FOR APPROVAL

A 27.Jul.2022 Jongpyo, Kim Choulho, Hwang Soowon, Lee FOR APPROVAL

REV DATE PREPARED CHECKED APPROVED STATUS
Owner

Owner’s Engineer

Contractor

Sub-Supplier

Project
ASH HANDLING FACILITIES FOR
JAWA 9 & 10 COAL FIRED STEAM POWER PLANT
Document Title

FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
Document Type
□ Basic Engineering Document □ Detail Engineering Document □ Vendor Document ■ Other

Document No.

J910-DH02-P10ZEN-040007
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
J910-DH02-P10ZEN-040007

RECORD OF REVISION
Rev. Date Page Affected Description of Revision

A 27.Jul.2022 First Issue

Rev.A 2 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
J910-DH02-P10ZEN-040007
CONTENTS

1. INTRODUCTION.............................................................................................................................4
1.1 Inspection and Test Plan (ITP) ..................................................................................................................... 4
1.2 Acceptance Conditions ................................................................................................................................. 4
1.3 Request for Inspection and Test (RFI) .......................................................................................................... 5
1.4 Documentation ............................................................................................................................................. 5

2. FLOW CHART OF THE INSPECTION........................................................................................6

2.1 General Inspection Flow Chart ..................................................................................................................... 6
2.2 Flow Chart for Field Inspection of Concreting Works ................................................................................. 6

3. DETAIL ITP FOR CONCRETE WORK ........................................................................................7

2.2.Line & Grade ................................................................................................................................................ 7
2.3 Soil condition at the bottom of excavation ........................................................................................... 7
2.5 Final Survey ................................................................................................................................................. 7

4. APPENDICES ..................................................................................................................................12
APPENDIX 1 ...................................................................................................................................................... 12
Form No. ITP-M-0001-01 MATERIAL RECEIVING INSPECTION RECORD ............................................... 12
APPENDIX 2 ...................................................................................................................................................... 13
Form No. ITP-M-0001-02 INSPECTION FOR SURVEYING RECORD REPORT .......................................... 13
APPENDIX 3 ...................................................................................................................................................... 14
Form No. ITP-M-0001-03 INSPECTION FOR EXCAVATION RECORD REPORT ........................................ 14
APPENDIX 4 ...................................................................................................................................................... 15
Form No. ITP-M-0001-04 INSPECTION FOR BACKFILL RECORD REPORT ............................................. 15
APPENDIX 5 ...................................................................................................................................................... 16
Form No. ITP-M-0001-05 INSPECTION FOR CONCRETE CHCEKLIST ...................................................... 16
APPENDIX 6 ...................................................................................................................................................... 17
Form No. ITP-M-0001-06 INSPECTION FOR CONCRETE TEST REPORT .................................................. 17
APPENDIX 7 ...................................................................................................................................................... 18
Form No. ITP-M-0001-07 INSPECTION FOR POST-POURING REPORT ..................................................... 18

Rev.A 3 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
J910-DH02-P10ZEN-040007

1. INTRODUCTION
1.1 Inspection and Test Plan (ITP)

a. Scope
The Inspection and Test Plan (ITP) is an engineering document, which described the inspection
and tests to be performed. The inspection is performed in accordance with Owner specification
requirements and specified codes & standards.
b. Composition
This ITP is composed as belows:
- Cover Sheet with project name, Owner name, application and related personnel's name.
- Introduction with general notes
- ITP with Inspection and test activities

1.2 Acceptance Conditions

a. The equipments, materials are inspected and tested at Site in confirmation of the conditions
specified in the ITP. Each operation refers to the whole or part of a standard, a technical
specification and a regulation.
b. Detailed Legend
Detailed Legend for Inspection activity points shall be designated on the ITP by the related
parties as follows;
P : Performance Point. Responsible to perform or execute the actual works.
R : Record/review Point. Responsible for Generating record/review.
W : Witness Point. Consortium shall send a notification to the Owner prior to perform
the related test or inspection. If the Owner fails to be present, the test or inspection
may be carried out by Consortium without witness of the Owner.
SW : Spot Witness Point. The spot witness point that is handled like as a sample witness
point, it will be witnessed by related parties only for several activities/ item to be
inspected. But, if inadequate working procedures are detected by related parties,
this point will be treated as witness points after the proper action.
S : Surveillance Point. Random attendance at site, no signature required on the
Inspection Request ( IR ) or its accompanying documentation.
H : Hold Point. Consortium shall also send a notification to the Owner prior to perform
the related test or inspection. If the Owner fails to be present, any construction
activities shall not be proceeded by Consortium without attendence or any written
approval of the Owner.

