AP RELEASE PURPOSE : IFA

DOCUMENT COVERSHEET

Document Information
Project No: PM210012 Project Name: NEOM Green Hydrogen Project
Project Doc No: PM210012-LTG520-OI3-00012 Rev 04

Document Title: ITP & Checklist for WTG Foundation – Excavation, Conduit Pipe, Lean Concrete

VDR Code(s) - Page 1 OF 11

Tag No(s):(1):
Vendor Doc No: Rev
Client Doc No: Rev
Note 1 – For multiple Tag No: fill in page 2

Purchase Order Information

Vendor Name: Larsen & Toubro Saudi Arabia Co
PO Number: 4505799553
PO Date: 1-Aug-22
Vendor Org Code: LTG520
Vendor SAP ID: 10096211
Air Products Specifier:

Status Code Legend

Code 1 Reviewed by Air Products – REJECTED Resubmit for Review
Code 2 Reviewed by Air Products – COMMENTS AS NOTED Resubmit for Review
Code 3 Not Used
Code 4 Reviewed by Air Products – NO COMMENTS, No Further Submittal Required Unless Drawing/Document is Revised
Code 5 ACCEPTED FOR INFORMATION ONLY
Vendor is not relieved of responsibility for accuracy of dimensions, performance, design, design of details or any code requirements. Further, review by Air Products does not relieve Vendor of
responsibility or liability, or from furnishing material in conformance with the contract, purchase order, or other agreement. Air Products’ review shall not be construed as an Approval by Air
Products of such documents or an opinion by Air Products that such documents are true and accurate.

Review Status
Specifier (Email)
Status Code:
Date(DD-MMM-YYYY)

Revison History
AP.
Date Vendor / 3rd Party Doc. Release Purpose Prepared By Checked By Approved By
Rev
00 13-Feb-23 ISSUED FOR APPROVAL AJ AC KM
01 17-May-23 ISSUED FOR APPROVAL AJ AC KM
02 30-May-23 ISSUED FOR APPROVAL AJ AC KM
03 4-Jun-23 ISSUED FOR APPROVAL AJ AC KM
04 6-Jun-23 ISSUED FOR APPROVAL AJ AC KM

Page 1 of 2
 TAG Nos
Fill in list of Multiple Tags if not able to accommodate on cover sheet.

Page 2 of 2
 DOCUMENT / DRAWING
COMMENTS RESOLUTION SHEET (CRS)

Project Name: NEOM Green Hydrogen Project AP Project No.: PM210012 Review Code:

3rd Party/Vendor Transmittal Ref.: LTGEN-TRANSMIT-001952 Actual Date Received: 06-Jun-2023 Code 2 - Comments as Noted

3rd Party/Vendor Name: LARSEN & TOUBRO SAUDI ARABIA Co Unit Code: 520 - Wind General

Document / Drawing Title: Document / Drawing Ref. No.: Rev. No.

ITP & Checklist for WTG Foundation – Excavation, Conduit Pipe, Lean Concrete PM210012-LTG520-OI3-00012 04

