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23rd MAR TANG CHEN

A FOR APPROVAL CHE JIANHUA PANGWEI


2015 SHANJUN RUNQUAN

REV. DESCRIPTION DATE DESIGNED BY CHECKED BY REVIEWED BY APPROVED BY

OWNER
POWER GENERATION CORPORATION 1
THERMAL POWER PROJECT MANAGEMENT BOARD 3

CONSULTANT

POWER ENGINEERING CONSULTING JOINT STOCK COMPANY 3

CONTRACTOR

THE CONSORTIUM OF CHENGDA-DEC-SWEPDI-ZEPC

Sub-Contractor

GUANGZHOU SALVAGE

DUYEN HAI 3 THERMAL POWER PLANT CONTRACT


PROJECT:
PROJECT NO: DH3-05082011

DOCUMENT NAME:

ITP FOR CW Pipe Behind Connection Pit Construction (Civil)

PROJECT
DH3-39U-C-ITP-0019 REV: A
CONTROL NO.:
DUYEN HAI 3 THERMAL POWER PLANT PROJECT
EPC Contractor
ITP No : DH3-39U-C-ITP-0019
ITP FOR CW DISCHARGE PIPELINES CONSTRUCTION Date : 24th March,2015
Rev. No: A
APPLICABLE PARTICIPATION BY
NO. DESCRIPTION OF INSPECTION / TEST SPECIFICATION or RECORD FORMAT Frequency Acceptance Criteria
PROCEDURE SUBCON CD A3-C2
1 EXCAVATION REPORT
1.1 Description of Location WPP DH3-39U-C-ITP-0019-01 P W W during excavation During excavation
1.2 Elevation WPP DH3-39U-C-ITP-0019-01 P W W during excavation Satisfy the spec requirement
1.3 Equipment WPP machine check record P W W during excavation consistent with design
2 PILE DRIVING & CUTTING:
2.1 Input material checking As per design DH3-39U-C-ITP-0019-32 P W W before commencement consistent with design
2.2 Pile type,size,length As per design DH3-39U-C-ITP-0019-02 P W W before driving Φ500 PHC pile
2.3 Location As per design DH3-39U-C-ITP-0019-02 P W W before driving +50mm
2.4 Plumbness As per design DH3-39U-C-ITP-0019-02 P W W before driving 1%
2.5 Elevation As per design DH3-39U-C-ITP-0019-02 P W W at the end of driving +10mm
2.6 Pile head cutting (Elevation) WPP DH3-39U-C-ITP-0019-02 P W W at the end of driving consistent with design
3 GROUTING:
3.1 Input material checking and sample(if any) As per design Lab. Test Report P W R before commencement consistent with design
3.2 Formwork WPP DH3-39U-C-ITP-0019-03 P W W before grouting consistent with WPP
3.3 Construction method WPP DH3-39U-C-ITP-0019-03 P W W during grouting consistent with WPP
3.4 Full WPP DH3-39U-C-ITP-0019-03 P W W during grouting consistent with design
4 LIFTING & INSTALLATION:
4.1 Input material checking(if any) WPP DH3-39U-C-ITP-0019-32 P W W before commencement consistent with design
4.2 Equipment,Lifting tools,Communication WPP DH3-39U-C-ITP-0019-04 P W W before lifting consistent with WPP
4.3 Lifting point connect correctly WPP DH3-39U-C-ITP-0019-04 P W W during lifting consistent with WPP
4.4 Lifting surroundings WPP DH3-39U-C-ITP-0019-04 P W W during lifting Satisfy the lifting requirement
4.5 Location of installation As per design DH3-39U-C-ITP-0019-04 P W W during lifting +50mm
5 RIPRAP:
5.1 Location As per design DH3-39U-C-ITP-0019-05 P W W during riprap consistent with design
5.2 Elevation As per design DH3-39U-C-ITP-0019-05 P W W during riprap +150mm
6 BACKFILL:
6.1 Original backfill As per design DH3-39U-C-ITP-0019-06 P W W during backfill consistent with design
6.2 Elevation As per design DH3-39U-C-ITP-0019-06 P W W during backfill +500mm
7 STEEL BAR INSTALLATION INSPECTION RECORD
7.1 Input material checking & sampling As per design Lab. Test Report P W W,R Per 50 tons consistent with design
