Form: QD-LUS-C-CON-01 Revision: October 2012 Contractor Consultant PM/CM

LREDC - INFRASTRUCTURE DEPARTMENT

Pre-concreting Inspection

Request No.: LUS-CP7B-QDSBG-PCI-CV-06690R0 Submission Date: Oct 29, 2020

Project Title: CP7B-Lusail plaza infrastructure,LRTstation,publice car par Project No.: CP 07B

Contractor: QD-SBG Contract No.: 5297

Date Inspection Required: Oct 31, 2020 Time Inspection Required: 9:00:00 PM BOQ Ref.:

Drawing No.: As per attached drawing Revision No.:

Method Statement Ref. No.: ITP Ref. No.:

Structure: Blinding For SSD - 43 Duct Bank Part of Structure: at Road F3

Area Road F3 Component Works SSD Discipline Civil

Contractor

Signature & Stamp

All Work referenced to have been inspected

No. Inspection Stage Inspected on Check Comments

1 Excavation
2 Formation
3 Blinding
4 Membranes
5 Waterbars
6 Joints
7 Reinforcement
8 H.D. Bolt
9 M & E Built In Items
10 Formwork
11 Line and Level
12 Strutting
13 Cleanliness

Necessary Reliable concrete mixer (for quantities <2 m³ only) Testing cubes Thermometer Water tank
Equipment
Reliable concrete vibrators Water pump Polythene sheets Hessian cloths Scaffolding
Hose Other

Consultant Final Decision: Approved for concreting Rejected for concreting

Consultant 1. The check on above structure does not relieve the contractor of his contractual
obligations under the contract.
Received on 2. This form must be submitted at least four working days prior to concreting.
3. This form shall be submitted on applicable workflow on ACONEX.
Actioned on 4. Failure to fulfill the above instruction will result in delaying the job.
Signature & Stamp 5. Inspection should be executed on the time and date stated.
 Blinding For SSD-DB-43Road F3

CP07‐B Lusail Plaza Infrastructure, LRT Station, Public Car Contract No. Location:
Parks and Landscape 5297 Lusail, Qatar

Pre ‐ Pouring Checklist

Location of Work: Reference No: SUR-76160
Road F3
Date : 29/10/2020
QD‐SBG Dorsch
SR. Description of Works Remark
Accepted Rejected Accepted Rejected
Check that formation level is acceptable (before
1
blindingconcrete works)
Check that necessary tests have been conducted on
2
thesoil surface (as applicable before blinding)
Check that existing concrete surface has been
3 chipped joints has been prepared properly and the
application of bonding agent (if necessary)
Installation of water proofing membrane/ water
4
stopshas been done as per requirement (if required)
Check that formwork installation had been proper
5 release agent applied and meets the requirement as
per
Checked that reinforcement has been erected as per
6
drawing / specification (if required)
CPC-8724
Check that all civil piping has been fixed as drawing /
7
specifications (if required)
Check that all embedded electrical items are fixed are
8 compliance to drawing and specification and
supported (if required)
Check that all embedded items, box out, metal
sleeves, bolts and dowel bars have been were
9
installed as per position indicated in the approved
shop drawing (if required)
Check that area has been cleaned, proper access has
10
been provided and safely are in placed
Sufficient lighting provided at site and lab QA/QC
11
check
Adequate tools and equipment are in place including
12
testing and measuring equipment
All setting out verified by surveyor including
13 concrete levels and all dimensions checked and
correct within tolerances
Comments :

Approved Approved with comment Revise and Resubmit

Checked By: Inspected By: Witnessed By:
QD‐SBG Execution
QD‐SBG QA/QC Engineer Dorsch QC Engineer/Inspector
Engineer
Name: Khaled Tarek Name: Name:

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