQI-C-0.01IWsWs3)Investigation of Existing under-ground FacilitiesProtection of Existing FacilitiesVisual100%AFC drawingsQI-C-0.01IWWsBExcavation Work1)Depth and width of excavationCorrect dimensionSurvey100%AFC drawingsQI-C-0.01IWsWs2)Line, Slope and Grades according to approved drawingCorrect dimensionSurvey100%AFC drawingsQI-C-0.01IHH3)Protection of Slope, AcceptedCorrect protectionVisual100%AFC drawingsQI-C-0.01IWsWs4)Quality of CleaningCleaningVisual100%AFC drawingsQI-C-0.01IWsWs5)Excavation In WorkCorrect dimensionVisual100%AFC drawingsQI-C-0.01IWsWs5BACK FILLINGAPreparation1)Quality of cleaning before fillingCleaningVisualRandomPTS 34.11.00.11QI-C-0.06IWsWs2)Quality of filling materialcorrect filling materialVisualRandomPTS 34.11.00.11QI-C-0.06 & others reports for soil testIHHPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksSITE PREPARATION (EARTH WORK) (2/2)Sub-ContractorContractorOWNERRegulatoryActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignDate/SignBPlacement of fill1)Cleaning (removal of trash debris, etc.) in soilCleaningVisualRandomPTS 34.11.00.11QI-C-0.06WsWs2)Sand filling around underground pipe and cable (if any)correct as per specificationVisualRandomPTS 34.11.00.11QI-C-0.06IWsWs3)Final ElevationCorrect ElevationSurveyIFC DrawingAFC drawingsQI-C-0.06, QI-S.0.01, QI-S.0.02IHH4)Spreading Thickness per LayerAs Field Compaction Trial (150 mm to 450 mm)Surveyeach LayerAASHTO T 180, ASTM D 5195, BS 1377Sub-cont. reportIWWsCTesting / Monitoring1)Compaction TestCompaction resultSand Cone testConstruction Specification for Site Preparation and Earth Work (6419P C265-00102)ASTM D 5195, BS 1377Lab.Test ReportIHH2)Demolish of debris, etcCleanMonitoring100%Good cleanQI-G.01IWWs3)Soil MonitoringInclinometerMonitoringweeklyITB 8.19.11 & 8.19.12Sub-cont. reportIWWsSettlement MarkerMonitoringweeklySub-cont. reportIWWsPiezometerMonitoringweeklySub-cont. reportIWWsPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008HC-T-&C/2010/000888HC-T-&C/2010/0008HC-T-&C/2010/0008

TF-ITP(CIVIL) (3)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksTEMPORARY FACILITIES (1/1)Sub-ContractorContractorOWNERRegulatoryActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignDate/SignIIITEMPORARY FACILITIESa)Survey coordinate and elevationLocation,coordinate & elevationDimensional100%Correct location,coordinate & elevation and within tolerancesQI-S.0.01,QI-S.0.02IWsWsb)Check for building erectionFoundation, plumbness, building completionVisual100%As per Approved Drawing & requirementsQI-G.05IWsWsc)Check for equipments and fittingsInstallation and functionVisual100%Correct Install & Function & within tolerancesQI-G.05IWsWsd)Check for sanitationInstallation and functionVisual100%Correct Install & Function & within tolerancesQI-G.05IWsWse)Check for plumbingInstallation and functionVisual100%Correct Install & Function & within tolerancesQI-G.05IWsWsf)Check for lighting & telecommunicationInstallation, illumination and functionVisual100%Correct Install & Function & within tolerancesQI-G.05IWsWsg)Check for Ventilation & Air ConditionerInstallation and functionVisual100%Correct Install & FunctionQI-G.05IWsWsh)Check for FurnitureType and NumberVisual100%Correct type and Number as specified on contractQI-G.05IWsWsi)Check for Portable Fire ExtinguisherType and NumberVisual100%Correct type and Number as specified on drawingQI-G.05IWsWsj)Check for internal finishedInternal finishedVisual100%Complete as per Dwg. RequirementsQI-G.05IWsWsk)Check for external finishedExternal finishedVisual100%Complete as per Dwg. RequirementsQI-G.05IWsWsl)Check for GroundingInstallation and functionVisual100%Complete as per Dwg. RequirementsQI-G.05IWsWsm)Check for Satelite TVInstallation and functionVisual100%Complete as per Dwg. RequirementsQI-G.05IWsWsn)Final InspectionRemain of inspectionVisual100%Close punch listQI-G.05IWWo)Authority InspectionFitnessVisualas requiredAs per DwgTemporary CF (Certificate of Fitness)IHHPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008HC-T-&C/2010/00088