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 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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1.3 Request for Inspection and Test (RFI)

a. RFI will be issued by Consortium through Aconex at least three (3) days in advance for
site/field inspection and 7 days for outside inspection. For overseas inspection, RFI shall be
issued 35 days in advance prior to the inspection and test in accordance with the Contract.
b. RFI is required for all action points excluding Surveillance Point.
c. RFI will contain as a minimum of the following details:
- ITP No./Drawing No./Equiment name/System Name
- Inspection tem/activities on the ITP to be inspected
- Inspection date and time
- Unit No./Area/Building/Location/Elevation
- Any comments to be considered

1.4 Documentation

a. The results of inspections and tests shall be documented in writing and signed by the related
parties as a token of approval
b. Signed documents shall be controlled as a QA records in accordance with the related procedure.
c. Photos related to the work. Minimum captured: before test/inspect, on progress, after.

Rev.A 5 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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2. FLOW CHART OF THE INSPECTION

2.1 General Inspection Flow Chart

SHOP / MANUFACTURER

Engineering Purchase Order Fabrication Owner Witness Transport,

Design Issue to and Inspection as Shipping &
Information as Supplier (PO) Manufacturing per approved Pass Customs
per Contract in shop ITP

Move to Material &

Warehouse Inspection at Warehouse as per Accept Laydown area Equipment to
Receiving Packing list. or Warehouse be released to
point at Site as per Storage Site
Receiving Inspection report Issue. Levels Construction

Package damaged Re-packing Reject

Inspection
Open box Issue HOLD activity as per
Inspection to Tag & NCR approved ITP
check package
inside

SITE

2.2 Flow Chart for Field Inspection of Bund Wall Works

Precast panel Concrete pouring

Accepted? inspection
formwork check &
Rebar check (Slump, sample, etc.)
Repair
Post-pouring
inspection
Accepted? (Honeycomb, crack,
etc.)

Inspection Inspection of Survey

Inspection tests
Request for coordinate points and
plan as per
Survey and Install
approved ITPs Level as per approved
Bund Wall drawings
work

Approval for Witnessing and Final

back filling & testing for back Inspection as
Materials as filling &geostrap per ITPs
per ITPs as per ITPs

Rev.A 6 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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3. DETAIL ITP FOR BUND WALL WORK

Verification Inspection and Test Activities by

Inspection / Test Items Applied Procedure, Frequency of
Document (QC Acceptance Criteria
No. Description Code, DWG, etc. Inspection / Test
Record)
Sub-Con EPC IRT/OE Auth.

1 VERIFICATION OF RELEVANT DOCUMENTS

Comply with Approved
Comply with Contract &
1.1. AFC Drawing DWG, CODE and AFC Drawings As per Report P R R
Design Criteria
Standard

1.2. Method Statement & Contract Book 4, Method Statement Comply with Approved
As per Report P R R -
Risk Assessment Method Statement &Risk Assessment Method Statement.

Equipment &
Equipment & Machinery Comply with Approved
1.3. Equipment & Machineries Machineries As per Report P R R -
certificates inspection records
inspection records
Method Statement, Comply with Approved
calibration
1.4. Calibration Certificate Instrument specification, Valid calibration As per Report P R R -
certificates
Calibration Procedure certificates

2 Excavation

2.1. Instrument Calibration for Calibration As per the

P R R -
Surveying Equipment Certicate calibration report

Contract Book 4. As per approved

2.2.Line & Grade ITP-C-0001-10 P W SW -
Chapter 4. Attachment drawings
of Design Specifications
2.Technical
2.3 Soil condition at the bottom of Comply with contract Before pouring
Specifications for Civil Lab Report P W SW -
specification, Approved
excavation Works Lean concrete
drawings
2.1 Earth Works,
AFC Drawings,
Approved Method Before pouring
2.4.Dewatering (if water rises) Statement ITP-C-0001-10 P W SW -
Lean concrete

Before proceeding
2.5 Final Survey ITP-C-0001-09 P W SW -
rebar works

Rev.A 7 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
J910-DH02-P10ZEN-040007

Verification Inspection and Test Activities by

Inspection / Test Items Applied Procedure, Frequency of
Document (QC Acceptance Criteria
No. Description Code, DWG, etc. Inspection / Test
Record)
Sub-Con EPC IRT/OE Auth.

