EPM-ITP-CC-

Doc No 003
SAFCO/IBB MOBILE COATING
Rev. No. 00
UNIT POJECT
ITP FOR CONCRETE Date 25th Jun, 2020
Page 1 of 21

XX

IBB MCUP & MODIFICATION OF K-12 BUILDING

PROJECT NO. : SP-173100119

INSPECTION AND TEST PLAN

FOR
CONCRETE WORK

A 25 Jun, 2020 Issue for Approval MSH NCC

Rev
Date Description Original By Checked By Approved By Checked By Approved By
.

No Part of this document or the information it contains may be reproduced or transmitted in any
form or by any means electronic or mechanical, including photocopying, recording, or by any
information storage and retrieval system, without permission in writing from SABIC or NCC
 EPM-ITP-CC-
Doc No 003
SAFCO/IBB MOBILE COATING
Rev. No. 00
UNIT POJECT
ITP FOR CONCRETE Date 25th Jun, 2020
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SAFCO/IBB MOBILE COATING
Rev. No. 00
UNIT POJECT
ITP FOR CONCRETE Date 25th Jun, 2020
Page 2 of 21

TABLE OF CONTENTS

1.0 ITP for Concrete Work.................................................................................................................3

2.0 Checklist-Material Receiving Inspection.....................................................................................6

3.0 Checklist-Field Survey for Excavation.........................................................................................7

4.0 Checklist-Backfill/Compaction.....................................................................................................8

5.0 Checklist-Installation of Lean Concrete......................................................................................9

6.0 Checklist Pre-Concrete Inspection.............................................................................................10

7.0 Checklist- Concrete Placement...................................................................................................11

8.0 Concrete Placement and Test LOG............................................................................................12

9.0 Concrete Curing Record.............................................................................................................13

10.0 Checklist-Leak Test Inspection Record...................................................................................14

11.0 Checklist-Coating Record.........................................................................................................15

12.0 Checklist- Acceptance Certificate Civil Works.......................................................................16

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1.0 ITP for Concrete Work

Print Name Signature Name of Doc No: EPM-ITP-BC-003
INSPECTION AND TEST PLAN (ITP) FOR COMPANY
Prepared By: (1) MSH/NCC Revision: 00
( CONCRETE WORK ) Approved By: (2) Date: 25 Jun,2020
COMPANY App: Page:
Discipline: CIVIL PROJECT: IBB MCUP & MODIFICATION OF K-12 BUILDING
Inspection Level :
Location: (3) IBB/SAFCO
Table No:
Criticality Level : Item Name (3): Tag No (3):

Inspection Responsibility
Sr. Acceptance Verifying Sub-
Inspection Activity Characteristic Verified (4) Reference Document (5)
No Criteria (6) Document (7) Contractor CONTRACTOR COMPANY
/Vendor

1 Material Verify or approval

B
SABIC Approved
Vendor List /Approved
Concrete, steel, backfill material. Coating Material Data
Type of material SES
1.1 material, water stopper, manhole/Catch Submittal/SES-C03-S01, Approved Document I W A
Conformance to Specification IFC Drawings
basin cover and etc. C04-E02, B51-S01, B01-
F01 , B55-S01 & T01-
S01

Approved
SES-B51-S01
1.2 Concrete Trial Mix approval Concrete Strength SES-B51-S01 Document/ I H H
IFC Drawings
Lab Test Report
B
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Inspection Responsibility
Sr. Acceptance Verifying Sub-
Inspection Activity Characteristic Verified (4) Reference Document (5)
No Criteria (6) Document (7) Contractor CONTRACTOR COMPANY
/Vendor

Manufacture
Manufacture Compliance
Compliance
As per inspection items Certificate,
1.3 Material Receiving Inspection Certificate, CV-MRI-1 I W R
in the Checklist of QVD Material Receiving
Material Receiving
Inspection Report
Inspection Report

2 Earth Work

As per inspection items SES-C02-S02,

2.1 Excavation SES-C02-S02, CV-002-1 I W SW
in the Checklist of QVD IFC Drawings

As per inspection items SES-C02-S02 CV-002-2

2.2 Compaction prior to lean concrete SES-C02-S02 I W W
in the Checklist of QVD IFC Drawing Lab Test Report

As per inspection items SES-B51-S01 CV-002-3

3 Installation of Lean Concrete SES-B51-S01 I W SW
in the Checklist of QVD IFC Drawings Lab Test Report

As per inspection items SES-B51-S01 SW

4 Install Polyethylene Sheet SES-B51-S01 CV-002-4 I W
in the Checklist of QVD IFC Drawings

As per inspection items SES-B51-S01 B

5 Rebar SES-B51-S01 CV-002-4 I W W
in the Checklist of QVD IFC Drawings

As per inspection items SES-B51-S01

6 Formwork SES-B51-S01 CV-002-4 I W W
in the Checklist of QVD IFC Drawings

7 Embedded Item, Lifting Lug As per inspection items SES-B51-S01 SES-B51-S01 CV-002-4 I W W
in the Checklist of QVD SES-C03-S01 SES-C03-S01
SES-C01-F01 SES-C01-F01
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Inspection Responsibility
Sr. Acceptance Verifying Sub-
Inspection Activity Characteristic Verified (4) Reference Document (5)
No Criteria (6) Document (7) Contractor CONTRACTOR COMPANY
/Vendor