PILE- ITP(CIVIL) (4)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksPILING WORK (Concrete Pile) Including Jetty (1/1)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignIVPILING WORK (Concrete Pile) Including Jetty1MATERIAL RECEIVING INSPECTIONCorrect material and AppearanceVisualEach ReceivingSpecification and CodeQI - G.07aIWW2PREPARATIONa)Coordinates of setting out of piles by surveyCoordinate and levelDimensional100%AFC DrawingsQI-S.0.01RRR3PILING WORKa)Location and inclination of pile and survey for Piling pointsCorrect location and plumbnessVisual100%AFC DrawingsQI-S.0.01IWSb)Number of blowCorrect blowVisual & Dim.as per specificationConstruction SpecificationQI-C.1.02IW,RRc)Check of welding joint.Complete welding/ WPSVisual100%Construction SpecificationQI-C.1.03IWSd)Dye Penetrant TestDefectTestminimum10% random locationsConstruction SpecificationQI-C.1.03/NDE ReportIWSe)Coating Check (Coal tar Epoxy coating or similar)Complete CoatingVisual100%Construction SpecificationQI-C.1.03IWWf)Elevation of pile head cut offCorrect levelDimensional100%AFC DrawingsQI-S.0.01RRRg)Survey of pile off set after blowedCorrect coordinateDimensional100%AFC DrawingsQI-S.0.01RRR4LOAD TESTb)Identify point, Test Execution and ResultCorrect poinVisualAs per approved procedurePTS 34.11.00.12QI-C.1.04IW/RW5FINAL INSPECTIONa)Final InspectionRemaining item inspectionReview100%AFC DrawingsInspection and test reportsRRRPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008HC-T-&C/2010/00088

Civil work ITP(CIVIL) (5)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksCIVIL WORKS (1/3)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentVerifing DocumentDate/SignDate/SignDate/SignVCIVIL WORK1MATERIAL RECEIVING INSPECTIONCorrect material and AppearanceVisualEach ReceivingSpecification and CodeQI - G.07aIWWCivil materials including :a)(i) Portland Cement,Cyment typeReview, Visual, Testonce in every monthASTM C 150CertificateR,IWW(ii) Blast Furnace Cement/Silika Fume (if required)Cyment typeReview, Visual, Testonce in every monthASTM C 150CertificateR,IWWb)Fine AggregateVisualSieve Analysis, Elongation and Flakiness Testonce/ 3500T~5000TASTM C 33Inspection ReportIWWc)Coarse AggregateVisualSieve Analysisonce/ 3500T~5000TASTM C33Inspection ReportIWWd)Reinforcing BarsVisual , TestVisual , Tensile Test , Bend Testeach supplier & heat.noASTM A615Certificate & Test ReportIWWe)WaterpHTesttwice / year January&JuneBS 3148, BS 2690Test ReportIWWf)AdmixtureAs spesifiedVisual & ReviewEach concrete typeASTM 494CertificateIWW2PREPARATIONa)Mix design and Trial mix of concreteConcrete composition, slump & stregth requirementsVisual & ReviewEach concrete typeBS 1881, BS 5328Mix Design ReportR,IWWb)Survey WorkCoordinate, elevationDimensioneach survey workAFC DrawingQI-S.0.01 & QI-S.0.02IW/RR3CONCRETING (Foundation, Column, Slab, Pavement, etc)a)ExcavationLocation and DimensionVisual & Dimensional100%AFC DrawingsQI-C.0.01IWSb)Inspection of Re-bar , incl. Barbending ScheduleDiameter, Spacing, Number