PROVISIONAL SITE ACCEPTANCE CHECKLIST

v20210518
Project - Phase: Date of Inspection:
Unity Site ID: Customer ID: Site Type: Tower Model:
Site Address: Green Field
Contractor: Roof Top

Contractor's Representative Unity Digital Infrastructure

Name Name
Signature Signature
Date Date

Deficiency Major / Description Deficiency Description Pass Fail N/A

Item No. Minor
CW-A CIVIL WORKS
CW-A 1.0 Site Development and Restoration
CW-A 1.1 Major Layout conforms with the approved construction drawing

CW-A 1.2 Minor Excess soil from excavation has either been removed or landscaped
property
CW-A 1.3 Minor Site is free from trip hazards
Resurfacing / restoration of damaged properties where applicable for
CW-A 1.4 Minor both GF and RF site

CW-A 1.5 Minor Manhole/Handhole and duct pipes installed correctly

CW-A 1.6 Major Retaining wall, soil protection, if required installed correctly
CW-A 1.7 Minor Rooftop waterproofing applied correctly

CW-A 1.8 Minor Access road restored to a state equal to or better than the initial
condition. Vehicles are able to pass easily
CW-A 2.0 Records & Documents
CW-A 2.1 Minor Redline Drawing sign-off by Contractor and Unity during site visit
Concrete cube test passed for 7,14,28 days verified by Unity during
CW-A 2.2 Major site visit
CW-A 3.0 Earthworks
CW-A 3.1 Minor Grading and levelling as indicated according to approved DDD

CW-A 3.2 Minor Crushed rock gravel surfacing 100mm thk with geotextile membrane;
random location to be checked
CW-A 3.3 Major Site is free from soil settlement
CW-A 3.4 Major Final site elevation according to approved DDD
CW-A 3.5 Minor Access road construction 3m wide according to approved DDD
CW-A 3.6 Minor Access road length according to approved DDD
CW-A 4.0 Site Final Clean
CW-A 4.1 Minor General Cleaning (inside compound)
CW-A 4.2 Minor General Cleaning (outside compound within Lease area)
CW-A 5.0 Fence

CW-A 5.1 Minor 3 strand galvanized barbed; check quality, connections and tension of
wires
CW-A 5.2 Minor Gate installed properly according to approved DDD

CW-A 5.3 Minor Barrel bolt and lock plates properly installed according to approved
DDD
CW-A 5.4 Minor Gate hinges installed correctly and welded to column rebars
CW-A 5.5 Minor Footbolts installed correctly on both gate opening
CW-A 5.6 Minor Footbolt catcher installed correctly according to approved DDD

CW-A 5.7 Minor Mesh wire of approved type and installed according to approved DDD

CW-A 5.8 Minor Fence is aligned, plumb, secure and correct tension
CW-A 5.9 Minor Secuirty bolts installed with bolt head on the outside and tightened
CW-A 5.10 Minor Fence materials sizes according to approved DDD
CW-A 5.11 Minor Fence materials are hot dip galvanized

Minor Concrete
tapping of top CHB done correctly according to approved
CW-A 5.12 DDD
CW-A 5.13 Minor CHB construction joints plastered and tidy
CW-A 5.14 Minor Weep holes installed according to approved DDD; 2 pcs per span
CW-A 5.15 Minor concrete columns done correctly
CW-A 5.16 Minor CHB wall plastered smooth on both sides

Minor Padlock
of approved type; provide key handover form signed by Unity
CW-A 5.17 during site visit
CW-A 5.18 Minor Perimeter fence ligthing installed correctly; check functionality

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 PROVISIONAL SITE ACCEPTANCE CHECKLIST
v20210518
Project - Phase: Date of Inspection:
Unity Site ID: Customer ID: Site Type: Tower Model:
Site Address: Green Field
Contractor: Roof Top

Contractor's Representative Unity Digital Infrastructure

Name Name
Signature Signature
Date Date
CW-A 6.0 Power and Equipment Slab
CW-A 6.1 Major Correct position, height and size
CW-A 6.2 Major Constructed according to approved DDD
CW-A 6.3 Minor No vissible cracks and voids in concrete
CW-A 6.4 Minor Finished concrete surface is smooth and tidy
CW-A 6.5 Minor Concrete stairs according to approved DDD
CW-A 6.7 Major Grounding bar installed according to approved DDD
CW-A 6.8 Major Slab over 1.5m high, safety handrail has been installed
Cable tray and supports properly installed according to approved
CW-A 6.9 Minor
DDD
Fire extinguisher installed and stored correctly
CW-A 6.10 Major S/N: ___________________________
CW-A 7.0 Tower (Visual & Physical Inspection)
CW-A 7.1 Major Tower height and type according to approved DDD
CW-A 7.2 Major Tower base plates is filled with non-shrink grout
CW-A 7.3 Major Water drain pipes installed correctly
CW-A 7.4 Major Concrete plinth is built at base of climb ladder
CW-A 7.5 Major No visible cracks and voids in concrete
CW-A 7.6 Major Ladder and rest platforms are properly installed
CW-A 7.7 Major Vertical cable ladder orientation according to approved DDD
CW-A 7.8 Major Vertical and horizontal cable ladders are connected properly

