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No.

Submission Checksheet (MST) Status Comments

1 Scope definition

2 Objective

3 References (incl. relevant Contract Specification) -N/A-

4 Codes and standards

5 Manpower and Responsibility

6 Tools and equipment

7 Pre-requisite approvals/permits

8 Work phases (if applicable)

9 Preparation

10 Construction work methodology and sequence

11 QA/QC control procedure

12 Health and Safety procedures / instruction

13 Emergency response protocol, team and communication

14 Risk assessment register and prevention action

15 Testing/inspection plan

16 Management of as-built data -N/A-

17 Other enclosure (if any) -N/A-

Checked by : Reviewed by :

NorNurnadia Binti Zakaria


Diana Samsuri Syerifaizal Hj. Mustapha
Sr.QAQC Engineer QAQC Manager
RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

METHOD STATEMENT FOR

Pipe Rectification Work for External Bitumen


Coating and Concrete Lining of Pipes and Fitting

Reference No : RWTP-GB-CNS-MST-000030

Revision : 00

Date : 24 April 2024

Action Name Designation Signature

Approved by Khor Thiam Chay Project Director

Consultant
Ir.Leong Khoon
Approved by (Sepakat Setia
Heng
Perunding)
Construction
Reviewed by Joshua Entol
Manager

Reviewed by Syerifaizal QAQC Manager

Prepared by Nurul Hazwani Project Engineer

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 1


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

Contents
1.0 SCOPE OF WORKS ......................................................................................................................... 3
1.1 General Description .............................................................................................................. 3
1.2 Reference ............................................................................................................................... 3
1.3 Materials ................................................................................................................................. 4
1.4 Plant and Equipment ............................................................................................................ 5
1.5 Manpower............................................................................................................................... 6
1.6 Repair Procedure for External Bitumen Coating of Pipes and Fittings .......................... 7
1.7 Repair Procedure for Concrete Lining of Pipes and Fittings ........................................... 9
2.0 SAFETY AND HEALTH REQUIREMENTS ................................................................................... 11
2.1 Job Safety & Health Analysis ............................................................................................. 11
2.2 Information to Personnel .................................................................................................... 11
2.3 Emergency Arrangements ................................................................................................. 11
2.4 Permit Requirements .......................................................................................................... 12
2.5 Housekeeping ...................................................................................................................... 13
3.0 ENVIRONMENTAL ISSUES ........................................................................................................... 14
3.1 Environmental Aspects, Impacts & Control Measures ................................................... 14
4.0 QUALITY ASSURANCE & QUALITY CONTROL ......................................................................... 16
4.1 Contractual Requirements ................................................................................................. 16
4.2 Inspection and Testing ....................................................................................................... 16
5.0 APPENDICES ................................................................................................................................. 17
5.1 Job Safety Analysis ............................................................................................................ 17
5.2 Emergency Response Flow Chart ..................................................................................... 18
5.3 Environmental Aspect & Impact Register ........................................................................ 20
5.4 Inspection & Test Plan ........................................................................................................ 21
5.5 Checklist .............................................................................................................................. 22

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 2


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

1.0 SCOPE OF WORKS

1.1 General Description

This Method of Statement (MST) is prepared to outline the construction


procedures and resources used for the work commencement of the pipe rectification
work at raw water pipe line from intake area to water treatment plan.

In this document also included with activity procedure of the rectification work
for external bitumen coating and concrete lining of pipes and fittings. This applied to
all activities along the raw water pipe line rectification work for the scope of the project
to the extent of repairing all the damage as well as handling and storage.

1.2 Reference

1.2.1 The relevant references are as follows:

Bil Document Reference no.

1. Project Quality Plan RWTP-GB-QSHE-PQP-000001


2. Safety & Health Management Plan RWTP-GB-QSHE-SHP-000001
3. Environmental Management Plan RWTP-GB-QSHE-EMP-000001
Emergency Preparedness and
4. RWTP-GB-QSHE-ERP-000001
Response Plan
Raw Water Pipe Line Laying and
5. RWTP-GB-CNS-MST- 000015
Installation work
RWTP-GB-H-RWP-BNC-GEN-WPL-
TYP-000001
RWTP-GB-H-RWP-BNC-GEN-WPL-
6. Pipe Drawing
TYP-000002
RWTP-GB-H-RWP-BNC-GEN-WPL-
TYP-000003

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 3


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

Bil Document Reference no.

RWTP-GB-H-RWP-APT-GEN-WPL-
TYP-000001
RWTP-GB-H-RWP-APT-GEN-WPL-
TYP-000002
RWTP-GB-H-RWP-APT-GEN-WPL-
TYP-000003
RWTP-GB-H-RWP-OSP-GEN-WPL-
TYP-000001
RWTP-GB-H-RWP-OSP-GEN-WPL-
TYP-000002
RWTP-GB-H-RWP-OSP-GEN-WPL-
TYP-000003
RWTP-GB-H-RWP-PTT-GEN-WPL-
TYP-000001
RWTP-GB-H-RWP-PTT-GEN-WPL-
TYP-000002
RWTP-GB-H-RWP-PTT-GEN-WPL-
TYP-000003
RWTP-GB-H-RWP-PTT-GEN-WPL-
TYP-000004
RWTP-GB-H-RWP-PTT-GEN-WPL-
TYP-000005

1.3 Materials

1.3.1 Materials for activity associate:

Item Materials

1. Medium Sand Conforming to BS 882

2. Ordinary Portland Cement to BS 12

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 4


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

Item Materials

3. Potable Water

4. Nitomortar UA grade or Equivalent

5. Nitobond Type AR or Equivalent

6. Grebond AC or Equivalent

7. Bituminous primer conforming to Type A Grade B of BS4147

8. Bitumen enamel conforming to Type II Grade B of BS4147

1.3.2 Material deliver to the site will be inspected. Only materials that have been
inspected and approved will be used for the works. Type of materials shall
be accordance to BS and/or JKR specification & standards (based on
existing materials used at site).