COMMENTS RESPONSE

AIR PRODUCTS LARSEN & TOUBRO SAUDI ARABIA Co Reviewers' STATUS

Item Doc Page /
Section Reviewers' Names /Initials Comments
No. Rev Sht. No. LARSEN & TOUBRO’s Response
Document
AIR PRODUCTS’s Comments Incorporated? Reviewer
Originator
Kindly add section for compactation of soil after ducts installation as per
01 00 01 02.5 RPB Incorporated in Section 2.5 Yes Closed Closed
Foundation's drawing.
Kindly add section for any embebed plate that needs to be installed for
00 02 02.6 RPB Incorporated in Section 2.6 Yes Closed Closed
02 anchor cage activity.
01 02 02.6 SRB Please incorporate the L&T "H" point, and APEPC/NGHC "R" point. Noted & Incorporated Yes Closed Closed
There is no item in the checklists corresponding to point 2.5 of the ITP,
03 00 02.5 HF Please add the check point or construction clearance from the concerned Incorporated in Checklist "520-CHL-CIV-GENE-WTG-014" Yes Closed Closed
discipline
L&T shall submit the "Plate bearing test, Cone Penetration Test" reports for
04 00 03 02.3 SRB Noted & will be submitted Yes Closed Closed
review and approval.
520-CHL-CIV-
L&T shall submit the "Concrete Mix design, Admixture data sheets" for
05 00 01 GENE-WTG- SRB Noted & will be submitted Yes Closed Closed
review and aproval.
014
520-CHL-CIV-
06 00 01 GENE-WTG- SRB L&T shall submit the "Delivery notes" for review and aproval. Noted & will be submitted Yes Closed Closed
014
WTG foundation is a critical part of project, APEPC QA/QC needs the WTG
07 00 General SRB Noted & IFC will be submitted. "PM210012-LTG520-OD2-00058" Yes Closed Closed
drawing for the approval of all the related ITPs.
Why there is no any "parameter / characteristics to be checked" for the
08 00 General SRB Incorporated in Checklist "520-CHL-CIV-GENE-WTG-014" Yes Closed Closed
"lean concrete pouring"? Please elobrate
520-CHL-CIV-
09 01 GENE-WTG- SRB Please revise; Compressive Strength 16 Mpa achieved @ 7 & 28 Days Incorporated in Checklist "520-CHL-CIV-GENE-WTG-014" Yes Closed Closed
014
Please establish a separate check list for 2.4 - (Electrical conduit pipe/Duct
Noted & Established "520-CHL-CIV-GENE-WTG-022" & "520-CHL-CIV-
10 01 2.4 & 2.6 SRB installation) & 2.6 )Placement of Embedded plate). Yes Closed Closed
GENE-WTG-023"
Please revise accordingly.

11 01 02.6 SRB Please correct the serial No's. 2.6 id belongs with 2 points. Noted & Updated Yes Closed Closed

12 01 2.1-3.7 MK (NGHC) Items from 2.1 to 3.7: NGHC inspection level shall be ''S". Noted & Incorporated Yes Closed Closed

13 01 03.1 MK (NGHC) Items from 3.1: NGHC inspection level shall be 'W/R Noted & Incorporated Yes Closed Closed

14 01 02.6 MK (NGHC) Item 2.6: is duplicated and the sequence of activities shall be revised. Noted & Incorporated Yes Closed Closed

15 01 General MK (NGHC) Signatory of the ITP: Others shall be replaced by "NGHC". Noted & Incorporated Yes Closed Closed
Concrete Sampling and curing shall be incorporated as inspection Noted & Incorporated in ITP "520-ITP-CIV-GEN-WTG-004" Section 2.8,
16 01 General MK (NGHC) Yes Closed Open
interventions. & Checklist "520-CHL-CIV-GENE-WTG-014" Section 9,10
17 01 General MK (NGHC) Signatory box for NGHC shall be incorporated at Inspection Checklists Noted & Incorporated in all Inspection Checklists Yes Closed Open

S/C column is made void, as it is not applicable for the scope of this
The ITP shall be revised by removing "S/C" column and assign all "S/C"
18 02 General MK (NGHC) ITP. Further the participation levels of other stakeholders are revised as Yes Closed Open
inspection level to "L&T" and "L&T" inspection level to "APEPC".
per the comment

Page 1 of 1
 TAG Nos
Fill in list of Multiple Tags if not able to accommodate on cover sheet.

-NGGC Signatory box of all inspection checklists:

please replace "Approved" with "Accepted".

L&T Reply- NGHC Signatory box of all inspection

checklists: "Approved" is rephrased as "Accepted".

