SAUDI ARAMCO ID/PID - 18-MAY-05 - REV 0 (Standards Cutoff - JUNE 2008) Rev 3 30-Jun-08

SAUDI ARAMCO INSPECTION CHECKLIST SAIC NUMBER DATE APPROVED QR NUMBER

Surface Preparation and Formwork Inspection SAIC-Q-1053 1-Nov-09 CIVIL-

PROJECT TITLE WBS / BI / JO NUMBER CONTRACTOR / SUBCONTRACTOR

EQUIPMENT ID NUMBER(S) EQUIPMENT DESCRIPTION EQPT CODE SYSTEM ID. PLANT NO.

LAYOUT DRAWING NUMBER REV. NO. PURCHASE ORDER NUMBER EC / PMCC / MCC NO.

SCHEDULED INSPECTION DATE & TIME ACTUAL INSPECTION DATE & TIME QUANTITY INSP. MH's SPENT TRAVEL TIME
SAUDI ARAMCO USE ONLY
SAUDI ARAMCO TIP NUMBER SAUDI ARAMCO ACTIVITY NUMBER WORK PERMIT REQUIRED?

SAUDI ARAMCO INSPECTION LEVEL CONTRACTOR INSPECTION LEVEL

ITEM
ACCEPTANCE CRITERIA REFERENCE PASS FAIL N/A RE-INSP DATE
No.

Foundations under the mounting plate are chipped and free from dirt, SAES-Q-011
A1
dust, oil, and grease. (PIP STS03601, Sec. 6.2.1.1 and 6.2.1.2) Sec. III.B
Concrete in contact with the epoxy grout shall be clean, dry and oil free. SAES-Q-011
A2
(PIP STS03601, Sec. 6.2.6) Sec. III.B
The epoxy grout manufacturer's recommendations on maximum depth of SAES-Q-011
A3
pour and length to depth ratio are followed. Sec. 6.2.8
Anchor bolts are protected by sleeves and exposed threads are wrapped
SAES-Q-011
A4 with duct tape to prevent adherence of the epoxy grout. (PIP STS03601,
Sec. III.B
Sec. 6.2.4)
Formwork for epoxy grout are constructed to be liquid tight with adequate
SAES-Q-011
A5 strength, rigidity and dimensions to permit epoxy grout placement. (PIP
Sec. III.B
STS03601, Sec. 6.2.3)
Form joints and interface between forms and concrete foundation are
SAES-Q-011
A6 sealed with grout manufacturer's recommended sealant. (PIP
Sec. III.B
STS03601, Sec. 6.2.3.4)
If the grout pour is 100mm or deeper, the grout manufacturer's SAES-Q-011
A7
recommendations for installing reinforcement rebars are followed. Sec. 6.2.8
Chamfers strips with a width of 25mm , with 45° angle are installed at
SAES-Q-011
A8 each vertical corner and at the horizontal surfaces of the grout formwork.
Sec. III.B
(PIP STS03601, Sec. 6.2.3.3)
Three coats of paste wax shall be applied to the inside surface of forms
SAES-Q-011
A9 or other manufacturer recommended procedure for preventing bonding of
Sec. III.B
the epoxy grout to the formwork. (PIP STS03601, Sec. 6.2.3.2)

Suitable shelter or enclosures shall be provided to protect the foundation

and base plate from direct sunlight, dew, rain or other inclement weather.
SAES-Q-011
A10 During cold weather, adequate enclosure and heating shall be provided
Sec. III.B
to maintain foundation and base plate temperature with acceptable range
specified by the grout manufacturer. (PIP STS03601, Sec. 6.2.2)

REMARKS:

REFERENCE DOCUMENTS:
1- SAES-Q-011 -- Epoxy Grout for Machinery Support, 24 June 2006

Contractor / Third-Party Saudi Aramco

Construction Representative* PMT Representative
Work is Complete and Ready for Inspection: T&I Witnessed QC Record Reviewed Work Verified
Name, Initials and Date: Name, Initials and Date:

QC Inspector PID Representative

Performed Inspection Work / Rework May Proceed T&I Witnessed QC Record Reviewed Work Verified
Name, Initials and Date: Name, Initials and Date:

QC Supervisor Proponent and Others

Quality Record Approved: T&I Witnessed QC Record Reviewed Work Verified
Name, Organization,
Name, Sign and Date:
Initials and Date:

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 Quality Record Approved:
Name, Organization,
Name, Sign and Date:
Initials and Date:

*Person Responsible for Completion of Quality Work / Test Y = YES N = NO F = FAILED

Page 2 of 2