1.4 Plant and Equipment

1.4.1 List of plat, machineries, equipment and tools for execution of activities
stated in this document as follow:

Item Description

1. Chisel and hammer

2. Electric grinder with diamond cutter and filler gauge

3. Trowel and brush

4. Dust mask, goggle, hard hat, safety shoe and rubber gloves.

5. Blow torch and fettling knife / scraper

6. Holiday detector

7. Long leather gloves, safety helmet, safety shoes and clear spectacle.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 5


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

Item Description

8. First Aid Box

1.5 Manpower

1.5.1 Typical manpower that involved in relocation of existing electrical activities:

Item Designation Responsibilities

Project Manager Responsible for overall commercial, contractual,


1. and technical performances associated with
specific projects.

Construction Manager/ Ensure overall works implementation is in order.


2. Construction Foreman

Site Engineer/ Planning, coordinating and supervising site


3.
Supervisor activities.
HSE Personnel To control and ensure the Safety, Health and
4.
Environmental is adhere at site.
QAQC Personnel To control and ensure the quality of works is
5.
adhere at site.
Traffic Controller To control the ingress and egress of construction
6.
traffic at site.
7. Surveyor/chainman Setting out of work.
Welder To carry out welding works (competency
8. certificates required)

Fitter To carry out installation of fittings


9.
(Competency certificates required)
10. General workers To carry out physical work
11. Machineries Operator To Operate the machineries

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 6


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

1.6 Repair Procedure for External Bitumen Coating of Pipes and Fittings

1.6.1 Repair Of Pinholes, Bubble-Type Damage and Dents


I. Remove dirt and foreign matter from the damage area
II. Heat up the defective area with a blowtorch and re-fettle the
area.
III. Carry out Holiday Test on the affected area and if the defect is
not removed, cut open the defective area with a fettling knife
taking care not to damage the surrounding enamel.
IV. Peel the patch back slightly; remove the defect (e.g.air bubble
or dirt)
V. Apply heat to the damaged area and trim / patch / smoothen
the damaged area with a fettling knife.
VI. Carry out Holiday Test on the repaired area.

1.6.2 Repair Of Damage Where Metal Surface Is Not Exposed


I. The excess jointing materials are levelled and the dents are
patched back using these excess materials. If the repaired
thickness is insufficient, apply additional tar to the area. This is
by heating a bitumen tape / block and using the spatula to draw
the melted tar onto the repair area. Smoothen the repaired
area.
II. Where the coating does not adhere tightly to the steel surface,
peel the patch back slightly, apply heat to the damaged area
with the blow torch and use the fettling knife to trim / patch /
smoothen the damaged areas and disposing off excess
materials.
III. Use the Holiday Detector to detect any holidays before applying
limewash / vinyl acetate paint.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 7


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

1.6.3 Repair Of Damage Where the Steel Surface Is Exposed


- Removed all debris, dirt and foreign matter on damaged surface
I. Clean metal surface properly by wire brushing if required.
II. Apply a coat of quick drying primer to the bare area.
III. After the primer has dried, apply heated bitumen enamel over
prepared area to specified thickness and cover with a layer of
outer wrap if required.
IV. Apply additional bitumen enamel materials to the area if
necessary.
V. Smoothen the area with the fettling knife.
VI. Use the Holiday Detector to detect any holidays.
VII. Apply limewash / vinyl acetate paint to the repaired area

1.6.4 Repair Of Pipes with Under thickness Bitumen Wrapping


- Removed all debris, dirt and foreign matter on the non-complying
pipes.
I. Repair all the defective areas and smoothen these areas with
the fettling knife. Apply additional bitumen materials to these
areas if necessary.
II. Remove the limewash or paint on the pipe surface by using
scraper or heating the pipe surface with blow torch.
III. Apply a coat of quick drying primer to the external surface of
the pipe.
IV. After the primer has dried, apply heated bitumen enamel over
prepared area to specified thickness and cover with a layer of
outer wrap if required.
V. Use the Holiday Detector to detect any holidays.
VI. Apply limewash / vinyl acetate paint to the external pipe surface

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 8


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

1.7 Repair Procedure for Concrete Lining of Pipes and Fittings

1.7.1 Damage / Crack Caused by Some Direct Impact Force


I. Cut out all the spalled concrete by careful chiseling or grinding
off around the damaged area.
II. Thoroughly clean the area by using a wet brush.
III. Prepare a fairly dry concrete mix (one cement to two sands by
volume).
IV. Apply a bonding agent such as Nitobond Type AR
manufactured by FOSROC Expandite Limited to the jointing
edged of the damaged area.
V. Applied the concrete to the damaged area layer by layer (until
the thickness required is achieved) and spread them evenly
using the trowel.
VI. Cure the newly applied concrete by putting a damp cloth
covering the area.

1.7.2 Longitudinal or Circumferential Cracks Arising from Handling, Storage


or Flexibility of The Pipes
I. As the intention to repair the crack should base on sound
practice consideration, we propose that all cracks with width
below 0.25mm should be left alone as these would be self-
sealing by autogenously healing.
II. For crack exceeding 0.25mm crack width, cut out a groove by
electric grinder to a depth until the crack width is less than
0.1mm.
III. Well clean the groove with water, apply a bonding agent such
as Nitobond Type AR to the jointing edge and seal them with
Nitomortar Type UA manufactured by FOSROC Expandite
Limited. The application should be made in accordance with
the manufacturer’s instructions.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 9


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

1.7.3 Extensive Damage to The Cement Lining in Which the Lining Has
Spalled Off in Some Areas and Has Many Large Cracked Lines
I. Identify the area and remove the internal lining by chiselling.
II. Thoroughly clean the bare steel internal surface.
III. Remove any rusty surface using mechanized cup brush.
IV. Apply a bonding agent to the jointing edges.
V. Re-lined the internal pipe surface with cement lining to the
required thickness layer by layer with a fairly dry mix concrete
and cured the concrete.