Page 2 of 2
 LARSEN & TOUBRO
INSPECTION AND TEST PLAN (ITP)
520-ITP-CIV-GEN-
ITP No. ITP Description ITP for WTG Foundation- Excavation, Conduit Pipe, Lean Concrete Project NEOM Green Hydrogen Project
WTG-004
ITP Rev. No. 04 Client Air Products Contractor Larsen & Toubro Package ☐ Grid ☒ Generation: Wind BOP
Discipline Civil  Sub-Contractor  Vendor Contract No. PM210012 Date 06-06-2023

Reference Level of Participation

Parameter / Characteristics Method of Stage /
S. No Document / Acceptance Criteria Type of Record Remarks
to be Checked Check Frequency S/C L&T AP TPI NGHC
Code / Spec.
1.0 PRIOR CONTROL
Document Approved
1.1 Approval of Drawings Prior to start IFC Drawing IFC Drawing - R R R
review Transmittal
OTS Rev.8
Approval of Execution Document Page:58,73,7 Approved Method of Approved
1.2 Prior to start - R R R
Documents review 4 & IFC Statement Transmittal
Drawing
OTS Rev.8
Approval of Contractor Document Approved
1.3 Prior to start Project Project Quality Plan - R R R
Quality Documents review Transmittal
Quality Plan
2.0 EXECUTION CONROL
OTS Rev.8 Location of the area to be Survey Protocol
Land Survey
2.1 Excavation Location Handover Prior to excavate Page:229 excavated comply with design /520-CHL-CIV- - H W/R S
Measurement
Layout specifications GENE-WTG-012
Altimetry of the excavation Survey Protocol
Excavation pit. Geometrical Land Survey
2.2 After excavation IFC Drawing comply with design /520-CHL-CIV- - H W/R S
check measurement
specifications GENE-WTG-013
Testing of the coordinate (x,
Center point Survey Protocol
y) of center of foundation Land Survey Layout & IFC Center point matches the
2.3 matches the /520-CHL-CIV- - H W/R S
complying with Layout measurement Drawing Layout Drawing
Layout Drawing GENE-WTG-013
Drawing
Electrical conduit pipe/Duct Visual 520-CHL-CIV-
2.4 Prior to Blinding IFC Drawing As per the approved drawing - H W/R S
installation Checking GENE-WTG-022
Compaction of Soil after Duct Plate bearing test
Installation. 1 per each
OTS Rev.8 Test Results
Final condition test of the Quadrant, Cone Must meet the OTS
2.5 Testing Page:114 & /520-CHL-CIV- - H R H S
bottom of the excavation and Penetration Test requirements
IFC Drawing GENE-WTG-013
confirmation about the soil is Min 8 Tests Every
as per geotechnical study Foundation
Visual 520-CHL-CIV-
2.6 Placement of Embedded plate Prior to pour IFC Drawing As per the approved drawing - H W/R S
Checking GENE-WTG-023
ITP Template No: COM-ITP-TEMP-001 Revision Code: 00 Dated: 04-12-2022 Page 1 of 2
 LARSEN & TOUBRO
INSPECTION AND TEST PLAN (ITP)
520-ITP-CIV-GEN-
ITP No. ITP Description ITP for WTG Foundation- Excavation, Conduit Pipe, Lean Concrete Project NEOM Green Hydrogen Project
WTG-004
ITP Rev. No. 04 Client Air Products Contractor Larsen & Toubro Package ☐ Grid ☒ Generation: Wind BOP
Discipline Civil  Sub-Contractor  Vendor Contract No. PM210012 Date 06-06-2023