7.2 Size, bending position, length of steel bar As per design DH3-39U-C-ITP-0019-21 P W W During construction consistent with design
7.3 Steel bar connection WPP DH3-39U-C-ITP-0019-21 P W W During construction WPP
ITP No : DH3-39U-C-ITP-0019
ITP FOR CW DISCHARGE PIPELINES CONSTRUCTION Date : 24th March,2015
Rev. No: A
APPLICABLE PARTICIPATION BY
NO. DESCRIPTION OF INSPECTION / TEST SPECIFICATION or RECORD FORMAT Frequency Acceptance Criteria
PROCEDURE SUBCON CD A3-C2
7.4 Stirrup tying & spacing of transverse steer bar GB50204-2002 DH3-39U-C-ITP-0019-21 P W W 10% +20 mm
7.5 Horizontal and longitudinal spacing of steel bar GB50204-2002 DH3-39U-C-ITP-0019-21 P W W 10% +20 mm
Consistent with
7.6 The thickness of protective layer DH3-39U-C-ITP-0019-21 P W W Random: 2% +10 mm
design
8 FORMWORK INSTALLATION INSPECTION RECORD
8.1 Axis displacement GB50204-2002 DH3-39U-C-ITP-0019-22 P W W after installation 5 mm
8.2 Sectional dimenstion of formwork GB50204-2002 DH3-39U-C-ITP-0019-22 P W W after installation +10 mm
8.3 Surface evenness GB50204-2002 DH3-39U-C-ITP-0019-22 P W W after installation 5 mm
8.4 Correct installation of embedded component GB50204-2002 DH3-39U-C-ITP-0019-22 P W W 10% +15 mm
9 CONCRETE POURING:
9.1 Inspection before concrete pouring WPP DH3-39U-C-ITP-0019-23 P W W Before pouring Meet the requirements
Material sampling
9.2 Material checking and sampling As per design Lab. Test Report P W W,R consistent with design
procedure
9.3 Type of concrete mix As per mix design Approved Mix Design Report P W W,R Before pouring C40
9.4 Concrete sample As per design Lab. Test Report P W W,R Once per 40m3 consistent with design
9.5 Concrete slump control As per design DH3-39U-C-ITP-0019-24 P W W Before pouring 150±20mm
9.6 Concrete transport, pouring and intermittence WPP DH3-39U-C-ITP-0019-24 P W W during pouring <120min
9.7 Concrete temperature control and time waiting for pouring WPP DH3-39U-C-ITP-0019-25 P W W during pouring <30℃,<90mins
9.8 Construction method WPP DH3-39U-C-ITP-0019-24 P W W Before pouring WPP
9.9 Adequate manpower, tools and equipment WPP DH3-39U-C-ITP-0019-24 P W W Before pouring WPP
9.10 Smooth transportation WPP DH3-39U-C-ITP-0019-24 P W W during pouring WPP
9.11 HSE WPP DH3-39U-C-ITP-0019-24 P W W during pouring WPP
10 APPERANCE AND SIZE OF CONCRETE STRCUTURE
10.1 Appearance quality of concrete structure As per design DH3-39U-C-ITP-0019-26 P W W After pouring consistent with WPP
10.2 Dimension of concrete structure As per design DH3-39U-C-ITP-0019-26 P W W After pouring consistent with WPP
10.3 Visual inspection before transportation As per design DH3-39U-C-ITP-0019-26 P W W After pouring consistent with WPP
10.4 Axis position & Elevation of concrete structure (if any) As per design DH3-39U-C-ITP-0019-26 P W W After pouring consistent with WPP
11 Concrete Structure Anticorrosion (if any)
11.1 materials factory inspection report& compliance certification As per design DH3-39U-C-ITP-0019-27 P W W After pouring consistent with WPP
requirements on concrete surface: being solid, compacted, smooth
11.2 As per design DH3-39U-C-ITP-0019-27 P W W After pouring consistent with WPP
and clean
11.3 thickness of anticorrosion coating As per design DH3-39U-C-ITP-0019-27 P W W After pouring consistent with WPP