and CleanlinessVisual & Dimensional100%AFC DrawingsQI-C.2.02 & QI-C.2.03IWWPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksCIVIL WORKS (2/3)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentVerifing DocumentDate/SignDate/SignDate/Signc)Inspection of Embedded Material for EMC (Electro Magnetic Compatible)- Embedded PlateLocation and TightenessVisual & Dimensional100%AFC DrawingsQI-C.2.02IWW- Embedded CableLocation and TightenessVisual & Dimensional100%AFC DrawingsQI-C.2.02IWWd)Inspection of Form WorkInside dimensions, Rigidity and CleanlinessVisual & Dimensional100%AFC DrawingsQI-C.2.02IWSe)Measure inserts / Anchor BoltLocation and dimensionsDimensional100%AFC DrawingsQI-S.0.01IWWf)Take Concrete Test SamplesNumber of samplesVisual12 Samples /20m3Construction Specification for Concrete WorkQI-C.2.05 & QI-C.2.06IWWg)Measure SlumpEach LoadTestEach loadConstruction Specification for Concrete WorkQI-C.2.07bIWWh)Air Content TestMeasureTesttwice / weekASTM C 231Test ReportIWWi)Aggregate Gradation TestVisualTestRandomASTM C 136Test ReportIWWj)Method of CuringEach LoadVisualEach curingConstruction Specification for Concrete WorkQI-C.2.08IWSk)Measure Compressive Strength at 7 and 28 daysCompressive StrengthTest8 Samples /20m3Construction Specification for Concrete WorkQI-C.2.05RWWl)Visually Inspection Surface FinishAppearance (honeycomb,crack, etc)Visual100%PTS 34.19.20.31; Construction Specification for Concrete WorkQI-C.2.08IWSm)Water Absorption Test 2% of Concrete as per BSWater absorbtionTestevery casting 200m3, or per month to critical areaBS 1881Test ReportIWSn)Final CheckDimensions, Elevation and Anchor bolts / boxs positionVisual & Dimensional100%AFC DrawingsQI-C.2.08 & Survey ReportIHWo)OTHER TESTING - See PTS 34.19.20.31 Petronas Technical Specification , Reinforced Concrete Foundations and Structure, Appendix -3 (Attached)Prepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksCIVIL WORKS (3/3)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentVerifing DocumentDate/SignDate/SignDate/Sign4SEWERa)Installation checksurvey , excavation, sloping,elevation, backfill.Visual and Dimension100%AFC DrawingsQI-S.0.01 & QI-S.0.02,QI.C.0.01, C.0.06IWS5FENCINGa)Installation checkSurvey, post, chain link, tightenes chain link.Visual and Dimensional100%AFC DrawingsQI-S.0.09 & QI-C.5.11IWS6DRAINAGEa)Installation checkSurvey, pre-cast, joint filler, joint sealant, filling material, slope.Visual & dimensional100%AFC DrawingsQI-S.0.012, QI-C.0.01 & QI-C.5.12IWS7CABLE TRENCHa)Installation checkSurvey, pre-cast, joint filler, joint sealant, filling material, slope.Visual & dimensional100%AFC DrawingsQI-S.0.01 & QI-S.0.02, QI-C.0.01 & QI-C.5.14IWS8GRAVELa)Installation checkSurvey , gravel material, celaning before spreading, slope to drain.Visual & dimensional100%AFC DrawingsQI-S.0.01 & QI-S.0.02, QI-C.5.09IWSPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008888HC-T-&C/2010/0008HC-T-&C/2010/0008

Building ITP(CIVIL) (6)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksBUILDING WORK (1/2)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/SignVIBUILDING WORK1MATERIAL RECEIVING INSPECTIONCorrect material and AppearanceVisualEach ReceivingSpecification and CodeQI - G.07aIWsWs2CONCRETEING WORK (refer to section Civil Works)3WALL MASONRY WORKa)Installation checkBrick, mortar , coloumn practice, etc.VisualRandomAFC DrawingsQI-C.4.01IWS4PLASTERING WORKa)Installation checkMixing of plastering, finishingVisualRandomAFC DrawingsQI-C.4.02IWS5TILE WORKa)Installation