SES-B50-F01
SES-B50-F01
IFC Drawings

SES-B51-S01,
As per inspection items SES-B51-S01,
8 Release for Concrete Pouring SES-B50-F01 CV-002-4 I W W
in the Checklist of QVD SES-B50-F01
IFC Drawings

As per inspection items in the SES-B51-S01

9 Concrete Pouring SES-B51-S01 CV-002-5 I W W
Checklist of QVD IFC Drawings

As per inspection items CV-002-6 SW

10 Sampling & Testing of Fresh concrete SES-B51-S01 SES-B51-S01 I W
in the Checklist of QVD Lab Test Report

As per inspection items

11 Concrete Curing SES B51-S01 SES B51-S01 CV-002-7 I W SW B
in the Checklist of QVD

As per inspection items

12 Precast Foundation Release for shift/lifting SES B51-S01 SES B51-S01 Signed RFI I W W
in the Checklist of QVD

SES B51-S01
13 Compressive strength of Concrete Concrete Strength SES B51-S01 Approved Mix Lab Test Report I W SW
Design

As per inspection items W

14 Water Tightness Test (if applicable) SES B51-S01 SES B51-S01 CV-002-8 I W
in the Checklist of QVD

As per inspection items SES-T01-S01

15 Surface Preparation SES-T01-S01 CV-002-9 I W W B
in the Checklist of QVD IFC Drawings
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Inspection Responsibility
Sr. Acceptance Verifying Sub-
Inspection Activity Characteristic Verified (4) Reference Document (5)
No Criteria (6) Document (7) Contractor CONTRACTOR COMPANY
/Vendor

As per inspection items in the SES-T01-S01

16 Protective Coating SES-T01-S01 CV-002-9 I W W
Checklist of QVD IFC Drawings

As per inspection items SES-C02-S01 CV-002-2

Earth Work- Backfill & Compaction SES-C02-S01 I W W
in the Checklist of QVD IFC Drawings Lab Test Report
B
As per inspection items SES-B51-S01
17 Final Acceptance SES-B51-S01 CV-002-10 I H H
in the Checklist of QVD IFC Drawings

Legend

(1) ‘Prepared by’ should be the name, signature and COMPANY’s name for the Vendor’s/Sub-Contractor’s representative.
(2) ‘Approved by’ should be the name, signature and COMPANY’s name for the CONTRACTOR’s representative.
(3) ‘Location’, ‘Item Name’ and ‘Tag Number’ shall be used if applicable.
(4) ‘Characteristics Verified’ are the parameters checked during the inspection activity.
(5) ‘Reference Document’ is the Project Specification / Code / Standard / Drawing, Procedure etc. on the basis of which inspection shall be conducted.
(6) ‘Acceptance Criteria’ is the tolerance, reading, value or an outcome derived from reference documents.
(7) ‘Verifying Document’ is the record generated during inspection & Testing using approved forms / checklists.
(8) ‘Inspection Responsibility’ is the role of Vendor / Sub-Contractor, CONTRACTOR and COMPANY for each inspection step. Inspection responsibility shall be ‘I’ for Inspection, ‘R’ for review, ‘A’ for approval, ‘S’ for
Surveillance, “W’ for 100% Witness, ‘SW’ for random witness and ‘H’ for hold.
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UNIT POJECT
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2.0 Checklist-Material Receiving Inspection

CV-MRI-1
MATERIAL RECEIVING INSPECTION Record No
Date
IBB MCUP & MODIFICATION OF K-12 Disciplin
Project No. BUILDING Civil Area No
e

1 Material Type

2 Supplier

3 Purpose & Service

For further details, as per attached (Mention associated report no.)

□ Quality certificate/3rd Party Report

Inspection
Contents □ Test certificate/3rd Party Report
4
□ Catalogue
□ Specification
□ Sample

□ Satisfied
5 Visual Inspection
□ Unsatisfied

6 Remarks

Submitted by:
Review and approval Status:
□ (A) Approved without comments.
□ (B) Approved with comments.
□ (C) Disapproved.
Comments:

Sub-contractor NCC PMT

Name

Signature

Date
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3.0 Checklist-Field Survey for Excavation

CV-002-1
FIELD SURVEY FOR EXCAVATION Record
No
Date
Project No: PROJECT NO. : SP-173100119 Area No.