Reference Level of Participation

Parameter / Characteristics Method of Stage /
S. No Document / Acceptance Criteria Type of Record Remarks
to be Checked Check Frequency S/C L&T AP TPI NGHC
Code / Spec.
The surface leveling conforms Survey Protocol
Land Survey
2.7 Blinding concrete level Prior to pour IFC Drawing with drawings and specified / 520-CHL-CIV- - H W/R R
measurement
tolerances. GENE-WTG-014
520-CHL-CIV-
2.8 Concrete Sampling and curing Testing After the pour OTS Rev.8 Strength should be 16 Mpa - H W/R H R
GENE-WTG-014
The surface leveling conforms Survey Protocol
Top of lean concrete After Land Survey
2.9 After the pour IFC Drawing with drawings and specified / 520-CHL-CIV- - H W/R R
Pouring measurement
tolerances. GENE-WTG-014
3.0 FINAL CHECK
Final inspection and Document IFC Drawing Approved
3.1 After Completion Approved by Client - H/R H/R W/R
acceptance review & Design Transmittal
ITP ACKNOWLEDGEMENT / APPROVAL
Sub-Contractor (if applicable) Not Applicable Larsen & Toubro Air Products NGHC
Name: N/A Name: Name: Name:
Designation: N/A Designation: Designation: Designation:
Signature: N/A Signature: Signature: Signature:
Date: N/A Date: Date: Date:
LEGENDS
1. Hold (H): A mandatory inspection verification position per the contractual requirement beyond which the inspection/tests cannot proceed without the designated authorization/authority. The designated
authorization/authority shall be notified of the inspection/test schedule at least 24 hours in advance
2. Review (R): Required qualification/certification/reports/documents/records etc., as required, shall be submitted to the designated authorization/authority review and approval
3. Witness (W): The designated authorization/authority shall be notified of the inspection/test schedule at least 24 hours in advance. However, the inspection or test shall be performed as scheduled if the designated
authorization/authority is not present
4. Surveillance (S): The designated authorization/authority shall randomly verify or monitor or inspect without any notice on an ad-hoc basis
Note: The first (3) of each inspection or testing activity listed above requires 100% participation of the Client or Client representative as required by the level of inspection. After this period, the client may adjust the level of inspection
and client participation based on the construction & inspection performance. Such inspections shall not proceed without the consent or availability of the client or client representative
ABBREVIATIONS
S/C: Subcontractor L&T: Larsen & Toubro AP: Air Products TPI: Third-Party Inspection Agency NGHC: NEOM GREEN HYDROGEN COMPANY

ITP Template No: COM-ITP-TEMP-001 Revision Code: 00 Dated: 04-12-2022 Page 2 of 2

 WTG Foundation-Survey Before Excavation
INSPECTION CHECKLIST
Checklist No. 520-CHL-CIV-GENE-WTG-012 Rev.04 Date Page 1 of 1

Project Name NEOM GREEN HYDROGEN PROJECT Contract No.

Employer NEOM GREEN HYDROGEN COMPANY (NGHC)

Client AIR PRODUCTS (AP)

Contractor LARSEN & TOURBO SAUDI ARABIA LLC.

Sub-Contractor

WIR No. Dwg. No.

ITP No. 520-ITP-CIV-GEN-WTG-004 Location

S. Remarks
DESCRIPTION / CRITERIA Reference PASS FAIL NA
No / Re-Insp. Date
1 Approval of relevant documents such as Design Layout Document ☐ ☐ ☐
2 Topographic Survey Equipment Calibrated Certificate ☐ ☐ ☐
Coordinates (x,y) of Center of foundation complies Survey
3
with Layout Protocol ☐ ☐ ☐
Survey
4 Borders of Excavation Complies with the Design
Protocol ☐ ☐ ☐
Survey
5 Topographic Survey report to be attached
Protocol ☐ ☐ ☐
Sub-Contractor (If Applicable): Not Applicable L&T Construction Representative
Sub-Contractor Engineer ☐ Work is complete & Ready for Inspection L&T Construction ☐ Work Completed & Verified

Name: N/A Date N/A Signature N/A Name Date Signature

L&T QAQC Air Products NGHC

Remarks: Remarks:

L&T Site QAQC ☐ Records Verified Client / ☐ Documents Reviewed Client / ☐ Documents Reviewed
Engineer ☐ Work Verified Representative ☐ Approved Representative ☐ Accepted

Name Date Signature Name Date Signature Name Date Signature

Checklist Template No. Rev. No Date Page1 of 1

 WTG Foundation- Acceptance of Excavation
INSPECTION CHECKLIST
Checklist No. 520-CHL-CIV-GENE-WTG-013 Rev.04 Date Page 1 of 1

Project Name NEOM GREEN HYDROGEN PROJECT Contract No. PM210012

Employer NEOM GREEN HYDROGEN COMPANY (NGHC)

Client AIR PRODUCTS (AP)

Contractor LARSEN & TOURBO SAUDI ARABIA LLC.