3 Precast concrete Panel Material Verification

Applicable DWG for each Test result meets Once per design
3.1 Design mix Trial Mix Report P W SW -
works & specification targeted grade mix

3.2 Manufactured materials Applicable DWG for each One approval per
Material Approval Approve by IRT/OE P R R -
(Dowel bar, etc.) works & specification material per brand

3.3 Material receiving inspection As per approved

for manufactured materials
Material Approval (AFC) ITP-M-0001-01
material
Each delivery batch P W R - -

4 Precast concrete Panel Pre-Pouring

Contract Book 4. Chapter

4.1 Formwork 4,as clause 2.2.13 page ITP-M-0001-05 As per ACI 117 – 10 Each Pouring Area P W SW -
2.13-2.14

Applicable DWG for

4.2 Rebar each works ITP-M-0001-05 As per ACI 117 – 10 Each Pouring Area P W SW -
& specification

Contract Book 4. Chapter

4.2 Curing type 4,as clause 2.2.19 page ITP-M-0001-05 As per Casting Plan Each Pouring Area P W SW -
2.18

Contract Book 4. Chapter

4.3 Cleaning 4, as clause 2.2.13 page ITP-M-0001-05 As per Casting Plan Each Pouring Area P W SW -
2.14-2.15

Contract Book 4. Chapter

As per applicable
4.4 Embedded parts 4,as clause 2.2.13 page ITP-M-0001-05 Each Pouring Area P W SW -
drawing
2.14

Rev.A 8 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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Verification Inspection and Test Activities by

Inspection / Test Items Applied Procedure, Frequency of
Document (QC Acceptance Criteria
No. Description Code, DWG, etc. Inspection / Test
Record)
Sub-Con EPC IRT/OE Auth.

5 Field Control Testing

Applicable DWG for

As per applicable
5.1 Concrete grade each works & ITP-M-0001-06 Each Pouring Area P W SW -
drawing
specification

Clause 2.5.1 of ACI 117

5.2 Slump check ACI 301M – 10 ITP-M-0001-06 Every 5 M3 P W SW -
– 10

5.3 Temperature check ACI 301M – 10 ITP-M-0001-06 Less than 32°C Every 50 M3 P W SW -

6 Precast concrete Panel Post-Pouring

Contract Book 4. As per Clause 2.2.13.3

6.1 Formwork removal Chapter 4, as clause ITP-M-0001-07 point g) at the table , Each Pouring Area P W SW -
2.2.13 page 2.15 page 2.15

6.2 Visual inspection of concrete As per clause 5.3.3 and After formwork
ACI 301M – 10 ITP-M-0001-07 P W SW -
surface 5.3.4 of ACI 301M – 10 removal

Average of 28-day test

Applicable DWG for
Monthly Testing results equal to or 3 sets of 3 each at
6.3 Compressive strength test each works & P W SW -
Report greater to specified Every 50 M3
specification
strength

7 Backfilling

ITP-M-0001-04 or Once in Every

7.1 Material Check P W SW
Contract Book 4. Lab. Report sources of materials
Chapter 4. Attachment
Comply with contract
of Design Specifications
ITP-M-0001-04 or specification, Approved Once in Every
a) Soil Classification 2.Technical P W SW
Lab. Report drawings and ASTM sources of materials
Specifications for Civil
D1557 & D2049
Works
2.1 Earth Works, ITP-M-0001-04 or Once in Every
b) Sieve Analysis P W SW
Lab. Report sources of materials

Rev.A 9 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
J910-DH02-P10ZEN-040007

Verification Inspection and Test Activities by

Inspection / Test Items Applied Procedure, Frequency of
Document (QC Acceptance Criteria
No. Description Code, DWG, etc. Inspection / Test
Record)
Sub-Con EPC IRT/OE Auth.