checkTile material andn type, pattern & lay-out, plumb and level, joint.VisualRandomAFC DrawingsQI-C.4.03IWS6VINYL FLOOR TILE WORKa)Installation checkTile material and type, pattern & lay-out, cleaning.VisualRandomAFC DrawingsQI-C.4.04IWS7DOOR AND WINDOW WORKSa)Installation checkMaterial type,frame, operation.VisualRandomAFC DrawingsQI-C.4.05IWS8GLASS AND GLAZING INSTALLATIONa)Installation checkMaterial type,sealing, cleaningVisualRandomAFC DrawingsQI-C.4.07IWS9GYPSUM BOARD INSTALLATIONa)Installation checkMaterial type,joint, lay-out & patternVisualRandomAFC DrawingsQI-C.4.08IWSPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksBUILDING WORK (2/2)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentDate/SignDate/SignDate/Sign10FIRE PROTECTION EQUIPMENT INSTALLATIONa)Installation checkEquipment type, support/hanger, drain, union, pressure test, inside cleaning, painting.VisualRandomAFC DrawingsQI-C.6.03 & QI-C6.06IWS11WATER PROOFINGa)Installation checkMaterial type, layers,VisualRandomAFC DrawingsQI-C.4.10IWS12SANITARY EQUIPMENT INSTALLATIONa)Installation checkEquipment/material type, position, alignment, level.VisualRandomAFC DrawingsQI-C.4.10IWS13AIR CONDITIONER (A.C)a)Installation checkEquipment/material type, position, alignment, level, function testVisualRandomAFC DrawingsQI-C.7.01IWS14FIXTURE AND HARDWAREa)Installation checkequipment/material type, position, alignment, level.cleaning, test for proper function.VisualRandomAFC DrawingsQI-C.4.06IWSPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008Jan-11-20135Jan-11-2013529 Apr. 2013588HC-T-&C/2010/0008

Structure ITP(CIVIL) (7)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksERECTION OF STEEL STRUCTURE (1/1)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentVerifing DocumentDate/SignDate/SignDate/SignVIIERECTION OF STEEL STRUCTURE1MATERIAL RECEIVING INSPECTIONCorrect material and AppearanceVisualEach ReceivingSpecification and CodeQI - G.07a-IW1FABRICATION OF STEEL STRUCTUREAMATERIALa)Material CertificateType and Grade materialReviewEach MaterialCorrect type & grade and within specified tolerancesMfr. CertificatesRRRb)Material inspection(dimensional, thickness and appearance)Appearance & dimensionalVisual & DimensionalEach IncomingBS EN 10025Inspection reportIR,WsRBWELDINGIProcedure Approvala)WPS PreparationWelding requirementsReviewEach ProcedureAWS D1.1WPS FormRRRb)Mechanical TestingBend & Tensile TestTestEach ProcedureAWS D1.1Test reportRRRc)Perform PQRGuided bend test, etcReviewEach ProcedureAWS D1.1PQR FormRRRd)WPS and PQR ApprovalCompleteReviewEach ProcedureAWS D1.1WPS &PQR FormRRRIIWelders/Welding Qualificationa)Welder Qualification RecordQualification & performanceReviewEach WelderAWS D1.1Qualification RecordRRRb)Perform Test (if the welder has not qualified yet)Qualification & performanceTestEach WelderAWS D1.1Qualification RecordIWWsIIIConsumable Controla)Quantity / Type / Size / GradeQuantity, type, size and gradeReviewEach IncomingApproved WPSsInspection reportIRRb)Packaging/CertificationAppearanceReviewEach Containerseal is no damage & correct type and within specified tolerancesInspection reportIRRc)Storage Environment(heating according to requirement)ConditionReviewEach ContainerManufacturer's specInspection reportIWsWs2FABRICATIONIMarking & Cuttinga)Identification of Marks and DimensionalIdentification & DimensionalVisualEach MemberApproved Shop DrawingInspection reportIRRb)Cleaning of Surface to be WeldedClean of surfacesVisualEach MemberProject SpecsInspection reportIWWsc)Edge