Sub-Contractor

WIR No. Dwg. No.

ITP No. 520-ITP-CIV-GEN-WTG-004 Location

S. Remarks
DESCRIPTION / CRITERIA Reference PASS FAIL NA
No / Re-Insp. Date
Excavation Bottom Complies with Geotechnical Geotechnical
Forecasts: Report, Plate
-Conformity of soil encountered with geotechnical study Bearing Test, Cone
1
-Absence of water
Document ☐ ☐ ☐ Penetration Test
-Soil not decompressed report to be
-Confirmation of bearing capacity attached
Survey
2 Diameter of excavation complies with design
Protocol ☐ ☐ ☐
Altimetry of top of excavation bottom complies with Survey Altimetry report to
3
design Specification Protocol ☐ ☐ ☐ be attached
Positions (x,y,z) of the center of the foundation Survey
4
complies with design specification Protocol ☐ ☐ ☐
Slope of excavation complies with geotechnical
5
recommendations ☐ ☐ ☐
6 Surface is clean from loose materials, fragments ☐ ☐ ☐
Sub-Contractor (If Applicable): Not Applicable L&T Construction Representative
Sub-Contractor Engineer ☐ Work is complete & Ready for Inspection L&T Construction ☐ Work Completed & Verified

Name: N/A Date: N/A Signature: N/A Name Date Signature

L&T QAQC Air Products NGHC

Remarks: Remarks:

L&T Site QAQC ☐ Records Verified Client / ☐ Documents Reviewed Client / ☐ Documents Reviewed
Engineer ☐ Work Verified Representative ☐ Approved Representative ☐ Accepted

Name Date Signature Name Date Signature Name Date Signature

Checklist Template No. Rev. No Date Page1 of 1

 WTG Foundation- Blinding Concrete
INSPECTION CHECKLIST
Checklist No. 520-CHL-CIV-GENE-WTG-014 Rev.04 Date Page 1 of 1

Project Name NEOM GREEN HYDROGEN PROJECT Contract No.

Employer NEOM GREEN HYDROGEN COMPANY (NGHC)

Client AIR PRODUCTS (AP)

Contractor LARSEN & TOURBO SAUDI ARABIA LLC.

Sub-Contractor
WIR No. Dwg. No.
ITP No. 520-ITP-CIV-GEN-WTG-004 Location
S. Remarks
DESCRIPTION / CRITERIA Reference PASS FAIL NA
No / Re-Insp. Date
1 Surface is clean of loose material & fragments Document ☐ ☐ ☐
2 Electrical conduit pipe/Duct installed as per Design Design ☐ ☐ ☐
3 Embedded Plate placed as per the design Visual ☐ ☐ ☐
4 Trial Mix Design Approved Certificate ☐ ☐ ☐
Delivery Delivery notes to
5 Concrete Delivery note complies with specification
note ☐ ☐ ☐ be attached
Survey
6 Lean Concrete thickness is conformed to design
Protocol ☐ ☐ ☐
Survey Altimetry report to
7 Top level of lean concrete complies with design
Protocol ☐ ☐ ☐ be attached

8 Temperature, Slump & other parameters measured Visual ☐ ☐ ☐

1 Set for 7 & 28
9 Concrete Sampling done as per the OTS Test Result ☐ ☐ ☐ days each

10 Curing done as per the OTS Visual ☐ ☐ ☐ 7 Days

7, 28 Days Result to
11 Compressive Strength 16 Mpa achieved Test Result ☐ ☐ ☐ be attached

Sub-Contractor (If Applicable): Not Applicable L&T Construction Representative

Sub-Contractor Engineer ☐ Work is complete & Ready for Inspection L&T Construction ☐ Work Completed & Verified

Name: N/A Date: N/A Signature: N/A Name Date Signature

L&T QAQC Air Products NGHC

Remarks: Remarks:

L&T Site QAQC ☐ Records Verified Client / ☐ Documents Reviewed Client / ☐ Documents Reviewed
Engineer ☐ Work Verified Representative ☐ Approved Representative ☐ Accepted