Legend: H : Hold W : Witness R : Record P : Perform


DUYEN HAI 3 THERMAL POWER PLANT
PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-01- ( )
EXCAVATION REPORT
Date:
Sub. Contractor:GS Start Time:
Work title: Excavation works / Cutter suction dredge works Finish Time:
Inspected work: Foundation Pit Excavation works / Dredger works
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Description of Location

2 Elevation

3 Equipment

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full
Name
Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-01
DUYEN HAI 3 THERMAL POWER PLANT PROJECT
OWNER CONSULTANT EPC CONTRACTOR
PHC PILE DRIVING INSPECTION REPORT
Sub. Contractor: GS ID No.:DH3-39U-C-ITP-0019-02-( )
Work title: Working PHC pile works Start Time:
Inspected civil work: PHC Pile Driving Finish Time:
Structure/Location: Date :
Based documentation for acceptance:
1. Request for inspection:
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report:
5. Site Diary:
6. Other relative documents (if any):
Pile No. : Pile Size : Pile Type :
Hammer Type : Hammer Weight : Drop height of Hammer:
Coordinate Design Before Driving Difference (mm)
A
B
Pile No. Length/unit Start time Finish Time Total Driving Time Marking of Piles
1
2
3
Cut off Level : m Ground Level: m Pile Head level: m
Pile Tip level: m Actual Pile Length : m Length of Cut off: m
Number of blows:
Assessment
Inspection content
CD PECC3 TPMB3
Lifting and Setting out
Inclination
Welding joint
Depth Blows Depth Blows Depth Blows Depth Blows Depth BlowsDepthBlows Depth Blow Pile Head level
Pile No.2 Pile No. 3

(m) (m) (m) (m) (m) (m) (m) Cut-off Level

Actual Pile Lengt


Pile No. 1

Pile Tip Level

Comments from CD:


Comments from PECC3:
Comments from TPMB3:
Conclusion:
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name
Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-02
DUYEN HAI 3 THERMAL POWER PLANT
PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-03- ( )
GROUTING REPORT
Date:
Sub. Contractor: GS Start Time:
Work title:Grouting works Finish Time:
Inspected work: Grouting works
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Input material checking and sample(if any)

2 Formwork

3 Construction method

4 Full

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signatur
e
Full
Name
Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-03
DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-04- ( )
LIFTING & INSTALLATION REPORT
Date:
Sub. Contractor: GS Start Time:
Work title:Lifting & Installation works Finish Time:
Inspected work:
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Input material checking(if any)

2 Equipment/ Lifting tools & Communication

3 Lifting point connect correctly

4 Lifting surroundings

5 Location of installation

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-04


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-05- ( )
RIPRAP REPORT
Date:
Sub. Contractor: GS Start Time:
Work title:Lifting & Installation works Finish Time:
Inspected work: riprap
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Location

2 Elevation

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-05


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-06-( )
BACKFILL REPORT
Date:
Sub. Contractor: GS Start Time:
Work title:Lifting & Installation works Finish Time:
Inspected work: Backfill
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Original backfill

2 Elevation

3 Evenness of surface (if any)

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-06


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-21-( )
REBAR INSTALLATION INSPECTION RECORD
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Input material checking & sampling