ITP-M-0001-04 or Once in Every

c) Liquid Limit P W SW -
Approved Method Lab. Report Comply with contract sources of materials
Statement and ASTM specification, Approved
D1557 & D2049 drawings and ASTM
ITP-M-0001-04 or D1557 & D2049 Once in Every
d) Plasticity Index P W SW -
Lab. Report sources of materials

ITP-M-0001-04 or
e) Moisture Content Contract Book 4. Every 1000 Cum P W SW -
Lab. Report
Chapter 4. Attachment
of Design Specifications
2.Technical Comply with contract
7.2. Layer Thickness Specifications for Civil ITP-M-0001-04 specification, Approved Every 1000 Cum P W SW -
Works drawings and ASTM
2.1 Earth Works, D1557 & D2049
Field Density Test
Procedure and ASTM
7.3. Compaction Test ITP-M-0001-04 or
D1557 & D2049 Every 1000 Cum R W W -
Field Density & Moistire Test Lab. Report

Applicable DWG for

7.4. Geostrap installation each works & ITP-M-0001-04 Approved drawings Every layer P W SW
specification

8 Final Conformity / Final Walkdown Inspection

- AFC Drawings Completion of work as

8.1 Check Completeness of - Approved MS per AFC drawing and 100% (after work
Punchlist P H H -
Works - Inspection Records approved method completion)
Internal Punch List statement

- AFC Drawings
- Completion of works
8.2 Punch List Registration & - Approved MS 100% (after work
Punchlist Satisfactory clearance P H H -
Clearance - Inspection Records completion)
of punch list.
Internal Punch List

Rev.A 10 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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Verification Inspection and Test Activities by

Inspection / Test Items Applied Procedure, Frequency of
No. Document (QC Acceptance Criteria
Description Code, DWG, etc. Inspection / Test
Record)
Sub-Con EPC IRT/OE Auth.
Site Work
Final Review of All Inspection and Test Reviewed & signed- 100 % (All
9 Conformance R R R -
Documentation Records off by all parties records)
File (SWCF)

Note:
Legend Definition: P Perform R Record Review
H Hold Point Sub-Con Subcontractor (HJU)
W Witness EPC Contractor (DHII)
SW Spot Witness IRT/OE Owner (Indo Raya Tenaga) / Owner Engineer
S Surveillance Auth. Authorized third party for the specific item as applicable

Rev.A 11 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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4. APPENDICES
APPENDIX 1
Form No. ITP-M-0001-01 MATERIAL RECEIVING INSPECTION RECORD

MATERIALS RECEVING INSPECTION RECORD

Vendor/Sup
: _____________________ RFI No. : _________________
p
Unit/Area : _____________________ Date : _________________
Ref.
Project : Ash Handling Facilities for Jawa 9 & 10 CFSPP : _________________
Dwg.Doc
Material Description

Source of materials

Quantity

MTC for materials

Lab Test Report No. (IF ANY)

Inspection Result
No Check Items Acceptance Criteria Remarks
Accept Reject
1 Size

2 Type

3 Dimension

4 Color

5 Packing – class of storage

6 Others, if any

The material stated above has been inspected and Approved / Not Approved to take up the works

Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 12 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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APPENDIX 2
Form No. ITP-M-0001-02 INSPECTION FOR SURVEYING RECORD REPORT
INSPECTION FOR SURVEYING RECORD
REPORT (FOR BUND WALL)

Structure : _____________________ Report No. : _____________________

Area/Unit : _____________________ Date : _____________________
Location : _____________________ Subcon : _____________________
: ASH Handling Facilities For Jawa 9&10 CFSPP
Project Reff.Dwg. : _____________________
Project
Ref. Std. : _____________________
Inspection Result Acceptance
Check Items Remarks
Accept Reject Criteria
A. Description & Location

As per
approved
drawings

B. Benchmark used

As per
approved
drawings

C. Surveying data

As per
approved
drawings

Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 13 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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APPENDIX 3
Form No. ITP-M-0001-03 INSPECTION FOR EXCAVATION RECORD REPORT

INSPECTION FOR EXCAVATION RECORD

REPORT

Structure : _____________________ Report No. : _____________________

Area/Unit : _____________________ Date : _____________________
Location : _____________________ Subcon : _____________________
: ASH Handling Facilities For Jawa 9&10
Project Reff.Dwg. : _____________________
CFSPP Project
Ref. : _____________________
Inspection Result
No Check Items Acceptance Criteria Remarks
Accept Reject
1 The work site is cleared
All grass and weeds including roots are
2
stripped and removed
Excavation is performed to the lines, As per approved
3
grades, and slopes as drawing drawings
Slope of all excavation are cut true and As per the approved
4 straight and loos stone and boulders shall draings/field
be removed in area inspection
Excavation is made below the elevation As per approved
5
level indicates on the design drawing drawings
Excavation is kept free of water at all
6 times until complete of construction or Field Inspection
backfilling
7 Soil condition at the bottom of excavation Field Inspection
Protection work of excavated slope area
8 As per approved JSA
for safety
Demolition or protection of
9 As per approved JSA
existing/nearest facility
As per approved
Investigation of existing underground
10 drawings/as actual
faciliities
inspection at site
As per approved
11 Condition of compaction bottom surface drawings/
Specifications
Safety regarding excavation works,
12 As per approved JSA
confirmed
13 Quality of cleaning As per actul Inspection
Result of compaction test after
14 As per the test reports
excavation, confirmed (if necessary)
Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 14 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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APPENDIX 4
Form No. ITP-M-0001-04 INSPECTION FOR BACKFILL RECORD REPORT