1.7.4 Superficial Cracks Patch Up (Optional)


I. As the intention to repair the crack should base on sound
practice consideration, in accordance to clause 16.7.1.7 of
SPAN TS 21827 Part 1:2013 we propose that all cracks with
width below 0.25mm and less than 300mm in length should be
left alone as these would be self-sealing by autogenously
healing.
II. For patch up of the superficial cracks, well clean the area to be
repair with water, then pre-mix bonding agent such as Grebond
AC with cement and water.
III. Use trowel and brush to apply the cement and bonding agent
mixture onto the crack area to seal up the cracks. If necessary,
apply in few coats to achieve smooth surface, application shall
be at an interval of 3 to 5 minutes for each coat.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 10


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

2.0 SAFETY AND HEALTH REQUIREMENTS


2.1 Job Safety & Health Analysis
Job Safety & Health Analysis shall be carried on the project site. Cautions and hazards signs
shall be established at location of works. The hazards in a particular activity and the control
measures implemented shall be briefed to the workers during SHE induction, tool box talk and
JSA Briefing. Please refer to the attached Appendix 5.1

2.2 Information to Personnel


2.2.1 All workers employed in the project site must have CIDB green card.

2.2.2 All new workers and staff to attend the SHE Training or SHE Induction Course
before commencing works at site and attendances shall be recorded in an
induction checklist.
2.2.3 All site personnel are mandatory wear proper Personnel Protective Equipment
(PPE):
2.2.4 Safety helmets, Safety vest, Safety boots, Hand gloves and any other additional
PPE required in JSA or advised by SHE Department.
2.2.5 Monthly SHE Committee meeting shall be held with all the contractors related to
the works.
2.2.6 All workers are compulsory to attend the daily pre-task briefing and weekly toolbox
meeting conducted by the SHE Department/Representative and attendances shall
be recorded.

2.3 Emergency Arrangements


2.3.1 Project Emergency Response Plan and Procedure shall be established.
2.3.2 The potential hazards during Defect Rectification Works are as below:
i. Accident due to machinery/equipment failure and movement
ii. Fall from height, contact with sharp edges/protruding rebar and
etc.
iii. Fire
2.3.3 An Emergency Response Team shall be formed at the site.
2.3.4 Please refer to the Appendix 5.2 for Safety, Health & Environmental Emergency
Response Flow Chart.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 11


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

2.3.5 The organization chart, list of emergency contact person and relevant authorities
with their contact numbers shall be showed in the Notice Board.
2.3.6 In the event of emergency, the site management staffs must evaluate the situation
and commence the necessary procedures as follow:
• Raise the alarm
• Stop works
• Remain composed.
• Make sure notifications of emergency or evacuation are in place for
all workers surrounding the vicinity.
• Make sure all workers are assembled at designated assembly
point.
• Make sure first aid kits are prepared at assembly point.
• All workers are told not to leave the assembly point until clear sign
is issued.
• Headcount shall be conducted
• First aiders shall attend to the injured workers
• Prepare assessment reports for the losses.

2.4 Permit Requirements

No Description Person or Authorities in- Remarks


charge
1 SHE permit to work such as SHE Department
Crane and Lifting Operation
permit, Excavation permit, Night
work permit, Hot work permit
and etc.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 12


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

2.5 Housekeeping
Housekeeping is an essential part of SHE for the daily routine. Housekeeping would include
the following items:

• Maintain the access way to all working area.


• Proper material arrangement.
• Park the machineries in orderly manner.
• No littering around the site.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 13


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

3.0 ENVIRONMENTAL ISSUES


3.1 Environmental Aspects, Impacts & Control Measures
All activities at work site shall comply with requirements stated in Environmental
Management Plan. Work site shall observe potential environmental impacts that will be
generated from activities stated in this method of statement, proposed control
measures, responsible parties’ in-charge and relevant legal applicability.

The significant environmental impacts associated with the Defect Rectification Works
have been identified and listed in the Appendix 5.3.

3.1.1 Air Quality and Noise Level


Machineries shall be in well maintain and in good working condition to reduce
emission of soot, smoke and noise.

The following measures shall be implemented if the above mentioned (soot,


smoke and noise) is deteriorating:
• Increase maintenance frequency.
• Replace to better equipment if necessary.
• Switched-off equipment if not in used
• Supply workers on-site with proper PPE (i.e. ear plugs and mask).

3.1.2 Water Quality


All surface runoff and contaminated water generated from activities stated in
this method of statement, must be channel to temporary earth drain and shall
be channel into sediment basin/ silt trap for further treatment.

3.1.3 Soil Erosion and Sediment Control


Precaution measures of erosion and sediment transport during the surface
preparation, construction, operation and closure phase of project shall comply
with Erosion and Sediment Control Plan (ESCP).

Erosion control such as phasing of works, vegetation buffers, turfing,


protection of slopes and stockpiles to be implemented. Sediment control such

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 14


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

as construction of sediment basin/ silt traps, sump, silt fence, sandbag and
wash trough shall be provided and maintained regularly.

3.1.3 Waste Management


All type of waste must be segregated, stored and disposed of in accordance
with the Construction Waste Management Plan and shall be removed from
site regularly.

Scheduled waste from maintenance works of machineries, vehicles and tools


will be placed in designated areas. Proper oil tray or drum shall be placed to
prevent the oil spillage all over the place. Subsequent waste shall be
collected and transfer to area as assigned.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 15


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

4.0 QUALITY ASSURANCE & QUALITY CONTROL


4.1 Contractual Requirements

4.1.1 Shall be implemented in accordance with submitted comprehensive IMS plan.

4.2 Inspection and Testing

4.2.1 All inspection shall follow the inspection and testing plan.

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 16


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.0 APPENDICES
5.1 Job Safety Analysis

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 17


Appendix A to RWTP-GB-CNS-MST-000030

RWTP
RASAU WATER TREATMENT PLANT
PENGURUSAN AIR SELANGOR
SDN BHD JOB SAFETY & HEALTH ANALYSIS (JSA)

DESCRIPTION OF JOB: Method Statement for Pipe PREPARD BY:


PROJECT/DIV/DEPT: RWTP Rectification Work for External Bitumen Coating and Concrete Nurul Hazwani
Lining of Pipes and Fitting
LOCATION: RASAU INTAKE, RAW WATER PUMPING MAINS, REVIEWED BY:
JSA NO: 030 REV NO: 00 Siti Khairiah
WATER TREATMENT PLANT
APPROVED BY:
TYPE OF ACTIVITIES: ROUTINE / NON-ROUTINE / EMERGENCY DATE: 17 May 2023 PAGE: 1 - 4 Joshua Entol