Survey Basis Drawing No.

Location IBB/SAFCO
Description

Point Coordinate
Remark
No. N E

Survey and setting out

Excavation Depth m Check the stability of slope Satisfied Unsatisfied

Excavation EL m Excavation Bottom Satisfied Unsatisfied
Condition
Calibration Record
Surveying Equipment Series No. Manufacturer Calibrated Date Expired Date

Sub-Contractor NCC PMT

Name

Signature

Date
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4.0 Checklist-Backfill/Compaction
CV-002-2
Record
BACKFILL/COMPACTION CHECKLIST No
Date
Project No PROJECT NO. : SP-173100119 Area No.
Material Type Drawing No.
Compaction Optimum
Equipment Moisture
Field Test
Proctor Density
Equipment
Location IBB/SAFCO
Description
Examination Items Result Examination Items Result
Keep cleaning without  Satisfied
 Satisfied
water, roots, trash, other Fill material test Reports filed  Unsatisfied
 Unsatisfied
foreign materials  N/A
 Satisfied  Satisfied
Coating protection filler
 Unsatisfied Properly moistened before placing  Unsatisfied
board installed properly
 N/A  N/A
 Satisfied
Material comply with ≧90%
 Unsatisfied Compacted Density
specification ≧95%
 N/A
Bottom Bed/Backfill Depth 200 mm Total Layer of Compaction 2
Layer Density Test (Points)
Laye Thick Repor 1st 2nd 3rd 4th 5th 6th 7th 8th 9th
Result
r No. (mm) t No. Densit Densit Densit Densit Densit Densit Densit Densit Density
y y y y y y y y
1  Sat.  Unsat.
2  Sat.  Unsat.
3  Sat.  Unsat.
4  Sat.  Unsat.
5  Sat.  Unsat.
6  Sat.  Unsat.
7  Sat.  Unsat.
8  Sat.  Unsat.

Sub-contractor NCC PMT

Name

Signature

Date
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5.0 Checklist-Installation of Lean Concrete

CV-002-3
INSTALLATION OF LEAN CONCRETE Record No
Date

Project No PROJECT NO. : SP-173100119 Area No.

Drawing No.

Location
Description IBB/SAFCO

Test Reports

Inspection Results
Ite Sub Cont. NCC
Description of Check
m
Accept Reject Accept Reject
1 Compaction and surface preparation verified
2 Survey reports Verified
3 Mix design of lean concrete verified
4 Fresh concrete test are conducted and sample taken
5 Thickness and level of lean concrete is as per drawing
6 Continuous curing as per specification
7 Concrete test results are filed
Use concrete strength equal or higher than 17Mpa for
8
Lean Concrete

NOTES:

Sub-Contractor NCC PMT

Name N/A

Signature N/A

Date N/A
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UNIT POJECT
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6.0 Checklist Pre-Concrete Inspection

CV-002-4
PRE-CONCRETE INSPECTION CHECKLIST Record No
Date
Area Drawing
Project No PROJECT NO. : SP-173100119
No No
Location IBB/SAFCO
Description
Inspection Results Inspection Results
A. POLYTHYLENE SHEET E. Miscellaneous
Yes No N/A Yes No N/A
Vapor barrier laid as per Design
Key ways
Drawing
Vapor barrier thickness, Laps and
Blockouts
extension as per specification
Surface roughened
B. Formwork Bonding agent
Location Survey for Coordinates
Type of finish
Checked
Size Finished slope
Elevation Joints/Fiber boards
Clean and oiled
Chamfer
Straight, level and plumb, Adequate
bracing

C. Reinforcement
Grade
Size/Type
Spacing/Splices
Spacers
Tying every intersection of rebars
Clearance

Final Acceptance : Release to Pour

D. Embedment
Anchor bolts (Diameter / Length / Type) Name Signature Date
Anchor bolts (Location / Projection)
Anchor bolt sleeves
Subcontracto
r
Thread projection
Weld pads
Angle iron NCC
Inserts
Conduits
Water stop PMT
Others
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7.0 Checklist-Concrete Placement