INSPECTION FOR BACKFILL RECORD

REPORT

Structure : _____________________ Report No. : _____________________

Area/Unit : _____________________ Date : _____________________
Location : _____________________ Subcon : _____________________
: ASH Handling Facilities For Jawa 9&10
Project Reff.Dwg. : _____________________
CFSPP Project
Ref. Std. : _____________________
Inspection Result
No Check Items Acceptance Criteria Remarks
Accept Reject

Material for backfill are suitable and As per ITPs /

1
approved Specifications

No boulders and rock fragment are

2 As per actul Inspection
included

As per Visual and survey

3 The thickness per lay is adequated
reports

Adequated water sprayed when

4 As per test reports
compacting

Samples for field density test were taken

5 As per test reports
on test as per specification

Test result of field density are above for

6 fill or required by specification or Verify by test reports
contract dwgs

7 Recompact all faulted area and test As per test reports

Obtained max dry density according to

8 As per test reports
specification

9 Protection of slope safety As per approved JSA

Quality of cleaning before backfill

10 As per visual inspection
accepted

11 Install geostrap As per visual inspection

Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 15 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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APPENDIX 5
Form No. ITP-M-0001-05 INSPECTION FOR PRECATE CONCRETE PANEL CHCEKLIST
INSPECTION FOR PRECAST CONCRETE PANEL
CHCEKLIST
Project Title Sub-Contractor
Job No RFI No.
Project Owner Name Date
Owner Engineer Name
Page of
EPC Company Name
Equipment / Location : Revision :
Drawing no : Sheet :

RESULT
NO DESCRIPTION REMARK
Accept Reject

Dimension Alignment
Form Oil Coating
1 Formwork
Stability
Rebar
Cleaning Pouring Place
Slump Test
Stability
2 Concrete Availability Concrete Vibrators (Qty)
Removal Laitance
Appearance of Surface
Curing
Size Type Number
Stability
3 Embedded
Protection
Material

Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 16 of 18
 FIELD ITP FOR BUND WALL WORK FOR ASH HANDLING FACILITIES
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APPENDIX 6
Form No. ITP-M-0001-06 INSPECTION FOR CONCRETE TEST REPORT

INSPECTION FOR CONCRETE TEST REPORT

Structure : _____________________ RFI No. : _____________________

Area/Unit : _____________________ Date : _____________________
Location : _____________________ Concrete Supplier : _____________________
Project : Ash Handling Facilities for Jawa 9 & 10 CFSPP Concrete Grade : Fc’____ / Slump ______ / Type ____
Page : __________of________
Qty Accumulated Qty Slump Temp. Cylinder code
No. Truck No. Loading time Arrival time
(m3) (m3) (cm) (oC) (every 50 m3)

Note:

Performed By Check and Verify By

Involvement Party IRT/OE
Sub-Contractor EPC
Signature
Name
Sign Date
Job Title

Rev.A 17 of 18
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APPENDIX 7
Form No. ITP-M-0001-07 INSPECTION FOR POST-POURING REPORT

INSPECTION FOR POST-POURING REPORT

Structure : _____________________ Report No. : _____________________

Area/Unit : _____________________ Date : _____________________
Location : _____________________ Subcon : _____________________
: Ash Handling Facilities for Jawa 9 & 10
Project Reff.Dwg. : _____________________
CFSPP
Ref. Std. : _____________________
Inspection Result
No. Check tems Acceptance Criteria Remarks
Accept Reject
1 Finishing & Curing
a. Concrete finish acceptable As per ITP
b. Protection of surfaces from cracking
As per Actual
due to rapid drying
c. Form removal As per Actual
2 Test of Hardened Concrete
a. Curing of speciments Cylinder curing yard

Note:

Involvement Performed By Check and Verify By

IRT/OE
Party Sub-Contractor EPC

Signature

Name
Sign Date
Job Title

Rev.A 18 of 18