NO. JOB HAZARD CURRENT CONTROL RISK ASSESSMENT HIERARCHY ADDITIONAL LEGAL & REVISED RESIDUAL RISK RESPONSIB
SEQUENCE / IDENTIFICATION MEASURES OF CONTROL CONTROL OTHER RATING LE PERSON
STEPS MEASURES/ REQ
Proba Seve Risk Rating OPPORTUNITIES
Hazard & Risk P S Risk Rating
bility rity (O)
PxS PXS
(P) (S)
Score Level Score Level

1. Work i. Poor i. Conduct daily 2 2 4 L 4 - OSHA ‘94 - - - - Manager /


Preparation housekeeping housekeeping and FMA Engineer /
activity and material arrange the material (BOWEC) Supervisor
arrangement accordingly. 1986

ii. Poor manual ii. Works to be 2 2 4 L 4


handling conducted by - - - - -
trained/competent
workers. Correct
method of manual
handling.

2. Use of Power i. Defective i. All equipment, hoses 2 2 4 L 5 - OSHA ‘94 - - - - Manager /


Tools, Genset, equipment / connectors are FMA Engineer /
and Air inspected and must (BOWEC) Supervisor /
compressor in good condition 1986 Safety
prior to use. Personnel

3. Chemical i. Contact with i. Any contact with 2 3 6 M 3 Conduct PTT and OSHA ‘94 1 3 3 L Manager /
Handling chemicals chemicals to be emphasize on Guidelines Engineer /
cleaned immediately. chemical 2001 Supervisor /
Use PPE as per stated hazard/SDS. SDS Safety
Page 1 of 4
Rev. No:00 / Date: 15 AUG 2022
Appendix A to RWTP-GB-CNS-MST-000030

RWTP
RASAU WATER TREATMENT PLANT
PENGURUSAN AIR SELANGOR
SDN BHD JOB SAFETY & HEALTH ANALYSIS (JSA)

NO. JOB HAZARD CURRENT CONTROL RISK ASSESSMENT HIERARCHY ADDITIONAL LEGAL & REVISED RESIDUAL RISK RESPONSIB
SEQUENCE / IDENTIFICATION MEASURES OF CONTROL CONTROL OTHER RATING LE PERSON
STEPS MEASURES/ REQ
Proba Seve Risk Rating OPPORTUNITIES
Hazard & Risk P S Risk Rating
bility rity (O)
PxS PXS
(P) (S)
Score Level Score Level

in Safety Data Sheet copy available on Personnel


(SDS). site.
- - - -
ii. Improper ii. Chemicals stored on 1 2 2 L 4
chemicals site must complete with
storage tray, labeling, signage,
copy of SDS, ventilation
and .

4. Electrical i. Electric shock i. Use industrial plugs / 2 2 4 L 3 - OSHA ‘94 - - - - Manager /


Works cable. Electrical FMA Engineer /
equipment / wiring to (BOWEC) Supervisor /
be inspected / 1986 Electrician /
connected by Safety
electrician. Display Personnel
signages. Work
briefing prior to work
start. Check all
cables before
connection. Cable
hangs / not trailing
on ground / in water

5. Hacking and i. Flying chip / i. Works to be carried 3 1 3 L 5 - OSHA ‘94 - - - - Manager /


cutting particles / Dust out by competent FMA Engineer /
worker, spray of (BOWEC) Supervisor
water to control dust. 1986
Wear safety goggles
and dust mask.

ii. Noise/Vibration ii. Wear hearing 3 1 3 L 5 - - - - -


protection. Toolbox
briefing. Works
rotation / shift.

Page 2 of 4
Rev. No:00 / Date: 15 AUG 2022
Appendix A to RWTP-GB-CNS-MST-000030

RWTP
RASAU WATER TREATMENT PLANT
PENGURUSAN AIR SELANGOR
SDN BHD JOB SAFETY & HEALTH ANALYSIS (JSA)

PROBABILITY SEVERITY PRIORITY OF ACTION


Probability Description Rating Severity Description Rating Risk Rating Action Urgency
Very Is practically impossible and 1 Insignificant Minor ill health or first aid type 1 1-4 Risk is considered as acceptable and If required
Unlikely has never occurred /negligible injury further reduction may not be necessary.
Unlikely Has not been known to occur 2 Minor Injury involving temporary 2 LOW Continuous monitoring needs to be in
after many years disability place
Likely Might be occurred at some 3 Moderate Injury involving Permanent 3 5-12 Identified control measures shall be 1 week
time in future disability implemented to minimize the risk level.
Very Likely Has a good chance of 4 Major Single fatality or major 4 MEDIUM Continuous monitoring shall be in place.
occurring and is not unusual property damage
Almost The most likely result of the 5 Catastrophic Numerous fatalities or 5 15-25
Requires immediate action to control Immediate
Certain hazard/event being realized irrecoverable property damage and minimize the hazards. Work should
HIGH not commence until proposed control
measured have been implemented.
** Note: The description and level of severity and probability may vary, subjected to project, legal and other requirements. Loss on property damage can be incorporated and
shall be in accordance to project requirements.

Group Hierarchy of Control


1 Elimination
2 Substitution
3 Engineering controls, reorganization of work, or both:
4 Administrative Control
5 PPE

Page 4 of 4
Rev. No:00 / Date: 15 AUG 2022
Appendix A to RWTP-GB-CNS-MST-000030

RWTP
RASAU WATER TREATMENT PLANT
PENGURUSAN AIR SELANGOR
SDN BHD JOB SAFETY & HEALTH ANALYSIS (JSA)

NO. JOB HAZARD CURRENT CONTROL RISK ASSESSMENT HIERARCHY ADDITIONAL LEGAL & REVISED RESIDUAL RISK RESPONSIB
SEQUENCE / IDENTIFICATION MEASURES OF CONTROL CONTROL OTHER RATING LE PERSON
STEPS MEASURES/ REQ
Proba Seve Risk Rating OPPORTUNITIES
Hazard & Risk P S Risk Rating
bility rity (O)
PxS PXS
(P) (S)
Score Level Score Level

