IR — INSPECTION REQUEST WEST QURNAI—SECTION-A Contractor No.: AWQ0109 ExxonMobil 5, Produced Water Treatment M109 LOCATION: DS-8 | IRNO:IRNoCE-Co2a0 | iRISSUE DATE: 20 April 2017 DISCIPLINE: Civil SUBJECT: Witness | INSPECTION REQUIRED DATE:22 Apfil 2017 TIME:12:30 REF.SPECIFICATION: 1QWA-FT-NSPOS-00-040901 REV.1 EARTHWORK ren canainast 'QWA-CE1091-CDFND-D8-0002 REV.2_ FOUNDATION FOR PRE-SEPARATOR 1D * ‘AB1681050 PLAN SECTION & DETAIL; DB RFF, ITP: !QWQ-CE1092-CPQAC-00-0001 REV. ICIVIL INSPECTION AND TEST PLAN OTHERS REF.: ATTACHMENT /CHECK LIST IF ANY: NAME OF CONTRACTOR/SUBCONTRACTOR: CPECC/MFCO Our request the inspection of the following works for certificate/witness that all items has been properly executed in accordance with approved procedures, specifications, drawings and all items has been coordinated with future works. DISCRIPTION OF WORK TO BE INSPECTED: ‘Sampling the sub-grade layer inside the tank for the purpose of compaction degree test in DSB COMMENTS: z ama 45 not geocl. st 2 Agwreel Sth CREE @e comment LY Giaccerreo ClaccePreo with comments Sresecreo work is not ready Dunacceptable inspection result MSee comments Tick THIS BOX IF “NO” EMIL/ SOC and if tis a “WITNESS” as per ITP, {by ticking this box means CPECC needs to produce all the related documents and sign / close this IR) SIGNATURE FOR NOTIFICATION/ ACKNOWLEGEMENT SUBCONTRACTOR cvece ‘COMPANY OTHERS PRINT NAME: PRINT NAME: PRINT NAME PRINT NAME Aohabinad Sadi Ma Gran user Sha A ‘SIGNATURE: ‘SIGNATURE: See 2 ‘SIGNATURE: pares 227-2017 | oar: av M~Ie/Z | are: 22 /A\P/7..19 | areExxonMobil dis ‘West Qumna | Form No. F70101Q Contract:AWQ0109 Rev. 0 Project Location: Basra, Iraq INo. CE-C 0238 Ee QUALITY CHECKSHEET - SOIL INSPECTION CHECKLIST - PRODUCED WATER DSSMIO9 | Tag Description | TRPATMENT | Tag No, i Contract No. AWQ-0109 | System No. Contractor CPEC ‘Sub-System No. | !QDS-ABI681050 | Dewing Reference | \WOCETOSI-CDFND-DE-GOG2 | Loeaton DSE | Drawing No, 1QW0-cEt091-cDFND-Ds.0002 Specification No IQWQ-FT-NSPDS-00-040901_1 Inspection Reference Contractor | est auina | 1, Excavation cleared of foreign and loose material NA 2, Slopes shored or correctly stepped. NA 3. Fill Material cleans and conforms to requirements, v 4. Lift thickness and compaction procedures in accordance with specifications 4 5. Final elevation in accordance to drawings. v 6, Moisture control acceptable. ’ 7. Compaction Method and Equipment ’ Remarks: Contractor/Construetion Rep, Contractor/Quality Rep. Company Rep. ane Moharinad Soci] [Nam Mg Groen Nan : Signature: YE —— Sigutwe LP ‘Signature: | Duce? 2-H 2017 [oe p= Y- aor} = *PL/1*