CW-A 7.9 Major TEST: random torque check per tower sections; refer to separate
inspection sheet approved by Unity on site
TEST: Verticality, tolerance 1:500; refer to separate inspection sheet
CW-A 7.10 Major
approved by Unity on site
CW-A 7.11 Major No missing bolts/Nuts/flat washers/spring washers/lock nuts
CW-A 7.12 Major Bolts correct size and grade 8.8; no visible corrosion
CW-A 7.13 Major Protrusion above nut shall be minimum 2 full threads
CW-A 7.14 Major Bolts installed have correct sizes as per erection drawing
CW-A 7.15 Major No misaligned bolt holes and slotted holes

Check for bolt accessibility for maintenance purposes.

CW-A 7.16 Major Horizontal bracing and flanges - bolts head on top and nuts at the
bottom
Leg and Bracing - bolts head inside and nuts on the outside

CW-A 7.17 Major No vissible damage/bent and corrosion on profiles

CW-A 7.18 Major No major visible galvanizing scratches on the tower member
CW-A 7.19 Major Tower members installed in the correct position & orientation
CW-A 7.20 Major No large gaps on tower member joints and connection plates
CW-A 7.21 Major No sign of drilling or cutting of tower members
CW-A 7.22 Major Lighting arrester installed on top of tower
CW-A 7.23 Major GIN poles installed correctly; if required
CW-A 7.24 Minor Tower members are free from dirt
CW-A 7.25 Minor Platforms installed correctly as per erection drawing
CW-A 7.26 Minor Tower signage at base to tower leg secured with s/s straps
CW-A 8.0 Electrical System
CW-A 8.1 Major Panel boards of approved type and properly installed as per DDD
CW-A 8.2 Major TVSS of approved type and properly installed as per DDD
CW-A 8.3 Major Cable entries sealed and secured properly
CW-A 8.4 Major Panel boards properly sealed to the concrete wall

CW-A 8.5 Major Wires/cables of approved type and correct size as per approved SLD

CW-A 8.6 Minor Wires/cables properly labelled and groomed

CW-A 8.7 Minor Adequate size and lugs properly installed at cable ends
CW-A 8.8 Minor Panel doors are properly grounded

CW-A 8.9 Major Circuit breakers of approved type and capacity as per approved SLD

CW-A 8.10 Major Circuit breakers are labelled according to the approved SLD

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 PROVISIONAL SITE ACCEPTANCE CHECKLIST
v20210518
Project - Phase: Date of Inspection:
Unity Site ID: Customer ID: Site Type: Tower Model:
Site Address: Green Field
Contractor: Roof Top

Contractor's Representative Unity Digital Infrastructure

Name Name
Signature Signature
Date Date
CW-A 8.11 Major Mobile box of approved type and installed correctly

CW-A 8.12 Minor Conduits of approved type and properly installed with metal clamps

TEST: AC power distribution; refer to separate inspection sheet

CW-A 8.13 Major
approved by Unity on site

CW-A 8.14 Major Service entrance wires and conduits properly fix, sealed and secured;
provide adequate drip loop at entrance cap

CW-A 8.15 Minor Provide protective grill for KHh meter with padlock; if installed at
service entrance pedestal
CW-A 8.16 Major Panel boards grounded to the main busbar

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 PROVISIONAL SITE ACCEPTANCE CHECKLIST
v20210518
Project - Phase: Date of Inspection:
Unity Site ID: Customer ID: Site Type: Tower Model:
Site Address: Green Field
Contractor: Roof Top

Contractor's Representative Unity Digital Infrastructure

Name Name
Signature Signature
Date Date
CW-A 9.0 Earthing & Lightning Protection
CW-A 9.1 Major Ground rods installed installed according to approved DDD
CW-A 9.2 Major All grounding connections shall be exothermic welding
CW-A 9.3 Major Grounding inspection pit located according to approved drawing
TEST: Earth resistance should be less than 5 Ohm; refer to separate
CW-A 9.4 Major
inspection sheet approved by Unity on site
Tower Busbars properly installed at correct height according to
CW-A 9.5 Major
approved DDD
CW-A 9.6 Major Tower base plates grounded according to approved DDD
CW-A 9.7 Major Climb ladder grounded at base
CW-A 9.8 Major Cable tray properly grounded at splice connections and ground ring
CW-A 9.9 Major Vertical and horizontal cable ladders are grounded properly
CW-A 9.10 Minor Fence corner posts ground at base
CW-A 9.11 Minor Gate doors grounded at bottom hinges
CW-A 9.12 Minor No sharp bends within exposed grounding cables
CW-A 9.13 Minor 1.5m pigtail left extended up for future generator connection
CW-A 10.0 Site Signage