6. Night Works i. Insufficient i. Provide adequate 2 2 4 L 4 - OSHA ‘94 - - - - Manager /


lighting lighting. PTW system FMA Engineer /
implementation. (BOWEC) Supervisor /
Monitoring and 1986 Safety
supervision Personnel

Page 3 of 4
Rev. No:00 / Date: 15 AUG 2022
RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.2 Emergency Response Flow Chart


EMERGENCY PREPAREDNESS AND RESPONSE
Responsibility
Start

Identify potential incidents or emergency situations HOD/ SHE Manager

Establish an Emergency response Team (ERT) HOD/


structure. Emergency Commander

Gather emergency contact names and numbers for SHE Manager/


use during an emergency Assigned Staff

Emergency Commander/
Determine the necessary emergency equipment
SHE Manager

Determine a designated assembly area for personnel Emergency Commander/


and workers to gather during an emergency SHE Manager

SHE Manager/
Prepare an Emergency Response Plan Assigned Staff

Review and approve the Emergency Response Plan Emergency Commander


(ERP)

Revise ERP SHE Manager/


Assigned Staff
Is
No Emergency Commander
ERP acceptable ?

Yes

Issue ERP Emergency Commander

Brief ERP to ERT members, personnel & workers, Emergency Commander


subcontractors, etc and maintain attendance.

Provide the necessary emergency equipment as HOD


defined in ERP.

Provide training to ERT members and other selected SHE Personnel


personnel.

Plan and conduct emergency response drill test ERT Members

Review the effectiveness and appropriateness of the ERT Members


Emergency Response Plan No

Implement the Emergency Response Plan in an


ERT Members
incident or emergency

Identify potential causes and preventive action and ERT Members


implement action

Review the effectiveness of ERP implementation ERT members

ERP effective?

Yes

Maintain records SHE personnel/


Assigned Staff

End

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 18


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 19


EMERGENCY RESPONSE TEAM ORGANISATION CHART - RWPL
Date: 31st May 2023
EMERGENCY COMMANDER Rev. No.: 01

WONG CHEE KEONG


012-3913608 Prepared by: _____________________
Siti Khairiah
(Manager – SHE)

DEPUTY EMERGENCY COMMANDER


Reviewed by: _____________________
MOHD NOOR ZAIRI Lim Vin Hong
ERT HISTORIAN 013-6783172
(Project Manager)

SITI KHAIRIAH Approved by: _____________________


012-6950777 TEAM MEMBERS Wong Chee Keong
(Senior Project Manager)

WARDEN/EVACUATION FIRE FIGHTING SEARCH & RESCUE FIRST AIDER


MUHD AZHIIM TAN HENG BOON MOHAMAD AMIN ZAINAL
012-3626376 012-2502692 012-7132867 012-4965198

SECURITY & LOGISTIC SPILLAGE RESPONSE TRAFFIC


SARK CHOON YOONG SITI NORLISSA ABDUL AZIZ
012-3813862 012-4691422 011-63592447
CRISIS MANAGEMENT TEAM ORGANISATION CHART

SITE CRISIS MANAGEMENT


COMMANDER

PROJECT DIRECTOR

TEAM MEMBER TEAM MEMBER TEAM MEMBER TEAM MEMBER


SENIOR PROJECT
PROJECT MANAGERS QSHE SENIOR MANAGER PRSM MANAGER
MANAGER
RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.3 Environmental Aspect & Impact Register

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 20


APPENDIX 5.3

ENVIRONMENTAL ASPECTS AND IMPACT REGISTER


Reference No.: RWTP-GB-SHE-EAI-000030
Package/ Location: RWTP Rasau Water Treatment Plant
Revision No.: 00

Type of Work: Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting Date: 19/5/2023

Condition Risk Rating Significant R&O that need to be addressed


PROJECT ACTIVITY ASPECTS IMPACTS MITIGATION MEASURES TO BE IMPLEMENTED
N* A* E* L* S* Rate Yes No
(LxS)

Risk: 1. Recommend to conduct work at night or during off peak hours to minimize traffic
- Public complaint disruption.
- Heavy traffic congestion 2. Maintain most number of lanes wherever possible.
3. Reduce number of lanes (only when unavoidable and when all other alternatives
Road closure, lane diversion and
Traffic congestion N 3 3 9 YES Opportunities: have been exhausted) to be design to facillitate contra flow options.
reduction
- NA 4. Provide sufficient warning signs and flagmen at all work areas to facillitate better
traffic flow.
5. Maintain traffic management devices and temporary/ warning signs to ensure
maximum effectiveness in terms of traffic management.

Risk:
Legal action by authorities
1. Inspection by weekly and maintenance of machinery to be conducted regularly to
ensure machines are in good working condition with no leakage.
Opportunities:
Oil spillage/ leakage Land contamination E 2 2 4 YES 2. Manually excavate the contaminated area and put into a suitable container and
- NA
must be stored at scheduled waste storage for proper disposal.

Risk:
- Legal action by authorities

Generation of scheduled waste Opportunities: Immediately clear any spillage on the ground. Scheduled waste will be stored at
Land contamination N 2 2 4 YES
(including disposal of waste) - NA scheduled waste storage area and disposed by licensed contractor.

1.Mobilisation / Risk:
Demobilization (loading/ Public complaint
unloading of machinery)
Opportunities:
1. The machinery will be maintained in good working order to ensure that exhaust
- Regular maintenance of
Generation of black smoke Air pollution N 2 2 4 YES emission is controlled.
machinery
2. Allow only machinery that is in good condition to enter the site.
- Increase life span of machinery

Risk: 1. Speed limits (15km/ hr) and traffic volume restriction within the site area will be
- Public complaint implemented to reduce the dust dispersion.
2. Dampen all access. Water bowser need to standby for watering all the time.
Generation of dust Air pollution N 2 2 4 YES
3. Vehicles transporting earth to be installed with tailgate and covered with tarpaulin.
Opportunities: 4. To wash the construction vehicles wheels at a wash trough facility before leaving
- NA from construction site.

