Technical Affairs Directorate - Water Projects Dept.

Site Works Inspection

Inspection Request for Pipeline Projects
Date: ......./ ......../ ........
Contract Title :.......................................................................................................................................
Contract No....:............................................................................. IR. No.:............................................
Contractor :............................................................................. Rev. No.:..........................................
Consultant :............................................................................. Location/Area:.................................
Approved MST Ref ...................................................................... Chainage No.:.................................
Approved ITP Ref & Clause: ........................................................ Drg./Sheet No.: ..............................
1. Setting out 2. Trial holes ( ) No. 3. Trench Excavation
4. Pipe/Joint wrapping 5. Bedding Material 6. Pipe laying
7. 9 bar test (Initial) 8. Surround Material 9. Backfilling (1st layer)
10. Trench marker tape 11. Backfilling (2nd layer) 12. ( )Swabbing
13. Sterilizing/ Water Sample 14. Final Pressure Test 15. GIS Data Collection
16. Other
Allowable Water ..................... Lit. Taken Water .......................Lit.

Pipe Size Other

100mm 150mm 200mm 300mm 400mm 600mm 900mm 1200mm 1400mm 1600mm
(mm) ( mm)
Length
*The Pipe Size from 600 mm to above, the final pressure test to be inspected by Operation Section

The above work has been completed according to Drawings/KAHRAMAA requirements & specifications
and ready for inspection. (Drawing enclosed)

...................................................... ........................... ....................

Contractors Representative Name Signature Date
FOR THE USE OF CONSULTANT
CONSULTANT
Remarks.....................................................................................................................................................
...................................................... ........................... ....................
Consultants Representative Name Signature Date
FOR THE USE OF KAHRAMAA
GIS Collected Not Collected
...................................... ............................ ....................
GIS Surveyor Name... Signature ..................Date
OS
Remarks ..................................................................................................................................................
Approved Not Approved
........................................ .......................... ..................
Operation Engineer Name Signature Date
TW
Remarks.................................................................................................................................................
Approved Not Approved
.............................................. .......................... ..................
Project Engineer Name Signature Date
Note:
1- The role of KM GIS starts before the Surround Material. Contractor to make sure that the KM GIS Surveyor collects the data
before Surround Material.
2- Copy to Operation Engineer for activity no. 14, the original copy to be signed by all participants
3- Copy to GIS Surveyor for activity no. 15
4- This site inspection does not relieve the contractor of any of his contractual obligations

TW-P6/F1 Issue 2 21/09/2015

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CC: Project Engineer /Consultant / Contractor

TW-P6/F1 Issue 2 21/09/2015

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