Th e Client The Contract or

EOOOl - PACKAGE 2S HITAC HI

LJ ETIHADRAIL wlJlb.iill :>l.:iilJI
J acobs Railway Integratio n and System l n s pire th e N e x t:
56+4321nspection and Testing R equest
ITR Revision
,1 Inspection Request No.: E0001-S02-GQC-IR-00626 00
Number:
Inspection Date : 19 October 2021 Inspection Time: 04.00 p.m
' Reference no. Rev Status
1, ai Method Statement E000 1-S02-GCX-PM-00004 00 Code 1
.5:
,, g> ITP E0001-S02-GQA-PN-00002 00 Code 1
w V, J!l
Cl> C E000 1-FJP-GCX-DS-90015 AA X - Under Review by
u G> Drawing
I:\~ ; E
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the Engineer
1'i $u
Cl) 0 Material Approval E0001-S02-DCX-MT-90009 00 Code 1
0. ~o Others E0001-S02-GQC-IR-00624 00 N/A
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1, QI Contact Person: Engg.Baljindar Singh J Mobile No : 0589366565
,0::
:g Details of Inspection
ca Test/Inspection Stage r8:I Insta llation
v·5 □ Testing and Commissioning (T&C)

''.!
1-, ~ Discipline/ Subsystem:
181 Civil
O MEP
0 Power Supply and
Distribution System
D Signalling
0 Earthing and Bonding

O ICSS
D
D
.... OAPS D Telecommunication 0 Other (Specify) D
··1 Package 2A Line Section 2A GMA • Al Gharbla Mainline• Ghweilat to Ruwals Jen

~
i Site Name Shelter - GMA09 Chainage RUWAIS(CH:89+800,2 Way Duct)
I< C
0
Inspection Point O Ho ld Point 181 Witness Point ITP Item Number I 4. 1
'fl Item to be Inspected: Laying and Inspection of reinforcement for package 2A MV Cable Internal ring(2 Way Duct),
.~
C
Detailed description as per ITP Quantity=34 meter
11 --
., Inspection Requested By
Name Date /Time Desig nation S ignatu re
'
' '
Engg.Baljindar Singh 18-10-2021
Project
~,_,p-~J::. (IR Raised By STS/
' Engineer Subcontractor)

I:{.·,, .. ;; Inspection Requested Aooroved By (STS ·., I

Section Name Date/Time Designation ignature ! '

QC Department EDWIN SANTOS ~

·~ 18-10-2021 QAIOC Enginee~

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Cl)
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Survey Department
(If Applicable)
I
( __)
, ca
> Rall Systems Interface
e (if required)

\~ sPcJ~f l ~ ?'f-~ 11-)f~ ~ ~ p~ Cfaent reviewed & closed

(signature and date)
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plan, perform and record all QUALITY CONTROL activities lo ensure that all work is performed in accordance with the QMS
Engineer and in compliance with the requirements of the Contract.
r ~ft/1r
The Work Activity described here has been checked by the Contractor in accordance with Exhibit D, Part 1, Appendix 13.0, ::,- - e ~~ the contractor shall
entatio reviewed by the

This Is to certify that the above referenced work/activity has been Inspected and/or witnessed by the Engineer.
Ins pection Conducted By The En11 lneer's Representative
'

~
Name:
... - □ A pproved
'~ Designation:
'g>
w Date /Time:
□ Approved With Comments

~~~
QI
~ j ected
(=. Signature:
>,
.a D
ro
e
Comments: J .,~)ao1 \t~ ~-prl'()\[4J dv4 Declined
Reason to Decline:
a.
a.
<(
N.(~ (<_Q V, MJ c.\~<»~ J-Oi '-'(d /><felf<I /Jr) D The minimum quota of inspection/witness points required to be
allend by the Engineer has been exceeded, the ITR will be declined by
0:: the Engineer
!::
□ Others (specify): Comment reviewed & cloaed
(alanatura and datAI

Template No: E0001 -S02-GQC-WX-00002 Rev. 01 Date Issued: 02Jun-2 1

Hossam Elshenawy