Risk:
Inspection by weekly and maintenance of machinery to be conducted regularly.
- Public complaint
Installation of hoarding or temporary noise barrier. All noise generating equipment
Generation of noise/ vibration noise/ vibration nuisance N 3 3 9 YES
and machinery will be shut down when not in use and work will be conducted within
Opportunities:
approved working hour.
- NA

Risk:
- Public complaint 1. Wash trough to be provided at the site exit with water jet and operator.
Dirtying of public road Public nuissance/ public complaint N 3 3 9 YES 2. Temporary drainage will be constructed to channel surface runoff to silt trap.
Opportunities: 3. Water bowser need to be standy for watering purposes.
- NA
APPENDIX 5.3

ENVIRONMENTAL ASPECTS AND IMPACT REGISTER


Reference No.: RWTP-GB-SHE-EAI-000030
Package/ Location: RWTP Rasau Water Treatment Plant
Revision No.: 00

Type of Work: Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting Date: 19/5/2023

Condition Risk Rating Significant R&O that need to be addressed


PROJECT ACTIVITY ASPECTS IMPACTS MITIGATION MEASURES TO BE IMPLEMENTED
N* A* E* L* S* Rate Yes No
(LxS)

1. Speed limits (15km/ hr) and traffic volume restriction within the site area will be
Risk:
implemented to reduce the dust dispersion.
- Legal action by authorities
2. Dampen all access. Water bowser need to standby for watering all the time.
Air pollution N 3 3 9 YES
3. Vehicles transporting earth to be installed with tailgate and covered with tarpaulin.
Opportunities:
4. To wash the construction vehicles wheels at a wash trough facility before leaving
- Enhancement of SHEI
from construction site.
Generation of dust

Risk:
- Legal action by authorities
Public nuisance/ complaint N 3 3 9 YES Water bowser to be provided for access washing.
Opportunities:
- Enhancement of Construction
Waste Management Plan/ SHEI.

Risk:
- Legal action by authorities
Public nuisance/ complaint N 3 3 9 YES Provide maintenance on time for fuel burning equipment, vehicle & machineries.
Opportunities:
- Nil.

Noise generation
2. Repairing work for Risk:
External Bitumen Coating of - Nil
Pipes and Fittings
1. To turn off machineries when not in use.
Noise pollution N 2 3 6 YES Opportunities:
2. Limit working hours.
-Nil

Risk:
- Legal action by authorities
Immediately clear any spillage on the ground. Scheduled waste will be stored at
Land contamination N 3 2 6 YES Opportunities:
scheduled waste storage area and disposed by licensed contractor.
- NA

Generation of scheduled waste


(including disposal of waste) Risk:
- Legal action by authorities
Immediately clear any spillage from surface water, stream, pond by using spill kit
Water pollution N 3 2 6 YES Opportunities: manually and put into a suitable container and will be stored at scheduled waste
- NA storage prior to disposal.

Risk:
- Legal action by authorities
All type of waste will be segregated, stored and disposed in accordance with the
Generation of non-scheduled waste
Land contamination N 2 3 6 YES Opportunities: Construction Waste Management Plan. Open burning is strictly prohibited. Waste
(including disposal of waste)
- NA will be disposed at the approved disposal site.
APPENDIX 5.3

ENVIRONMENTAL ASPECTS AND IMPACT REGISTER


Reference No.: RWTP-GB-SHE-EAI-000030
Package/ Location: RWTP Rasau Water Treatment Plant
Revision No.: 00

Type of Work: Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting Date: 19/5/2023

Condition Risk Rating Significant R&O that need to be addressed


PROJECT ACTIVITY ASPECTS IMPACTS MITIGATION MEASURES TO BE IMPLEMENTED
N* A* E* L* S* Rate Yes No
(LxS)

Risk:
1. Speed limits (15km/ hr) and traffic volume restriction within the site area will be
- Legal action by authorities
implemented to reduce the dust dispersion.
2. Dampen all access. Water bowser need to standby for watering all the time.
Air pollution N 3 3 9 YES Opportunities:
3. Vehicles transporting earth to be installed with tailgate and covered with tarpaulin.
Enhancement of Construction
4. To wash the construction vehicles wheels at a wash trough facility before leaving
Waste Management Plan/ SHEI.
from construction site.

Generation of dust

Risk:
- Legal action by authorities
Public nuisance/ complaint N 3 3 9 YES Water bowser to be provided for access washing.
Opportunities:
Enhancement of Construction
Waste Management Plan/ SHEI.

Risk:
- Legal action by authorities
Public nuisance/ complaint N 3 3 9 YES Provide maintenance on time for fuel burning equipment, vehicle & machineries.
Opportunities:
- Nil.

Noise generation
Risk:
- Nil
1. To turn off machineries when not in use.
Noise pollution N 2 3 6 YES Opportunities:
2. Limit working hours.
-Nil

Risk:
- Nil
Depletion of non-renewable 1. Do not leave machineries unattended while machine in running condition.
Fuel consumption N 3 3 9 YES Opportunities:
resources 2. Turn off machine while not in use to avoid diesel wastage.
-Nil

3. Repairing work for


Concrete Lining of Pipes
and Fittings
Risk:
- Public complaint
- Legal action by authorities 1. Spent oil and grease from machines, generators will be collected in drums,
Water pollution E 3 2 6 YES transported and disposed off site by licensed contractor.
Opportunities: 2. To provide drip tray to contain spillage.
Enhancement of Construction
Waste Management Plan/ SHEI.

Oil spillage/ leakage Risk:


- Public complaint
- Legal action by authorities
1. To provide spill kits to contain and spillage.
Opportunities:
Land contamination E 3 3 9 YES 2. To provide adequate training to site off on schedule waste management.
Enhancement of Construction
Waste Management Plan/ SHEI.
APPENDIX 5.3

ENVIRONMENTAL ASPECTS AND IMPACT REGISTER


Reference No.: RWTP-GB-SHE-EAI-000030
Package/ Location: RWTP Rasau Water Treatment Plant
Revision No.: 00

Type of Work: Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting Date: 19/5/2023

Condition Risk Rating Significant R&O that need to be addressed


PROJECT ACTIVITY ASPECTS IMPACTS MITIGATION MEASURES TO BE IMPLEMENTED
N* A* E* L* S* Rate Yes No
(LxS)
Risk:
- Legal action by authorities
1. A petroleum based machines or equipment be placed on the secondary
Land contamination N 3 2 6 YES Opportunities: containment/ tray.
- NA 2. Any spillage to be collected and treated as scheduled waste.