Name Date Signature Name Date Signature Name Date Signature

Checklist Template No. Rev. No Date Page1 of 1

 WTG Foundation- Electrical conduit
pipe/Duct installation &
INSPECTION CHECKLIST
Checklist No. 520-CHL-CIV-GENE-WTG-022 Rev.04 Date Page 1 of 1

Project Name NEOM GREEN HYDROGEN PROJECT Contract No. PM210012

Employer NEOM GREEN HYDROGEN COMPANY (NGHC)

Client AIR PRODUCTS (AP)

Contractor LARSEN & TOURBO SAUDI ARABIA LLC.

Sub-Contractor

WIR No. Dwg. No.

ITP No. 520-ITP-CIV-GEN-WTG-004 Location

S. Remarks
DESCRIPTION / CRITERIA Reference PASS FAIL NA
No / Re-Insp. Date
1 Trench Executed as per the IFC Drawing Document ☐ ☐ ☐
Electrical conduit pipe/Duct will be from Approved
2
Vendor
Approval ☐ ☐ ☐
Delivery notes to
3 Material Receiving Inspection (MIR) Executed Visual ☐ ☐ ☐ be attached
Conduit pipe/Duct Dimension complies with IFC
4
Drawing
Visual ☐ ☐ ☐
The Orientation of the Electrical conduit pipe/Duct is
5
as per IFC Drawing
Visual ☐ ☐ ☐
6 Electrical conduit pipe/Duct has no damages Visual ☐ ☐ ☐
All the Outer Conduits must be protected & properly
7
sealed
Visual ☐ ☐ ☐
Sub-Contractor (If Applicable): Not Applicable L&T Construction Representative
Sub-Contractor Engineer ☐ Work is complete & Ready for Inspection L&T Construction ☐ Work Completed & Verified

Name: N/A Date: N/A Signature: N/A Name Date Signature

L&T QAQC Air Products NGHC

Remarks: Remarks:

L&T Site QAQC ☐ Records Verified Client / ☐ Documents Reviewed Client / ☐ Documents Reviewed
Engineer ☐ Work Verified Representative ☐ Approved Representative ☐ Accepted

Name Date Signature Name Date Signature Name Date Signature

Checklist Template No. Rev. No Date Page1 of 1

 WTG Foundation- Placement of Embedded
Plate
INSPECTION CHECKLIST
Checklist No. 520-CHL-CIV-GENE-WTG-022 Rev.04 Date Page 1 of 1

Project Name NEOM GREEN HYDROGEN PROJECT Contract No.

Employer NEOM GREEN HYDROGEN COMPANY (NGHC)

Client AIR PRODUCTS (AP)

Contractor LARSEN & TOURBO SAUDI ARABIA LLC.

Sub-Contractor

WIR No. Dwg. No.

ITP No. 520-ITP-CIV-GEN-WTG-004 Location

S. Remarks
DESCRIPTION / CRITERIA Reference PASS FAIL NA
No / Re-Insp. Date
1 All the Embedded Plate will be from Approved Vendor Approval ☐ ☐ ☐
Delivery notes to
2 Material Receiving Inspection (MRI) Executed Visual ☐ ☐ ☐ be attached
Embedded Plate Dimension complies with the IFC
3
Drawing
Visual ☐ ☐ ☐
The Orientation of the Embedded Plate according to
4
the IFC Drawing
Certificate ☐ ☐ ☐
Sub-Contractor (If Applicable): Not Applicable L&T Construction Representative
Sub-Contractor Engineer ☐ Work is complete & Ready for Inspection L&T Construction ☐ Work Completed & Verified

Name: N/A Date: N/A Signature: N/A Name Date Signature

L&T QAQC Air Products NGHC

Remarks: Remarks:

L&T Site QAQC ☐ Records Verified Client / ☐ Documents Reviewed Client / ☐ Documents Reviewed
Engineer ☐ Work Verified Representative ☐ Approved Representative ☐ Accepted

Name Date Signature Name Date Signature Name Date Signature

Checklist Template No. Rev. No Date Page1 of 1