Preparation InspectionAppearanceVisualEach MemberApproved Shop Drawing/AppearanceInspection reportIWsRPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:H:Hold,W:Witness,Ws: Spot Witness,R:Review I:InspectionName : Edi Sunardi / QC EngineerName : Amir GJ Tarigan / FQMCertified Complete (Contractor-SM/CM) Date:Authorization (Contractor FQM) Date:IIFit-Upa)Edge Preparation InspectionAppearanceVisualEach MemberApproved Shop Drawing/AppearanceInspection reportIWsRb)Weld Inspection for profile and finishProfile and DefectsVisualEach MemberAWS D1.1 / WPSsInspection reportIWsWsc)Dimensional inspectionDimensionalDimensionalEach MemberApproved Shop DrawingInspection reportIWsWsd)Weld RepairClean of defectsVisualEach repair memberWithin specified tolerancesInspection reportIWsWs3NDE PROCESSIRadiography Testa)Procedure / MethodContents of methodReviewEach ProcedureAWS D1.1ProcedureRRRb)Personnel Qualifications / CertificatesQualificationsReviewEach PersonalASNT or EquivalentProcedureRRRc)Identification of Joint for RadiographyWelded jointsReviewAs SpecifiedAWS D1.1ProcedureRRRd)Perform TestWelded jointsTestAs SpecifiedAWS D1.1Test reportRRRe)Evaluate of ResultsDefectsVisualEach ReportAWS D1.1Test reportRRRIIDye Penetrant Test/Magnetic Particle Test (if specified)a)Procedure / MethodContents of methodReviewEach ProcedureAWS D1.1ProcedureRRRb)Personnel Qualifications / CertificatesQualificationsReviewEach PersonalASNT or EquivalentProcedureRRRc)Perform TestWelded jointsTestAs SpecifiedAWS D1.1Test reportIWWsd)Evaluate of ResultsDefectsVisualEach ReportAWS D1.1Test reportRRRIIIUltrasonic Test (if specified)a)Procedure / MethodContents of methodReviewEach ProcedureAWS D1.1ProcedureRRRb)Personnel Qualifications / CertificatesQualificationsReviewEach PersonalASNT or EquivalentProcedureRRRc)Perform TestWelded jointsTestAs SpecifiedAWS D1.1Test reportIWWsd)Evaluate of ResultsDefectsVisualEach ReportAWS D1.1Test reportRRR4BLASTING AND PANTINGIMateriala)Specification / Type / ColorSpecificationReviewEach Spec.Painting SpecificationInspection reportRRRPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:H:Hold,W:Witness,Ws: Spot Witness,R:Review I:InspectionName : Edi Sunardi / QC EngineerName : Amir GJ Tarigan / FQMCertified Complete (Contractor-SM/CM) Date:Authorization (Contractor FQM) Date:IISurface Preparationa)Method / Type of AbrasiveContents of methodReviewEach ProcedurePainting SpecificationInspection reportRRRb)Climatic ConditionRain & WindVisualDailyPainting SpecificationInspection reportIWsWsc)Relative HumidityMax. HumidityVisualDailyPainting SpecificationInspection reportIWsWsd)Surface TemperatureMax. temperatureVisualDailyPainting SpecificationInspection reportIWsWsIIICoating Applicationa)Spray equipment / BrushesAppearanceVisualCompletionPainting SpecificationInspection reportIWsWsb)Curing / Drying TimeAppearanceVisualEach MemberPainting SpecificationInspection reportIWsWsc)Dry Film Thickness ( Primer, Intermediate)ThicknessDimensionalEach MemberPainting SpecificationInspection reportIWsWsVIFinal Inspectiona)Finish AppearanceAppearanceVisualCompletionPainting SpecificationInspection reportIWsWsb)Touch-up / RepairAppearanceVisualCompletionPainting SpecificationInspection reportIWsWsc)DFT ReadingsThicknessDimensionalCompletionPainting SpecificationInspection reportIWsWs2INSTALLATION OF STEEL STRUCTUREIPREPARATIONa)Construction MethodConstruction & inspection & test aspecsReview100%Project specProcedure standardRRRIIINSTALLATIONa)Foundation Released and Embeded itemsHand Over