Generation of scheduled waste


(including disposal of waste) Risk:
- Legal action by authorities
1. Immediately clean any spillage.
Water pollution N 3 2 6 YES Opportunities: 2. Scheduled waste shall be stores as designated scheduled waste storage area
- NA and disposed by licensed contractor.

Risk:
- Legal action by authorities
All type of waste will be segregated, stored and disposed in accordance with the
Generation of non-scheduled waste
Land contamination N 2 3 6 YES Opportunities: Construction Waste Management Plan. Open burning is strictly prohibited. Waste
(including disposal of waste)
- NA will be disposed at the approved disposal site.

Risk:
- Legal action by authorities
1. A petroleum based machines or equipment be placed on the secondary
Land contamination N 3 2 6 YES Opportunities: containment/ tray.
- NA 2. Any spillage to be collected and treated as scheduled waste.

Generation of scheduled waste


(including disposal of waste) Risk:
- Legal action by authorities
1. Immediately clean any spillage.
4.Housekeeping Water pollution N 3 2 6 YES Opportunities: 2. Scheduled waste shall be stores as designated scheduled waste storage area
- NA and disposed by licensed contractor.

Risk:
- Legal action by authorities
All type of waste will be segregated, stored and disposed in accordance with the
Generation of non-scheduled waste
Land contamination N 2 3 6 YES Opportunities: Construction Waste Management Plan. Open burning is strictly prohibited. Waste
(including disposal of waste)
- NA will be disposed at the approved disposal site.

Prepared by Reviewed By Approved By N* = Normal


Name Siti Norlissa Bt Ishak Siti Khairiah Mohd Hashim Joshua Enthol A* = Abnormal
E* = Emergency
L* = Likelihood (refer to Appendix B)
Signature
S* = Severity (refer to Appendix B)
# Risk Rating calculation shown in Appendix B
Date 19/5/2023 19/5/2023 19/5/2023
Appendix B
Risk Rating Evaluation
SEVERITY
1 2 3 4 5
No environmental change or the Adverse impact may occur, but the Adverse impact is not permanent, Can cause adverse impact, but the Can cause severe adverse impact,
environmental impact is benificial. effect is easily recoverable or short term and repairable or damage is not permanent / only major pollution, e.g. permanent / long
E.g.: Generation of used paper contribution to the impact is very low. contribution to the impact is low. medium term or contribution to the term environmental damage or
E.g.: Generation of food packaging on E.g.: Bentonite spillage on the road
impact is high. contribution to the impact is very high.
the ground E.g.: Black smoke from low E.g.: Silt trap malfunction/damage
maintenance machineries
No rectification needed Rectification can be done immediately Rectification can be done within 1 day Rectification can be done within 1 Rectification can be done more than 1
week week
Very likely. It is almost certain that the
event will occur. Common or frequent
occurrence.
5 5 10 15 20 25
May happen daily in normal situation.

Likely. There is a strong possibility the


event will occur or there is a history of
frequent occurrence.
4 4 8 12 16 20
May happen once a week in normal
situation.
1.Mobilisation / Demobilization (loading/ unloading of machinery)
Possible. The event could occur or
LIKELIHOOD

there is a history of occurrence.


3 3 6 9 12 15
May happen once a month in normal
situation.

Unlikely. Not expected, but there's a


slight possibility it may occur at some
time.
2 2 4 6 8 10
May happen once a year or only
happen in abnormal situation

Rare. It may only occur in exceptional


circumstances.
1 1 2 3 4 5
May happen more than once a year in
abnormal situation.

Risk Rating

Level Rating Significant


Level 1 - Very Minor 0-1 No
Level 2 - Minor 2-3 No
Level 3 - Moderate 4-6 Yes
Level 4 - Major 7 - 16 Yes
Level 5 - Critical 17 - 25 Yes
RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.4 Inspection & Test Plan

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 21


ITP For Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting
Document No. RWTP-GB-CNS-ITP-000030-00
Revision No. 00 Rev. Date 17 May 2023

RASAU WATER TREATMENT PLANT ITP For Pipe Rectification Work for External Bitumen
Project: ITP for: Rev: 00
(RWTP) Coating and Concrete Lining of Pipes and Fitting
Discipline: C&S Ref. No: RWTP-GB-CNS-ITP-000030-00
Discipline code: REFER TO PROCEDURE Date: 17 May 2023 No of Pages: 1 of 2
Inspection Point
No. Activity Description Controlling Document Acceptance Criteria Frequency Record
CR SC CA
Technical
Submission of Method Method Statement and Approved Method of
1.0 Specification/Construction Before start H R R
Statement for approval Inspection Test Plan (ITP) Statement; Approved ITP
Drawing
Safety and Health Prior to commencement
2.0 Tool & Equipment Inspection Safety and Health Instruction Before start S S R
Instruction Checklist of works
BS 534: Specification For
BS 534: Specification For Steel
Steel Pipes, Joint And Borehole log / soil
3.0 Rectification Works Pipes, Joint And Specials For Every sample S W R
Specials For Water And investigation reports
Water And Sewage
Sewage

Remarks: Inspection Authority:


H : Hold Point Points where no further works shall proceed without the written approval of the Supervising CR Contractor Representative
Consultant representative SC Supervising Consultant
W : Witness Point Points where Supervising Consultant can opt to observe/ or visually examine or participate in the
work operation. CA Contract Administrator
S : Surveillance Points where the SC representative monitor the contractor activities to the degree necessary for
confidences that work process/ method is complying with the established criteria
R: Review Review of the contractor’s ITP records for correctness and completeness

GAMUDA BERHAD
REF. NO: RWTP-GB-CNS-ITP-000030-00 Page 1
ITP For Pipe Rectification Work for External Bitumen Coating and Concrete Lining of Pipes and Fitting
Document No. RWTP-GB-CNS-ITP-000030-00
Revision No. 00 Rev. Date 17 May 2023