2 Size, bending position, length of steel bar

3 Steel bar connection

4 Stirrup tying & spacing of transverse steer bar

5 Horizontal and longitudinal spacing of steel bar

6 The thickness of protective layer


Comments from CD:
Comments from PECC3:
Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-21


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-22-( )
FORMWORK INSTALLATION INSPECTION RECORD
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Axis displacement

2 Sectional dimenstion of formwork

3 Surface evenness

4 Correct installation of embedded component

Comments from CD:


Comments from PECC3:
Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-22


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
INSPECTION RECORD BEFORE CONCRETE ID No.:DH3-39U-C-ITP-0019-23-( )
POURING Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3
Sufficient bearing capacity, stiffness & stability of formwork
1
and support
2 Leakage, ponding or foreign matters

3 Dirt or rust stains on steel bars

4 Design dimension & Actual dimension of structure


Quality, specification, number, length & arrangement of
5
steel bar
6 Embedded parts & casings

7 Sufficient manpower, materials, equipment & lighting


Comments from CD:
Comments from PECC3:
Comments from TPMB3:
Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-23


DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-24-( )
CONCRETE POURING INSPECTION RECORD
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work: Concrete pouring inspection
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Concrete slump control and sample

2 Concrete transport, pouring and intermittence

3 Construction method

4 Adequate manpower, tools and equipment

5 Smooth transportation

6 HSE
Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-24


DUYEN HAI 3 THERMAL POWER PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-25-( )
CONCRETE DELIVERY RECORD
Data:
Subcontractor: GS Spec:
Work title: Weather:
Inspected work: Quantity Requested:
Structure/Location: Air Temperature :
Time Slump(mm) Concrete Actual
Ticket
No. Departur Temperature Quantity Remarks
No. Arrival Start Finish Actual Type
e (℃) (m3)

Sub-Contractor EPC Contractor Consultant Owner


GS CD PECC3 TPMB3
Evaluated by: Name: Name: Review by:

Signature: Signature: Signature: Signature:

Date: Date: Date: Date:


Form: DH3-39U-C-ITP-0019-25
DUYEN HAI 3 THERMAL POWER PLANT
PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-26-( )
APPERANCE INSPECTION RECORD
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Appearance quality of concrete structure

2 Dimension of concrete structure

3 Visual inspection before transportation

4 Axis position & Elevation of concrete structure (if any)

Comments from CD:


Comments from PECC3:
Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-26


DUYEN HAI 3 THERMAL POWER PLANT
PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-27-( )
Concrete Structure Anticorrosion Record
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structure/Location:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3
Materials factory inspection report& compliance certification
1
(if any)
requirements on foundation: being solid, compacted,
2
smooth and clean
3 Thickness of anticorrosion coating

Comments from CD:


Comments from PECC3:
Comments from TPMB3:
Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full
Name
Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-27
DUYEN HAI 3 THERMAL POWER
PLANT PROJECT
Owner Consultant EPC Contractor
ID No.:DH3-39U-C-ITP-0019-32-( )
PRODUCT APPERANCE INSPECTION RECORD
Date:
Sub. Contractor: GS Start Time:
Work title: Finish Time:
Inspected work:
Structural title:
Based documentation for acceptance:
1. Request for inspection
2. Approved drawings:
3. Inspection and Test Plan or related standards(if any):
4. Measurement and Test Result report
5. Site Diary
6. Other relative documents (if any):
Product No.

Method of Inspection

□ Visual □ Laboratory Test □ Measurement □ Survey □ Others:………...…


Assessment
No. Inspection content
CD PECC3 TPMB3

1 Dimension of product structure

2 Appearance quality of product structure

Comments from CD:

Comments from PECC3:

Comments from TPMB3:

Conclusion: Accepted the above inspected work and agreed to carry out the next civil works.
Sub-Contractor EPC Contractor Consultant Owner
GS CD PECC3 TPMB3
Position

Signature

Full Name

Note: √= Accept, × = Reject. Form: DH3-39U-C-ITP-0019-32

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