CV-002-5
CONCRETE PLACEMENT CHECKLIST Record No
Date
PROJECT NO PROJECT NO. : SP-173100119 AREA NO

TYPE AND SOURCE

DRAWING NO
OF CONCRETE
CYLINDERS
TEST REPORT NO.
TAKEN
LOCATION OF CYLINDERS
POUR IDENTIFICATION

Inspection Results
Item Description of Check Sub Cont. NCC
Yes No Yes No
1.0 Concrete Delivery
1.1 Sub-contractor ready to place
1.2 Delivery ticket correctly completed
1.3 Correct mix concrete received
2.0 CONCRETE TESTING
Slump test, temperature, air content and unit weight checks have been
2.1
carried out and are within the specified tolerances
2.2 Specified number test cylinders/cubes taken
3.0 CONCRETE PLACEMENT
Method of placement :
3.1
Crane and bucket  Chute Pump
3.2 Pouring height maintained to avoid NCCregation
3.3 Correct size of vibrator(s) together with back-ups on location
Compaction / vibration is in accordance with the specified requirements:
3.4 - vibration carried out around reinforcement and embedment
- penetration into previous layer
4.0 CONCRETE FINISH
Brushed  Hand float 
4.1 Rough  Power float 
Steel Trowel 
Remarks:
NOTES :

Sub-Contractor NCC PMT

Name

Signature

Date
Note: Verify delivery ticket and attach the relevant fresh concrete placement log to this form
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8.0 Concrete Placement and Test LOG

CV-002-6
CONCRETE PLACEMENT AND TEST LOG Page: ____of ____ Record
Pour
Contract No: PROJECT NO. : SP-173100119 Contractor: NCC Mix Design No: ________________ _______________________________ Mix Type:
Truc Pour Time Concrete
Ticket Placement Represented Placed Cumulate Sample Air Unite
k Batc Finis Temp Slum ACC REJ.
Number (Structures) Start (m3) (m3) Taken Content Weight
No h h (℃) p
(mm)

Sub-Contractor NCC PMT

Name
Signature
Date
Note: Third Party Reports for 7 days and 28 days of test to be attached to this report.
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9.0 Concrete Curing Record

CV-002-7
CONCRETE CURING RECORD Record No
Date
Project No PROJECT NO. : SP-173100119 Area No
Location IBB/SAFCO Drawing No.
Description

Pouring Date
Curing Method WATER CURING
Curing End
Date

Curing Record
NCC Inspector
Result
No. Date Time Person of Curing/Signature
Accept Reject

Sub-Contractor NCC PMT

Name
Signature
Date
10.0 Checklist-Leak Test Inspection Record
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CV-002-8
INSPECTION RECORD FOR LEAK TEST Record No
Date

Project No PROJECT NO. : SP-173100119 Area No

Location Drawing
Description IBB/SAFCO No.

Activities / Items to be Inspected Subcontractor NCC

No
Accep Reject Accept Reject
t

1 Water Fill as per required Level

Check the concrete surface without any leakage/seepage

2 found
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START FINISH

Test
Date &Time Date: Date:
Time: ______:______ Time: ______:______

Remarks:

Remarks:

Sub-Contractor NCC PMT

Name

Signature

Date

11.0 Checklist-Coating Record

CV-002-9
RECORD OF COATING Record No
Date

Project No PROJECT NO. : SP-173100119 Area No

Location Description Drawing No

Material

Inspection Items Subcontractor NCC

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□ Satisfied □ Satisfied
Remove any oil, grease and wax □ Unsatisfied □ Unsatisfied

□ Satisfied □ Satisfied
A. Preparation of Surface Ensure the surface is dry □ Unsatisfied □ Unsatisfied

□ Satisfied □ Satisfied
Pinhole and crack repaired □ Unsatisfied □ Unsatisfied

□ Satisfied □ Satisfied
1st Coat (DFT Test) > _______ □ Unsatisfied □ Unsatisfied
m
B. Thickness of Coating □ Satisfied □ Satisfied
2nd Coat (DFT Test) > _______ □ Unsatisfied □ Unsatisfied
m

Foundation/Structure Related for □ Satisfied □ Satisfied

Backfilling □ Unsatisfied □ Unsatisfied
C. Remarks
Test report attached

Sub-Contractor NCC PMT

Name `

Signature

Date

12.0 Checklist- Acceptance Certificate Civil Works

CV-002-10
ACCEPTANCE CERTIFICATE CIVIL WORKS Record
No
Date

Project No PROJECT NO. : SP-173100119 Area No

Location Drawing
Description No.

Sub-contractor NCC
REQUEST INSPECTION Accepte Rejected Accepte Rejected
d d
1.Excavation checked

2.Rebar installation checked

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3.Anchor bolts installed to specification and preserved

4.Concrete pour checked

5.Pour slips and test cube documents available

6.Foundations,plinths and cubs, etc. orientation, alignment,
location and elevation in accordance with relevant drawings
7.Cable ducts, pipe inserts construction to specification

8.Expansion joint sealant in accordance with drawings

9.Coating checked

10.Backfill and Compaction checked

11. Finishing complete to required standards

12. Other inspection requirements (if any)

Comments:　

Sub-Contractor NCC PMT

Name

Signature

Date