Quality Assurance / Quality Control Form

Method Statement
Doc No: FR-01-QAQC-GF-015 Revision No. 2 Effectivity Date: April 18, 2022 Page 1 of 4

(Project Name)

Method Statement for (Scope of Work)

(Sub-con Name)
 Quality Assurance / Quality Control Form

Method Statement
Doc No: FR-01-QAQC-GF-015 Revision No. 2 Effectivity Date: April 12, 2022 Page 2 of 4

MS Reference Number
Revision Number
Date
Check the appropriate box below;
 Sub-contractor Works
 Self-performed Works

Document Review
Name Title
Prepared by Sub-contractor / MDC Field Engineer
Reviewed by MDC EHS Supt ./ Officer
Reviewed by MDC QAQC Supv./ Officer

Reviewed by MDC Project Trade Supv./ Supt.

Recommended by: Approved by:

Project In-Charge / Project Manager General Manager

Table of Contents

I. SCOPE OF WORK...........................................................................................3
 Quality Assurance / Quality Control Form

Method Statement
Doc No: FR-01-QAQC-GF-015 Revision No. 2 Effectivity Date: April 12, 2022 Page 3 of 4

II. DOCUMENTS.................................................................................................3

III. ALL PLANT AND EQUIPMENT..........................................................................3

IV. WORK EXECUTION........................................................................................3

V. QUALITY ASSURANCE AND CONTROL...............................................................3

VI. APPENDICES................................................................................................3

I. SCOPE OF WORK
Describe the scope of work covered by this method statement

II. DOCUMENTS
List other documents related to the work process which should be referred to

III. ALL PLANT AND EQUIPMENT

List all plant and equipment to be used with pictures and details of capacity, size etc

IV. WORK EXECUTION

 Quality Assurance / Quality Control Form

Method Statement
Doc No: FR-01-QAQC-GF-015 Revision No. 2 Effectivity Date: April 12, 2022 Page 4 of 4

Provide complete step by step process of work and ensure Quality and EHS requirements in
considered on the process. (Provide pictures, drawings, standards details and other necessary
information)

1. Material Handling, storage and Protection

2. Pre-installation/Application Requirements
3. Work Procedure
4. Testing Procedure
5. Acceptance Criteria

V. QUALITY ASSURANCE/CONTROL

A. TESTS Refer to Project-WP-ITP–Inspection and Test Plan/ Construction Specifications

INSPECTIONS Refer to ITP – Inspection Plans Refer to Forms – Inspection Checklists and
Forms

B. MEASURING AND TESTING EQUIPMENT TO BE CALIBRATED

List Survey Equipment, Pressure Gauges,etc to be used in the work process

C. PARTIES AND PRODUCTS REQUIRING ACCREDITATION OR CERTIFICATION

List parties (specialist subcontractors, testing laboratories, suppliers etc) that are required to
be accredited or certified.

VI. APPENDICES
Inspection Test Plan
EHS Risk and Opportunity Register