NoticeReview100%AFC DrawingsQI-S.0.04RRRb)Pad elevationLevelVisual100%AFC DrawingsQI-C.3.02IWSc)Erection Inspection (incl.Grating, starway, platform, handrail, etc.)Orientation, aligment, verticality, heigth, no temporary support.WWd)Bolting tighteningRequired Torque ValueVisualAs specifiedAFC DrawingsQI-C.3.02IHHe)GroutingType of material & Appearance (crack, thickness)Visual100%AFC DrawingsQI-C.3.02IWSBase Plate GroutingType of material & Appearance (crack, thickness)Visual100%AFC DrawingsQI-C.3.02IWWFinal Anchor Bolts TighteningWhite PaintedVisual100%AFC DrawingsQI-C.3.02IWWTouch-up PaintingClear DefectVisualAs requiredAFC DrawingsQI-C.3.02IWsWsFinal InspectionDimensionsVisual100%AFC DrawingsQI-C.3.02IWW2GRATINGa)Inspection of Grating InstallationAppearance(free defect)Visual100%AFC DrawingsQI-C.3.02IWsWs3ROOFING AND SIDINGa)Final Visual InspectionCompleteness as per drawing (Sealent,drain pipe, gutter, ventilation, etc)VisualRandomAFC DrawingsQI-C.5.01IWWa)Condition of materialsCorrect material , damageVisualRandomAFC DrawingsQI-C.5.01IWsWsb)Dimensional of materialsCorrect dimensionalDimensionalRandomAFC DrawingsQI-C.5.01IWsWs4PAINTINGVisual100%AFC DrawingsQI-C.3.02IWSd)Condition of cleaningCleanVisualRandomAFC DrawingsQI-C.5.01IWsWs4STAIRS AND HAND RAILSa)Stairs and hand railsInstallationVisual100%AFC DrawingsQI-C.3.02IWsWsPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/0008Jan-11-20135Jan-11-201358

Road ITP(CIVIL) (8)MHI-APEX-REKIND QA/QCInspection and Test Plan For Civil, Structural & Architectural WorkForm. NoRev.No.DateQI - G-0836-Aug-14Pages.:SAMUR PROJECTITP Sheet No.6419R A437-00001Project No.CommodityIdentificationInvolvement & SignatureRemarksROAD WORK (1/1)Sub-ContractorContractorOWNERActivity No.Inspection/ Test Activity ItemCharateristic to be Verified/Inspected/TestedMethode of InspectionFrequencyAcceptance Criteria/Reference DocumentVerifing DocumentVerifing DocumentDate/SignDate/SignDate/SignVIIIROAD WORK1MATERIAL RECEIVING INSPECTIONCorrect material and AppearanceVisualEach ReceivingSpecification and CodeQI - G.07aIWsWs2PREPARATIONa)Material Test for chemical organicAs specified on project specsTestAs specifiedConstruction specsSub-cont. reportIWWb)Survey WorkCoordinate and alignmentSurveyAs specifiedAFC DrawingsQI-S.0.01 & QI-S.0.02IWSc)Mix Design and trial mix of asphaltAs specified on project specsRevieweach Mix DesignAFC DrawingsSub-cont. reportRWW3INSTALLATIONa)CompactionLevel /Compaction (Sub-grade, sub base, base)Visual & TestAs specifiedPTS 34.13.20.31QI-C.0.03IWSb)Sweeping / blowing debrisFiller , SealentVisual100%AFC DrawingsQI-C.5.10IWSc)Primer coatConditionVisualEach spraidAFC DrawingsQI-C.5.10IWSd)Tack coatConditionVisualEach spraidAFC DrawingsQI-C.5.10IWSe)Bituminous macadam layersThicknessDimensionalEach layerAFC DrawingsQI-C.5.10IWSf)Construction jointFiller , SealentVisual100%AFC DrawingsQI-C.5.10IWSg)Final Survey WorkFinal LevelSurveyAs specifiedAFC DrawingsQI-S.0.01 & QI-S.0.02IWWh)Final Check of RoadLevel / SlopeVisual100%AFC DrawingsQI-C.5.10IHHPrepared by (Contractor)Approved by (Owner)Approved by (Contractor)Rev.No:Date:I:RFI, mandatory inspection and repprt16-Oct-14W:RFI, option inspection and as reportH:RFI, mandatory inspection and as reportR:No RFI, No inspection and review/sign reportName : Yudha Kristanto / QC EngineerName : Amir GJ Tarigan / FQMS:No RFI, monitoring works and no sign reportCertified Complete (Contractor-PM/CM)Authorization (FQM-REKIND/APEX)Authorization (FQM-MHI)Date:Date:Date:

HC-T-&C/2010/00088