CW-A 10.1 Minor Site Identification and warning board fitted to approached side of site

CW-A 10.2 Minor signage connected using stainless cable or proper clip approved by
Unity
CW-A 10.3 Minor Site identification clearly indicate the Unity Site ID

CW-A 10.4 Minor Signage supplied by the contractor indicates the Burmese and English
wordings on each signage
CW-A 10.5 Minor Supplied signage not fading or discoloration
CW-B BRACKET AND ACCESORIES INSTALLATIONS
CW-B 1.0 Bracket Installations
CW-B 1.1 Major RF and MW brackets installed at correct height

CW-B 1.2 Major No missing bolts/Nuts/flat washers/spring washers; double nut

secured
CW-B 1.3 Major Bracket installed according to client's requirement
CW-B 1.4 Major MW brackets installed at correct leg azimuth
HS-A HEALTH, SAFETY AND ENVIRONMENT
HS-A 1.0 Safety Requirements
HS-A 1.1 Major Standard PPE Sign Boards
HS-A 1.2 Major HSE Sign Board at existing site
Assembly Point Sign as meeting point evacuation if there is
HS-A 1.3 Minor
emergency condition
HS-A 1.4 Minor First aid box and it's content
HS-A 1.5 Major Barricade Line, especially for BTS project
Contractor's employee use PPEbased on DIN-PS00-CW0009 Standard
HS-A 1.6 Major PPE
HS-A 1.7 Major Safety shoes
HS-A 1.8 Major Safety Helmet
HS-A 1.9 Major Reflectorized Vest/ Overalls
HS-A 1.10 Major Full Body harness when working at height
HS-A 1.11 Major Safety Gloves when working at height
HS-A 1.12 Major Lanyard when working at height
HS-A 2.0 Environment and Workplace
Material placement in appropriate location/separate location so do
HS-A 2.1 Minor
not interfere with work process
HS-A 2.2 Minor Site Cleanness (grass or dirty)
HS-A 2.3 Minor There is no burning of garbage or waste material on site

HS-A 2.4 Minor Management waste in site (such as: temporary bin / separated area
for temporary waste)
HS-A 2.5 Minor Housekeeping for camp of contractor's employee
HS-A 2.6 Minor Hygiene for meal of contractor's employee

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 PROVISIONAL SITE ACCEPTANCE CHECKLIST
v20210518
Project - Phase: Date of Inspection:
Unity Site ID: Customer ID: Site Type: Tower Model:
Site Address: Green Field
Contractor: Roof Top

Contractor's Representative Unity Digital Infrastructure

Name Name
Signature Signature
Date Date
HS-A 3.0 HSE Documents
HS-A 3.1 Minor Health and Safety briefing durign site kick off
HS-A 3.2 Minor Permit letter (Valid and Not Expired)
HS-A 3.3 Major Certificate climbing tower still be have or expired date
HS-A 4.0 HSE Implementation

HS-A 4.1 Major Competent personnel's; there should be a foreman who supervised
the work and the implementation of the HSE on the site
HS-A 4.2 Major No workers under age
HS-A 4.3 Major There is no people smoking in site area and no cigarrete butts
If rain condition, there is no working employee for tower erection,
HS-A 4.4 Major electricity activity, etc. (If the condition is no rain, please interview
with the employee if possible)
There is no beer and drugs consumption by the workers and found no
HS-A 4.5 Minor
liquor cans on site
HS-A 4.6 Minor Padlock and keys when applicable
HS-A 5.0 Waste Management

HS-A 5.1 Major Flammable Material Sign and No Smoking Sign properly attached (If
there is permanent generator)
Material Safety Data Sheet (MSDS) for generator fuel and oil(s) are
HS-A 5.2 Minor available and attached to permanent generator body

HS-A 5.3 Major There is no leakage or spill of generator fuel/oil found on site
HS-A 5.4 Minor Locked Generator (If there is permanent generator)

HS-A 5.5 Minor There is any secondary containment for fuel tank with 110% capacity
(if there is permanent generator)
HS-A 5.6 Minor Is there any used oil temporarily stored around site area?

HS-A 5.7 Major Noise generated by permanent generator is considered acceptable?

During re-fueling process, appropriated log/record should be

HS-A 5.8 Minor updated.

HS-A 5.9 Major Spill kit available during maintenance supply by vendor such as
sawdust

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 PUNCHLIST
v20210518

Unity Site ID Contractor Name

Name & Sign
Customer Site ID Contractor Representative
Name & Sign

Inspection Date Unity Site Engineer

Deficiency Clearance Unity QA

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 PHOTOGRAPHIC DEFICIENCY CLEARANCE
Deficiency Clearance Photo Report
Name & Sign
Unity Site ID Contractor Name Unity Site Engineer
Name & Sign
Customer Site ID Contractor Reseprentative Clearance Date

Item Deficiency Description BEFORE - Deficiency Photo AFTER - Rectification Photo Pass / Fail Remarks
(same angle)