RASAU WATER TREATMENT PLANT ITP For Pipe Rectification Work for External Bitumen
Project: ITP for: Rev: 00
(RWTP) Coating and Concrete Lining of Pipes and Fitting
Discipline: C&S Ref. No: RWTP-GB-C&S-ITP-000030-00
Discipline code: REFER TO PROCEDURE Date: 17 May 2023 No of Pages: 1 of 2
Inspection Point
No. Activity Description Controlling Document Acceptance Criteria Frequency Record
CR SC CA
BS5930:1999 Code of BS5930:1999 Code of Practice Borehole log / soil
4.0 Ground water monitoring Every working day S S R
Practice for Soil Investigation for Soil Investigation investigation reports
Extraction of rock cores when BS5930:1999 Code of BS5930:1999 Code of Practice Borehole log / soil
5.0 Every sample S S R
rock is encountered Practice for Soil Investigation for Soil Investigation investigation reports
Technical
After completion
6.0 As built drawing Specification/Construction Joint survey data As-built drawing H R R
work
Drawing

Remarks: Inspection Authority:


H : Hold Point Points where no further works shall proceed without the written approval of the Supervising CR Contractor Representative
Consultant representative SC Supervising Consultant
W : Witness Point Points where Supervising Consultant can opt to observe/ or visually examine or participate in the work
CA Contract Administrator
operation.
S : Surveillance Points where the SC representative monitor the contractor activities to the degree necessary for
confidences that work process/ method is complying with the established criteria
R: Review Review of the contractor’s ITP records for correctness and completeness

Prepared Reviewed Approved

Joshua Entol
Nurul Hazwani Syerifaizal
(Construction
Name (Project Engineer) (QAQC Manager)
Manager)

Signature

Date 17 May 2023 17 May 2023 17 May 2023

GAMUDA BERHAD
REF. NO: RWTP-GB-CNS-ITP-000030-00 Page 2
RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.5 Checklist

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 22


RWTP
RASAU WATER TREATMENT PLANT

PENGURUSAN AIR SELANGOR


SDN BHD
METHOD STATEMENT

5.5 Checklist

REF. NO : RWTP-GB-CNS-MST- 000030-00 Page 20


Rasau WTP Form detail report

Form detail

#2867: QAQC CHECKLIST - RECTIFICATION FOR PIPE

Form details

Location

Form date May 15, 2023

Description

Created by Nurnadia Zakaria

Status In progress

Last update May 15, 2023, 3:45 PM +08

Last updated by Nurnadia Zakaria

Included references Assets | Documents | Form details | Issues | Photos

Supporting information
FOR PIPELINE USES ONLY

1. Form Details

1.1 Inspection Date

1.2 Detailed Location

If necessary

1.3 Drawing No.

1.4 Request for Inspection (RFI) No.

2. Rectification pipe

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 1 of 8
Rasau WTP Form detail report

2.1 Pipe number

2.2 Defect details

2.3 Before

A photo is required.

2.4 After

A photo is required.

3. Rectification pipe

3.1 Pipe number

3.2 Defect details

3.3 Before

A photo is required.

3.4 After

A photo is required.

4. Rectification pipe

4.1 Pipe number

4.2 Defect details

4.3 Before

A photo is required.

4.4 After

A photo is required.

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 2 of 8
Rasau WTP Form detail report

5. Rectification pipe

5.1 Pipe number

5.2 Defect details

5.3 Before

A photo is required.

5.4 After

A photo is required.

6. Rectification pipe

6.1 Pipe number

6.2 Defect details

6.3 Before

A photo is required.

6.4 After

A photo is required.

7. Rectification pipe

7.1 Pipe number

7.2 Defect details

7.3 Before

A photo is required.

7.4 After

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 3 of 8
Rasau WTP Form detail report

A photo is required.

8. Rectification pipe

8.1 Pipe number

8.2 Defect details

8.3 Before

A photo is required.

8.4 After

A photo is required.

9. Rectification pipe

9.1 Pipe number

9.2 Defect details

9.3 Before

A photo is required.

9.4 After

A photo is required.

10. Rectification pipe

10.1 Pipe number

10.2 Defect details

10.3 Before

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 4 of 8
Rasau WTP Form detail report

A photo is required.

10.4 After

A photo is required.

11. Rectification pipe

11.1 Pipe number

11.2 Defect details

11.3 Before

A photo is required.

11.4 After

A photo is required.

12. Rectification pipe

12.1 Pipe number

12.2 Defect details

12.3 Before

A photo is required.

12.4 After

A photo is required.

13. Rectification pipe

13.1 Pipe number

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 5 of 8
Rasau WTP Form detail report

13.2 Defect details

13.3 Before

A photo is required.

13.4 After

A photo is required.

14. Rectification pipe

14.1 Pipe number

14.2 Defect details

14.3 Before

A photo is required.

14.4 After

A photo is required.

15. Rectification pipe

15.1 Pipe number

15.2 Defect details

15.3 Before

A photo is required.

15.4 After

A photo is required.

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 6 of 8
Rasau WTP Form detail report

16. Rectification pipe

16.1 Pipe number

16.2 Defect details

16.3 Before

A photo is required.

16.4 After

A photo is required.

17. Rectification pipe

17.1 Pipe number

17.2 Defect details

17.3 Before

A photo is required.

17.4 After

A photo is required.

18. Rectification pipe

18.1 Pipe number

18.2 Defect details

18.3 Before

A photo is required.

18.4 After

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 7 of 8
Rasau WTP Form detail report

A photo is required.

19. Final Inspection Status


To be filled up by Supervising Consultant

19.1 Allowed to proceed with the next stage of work?


Yes No N/A

19.2 Reason for failure or reinspection

If any

19.3 Any Non Conformance Report (NCR) to be raised?

Please add the NCR as Form References if your answer is yes

Yes No N/A

20. Signatory
REMINDER: ALL NCR SHALL BE CLOSED BEFORE SIGNING OFF THIS CHECKLIST

20.1 Subcontractor
-

20.1 Contractor
-

20.1 Supervising Consultant


-

20.1 CA Representative
-

Created by Nurnadia Zakaria with Autodesk® Construction Cloud™ on May 15, 2023 at 3:46 PM +08 Page 8 of 8

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