FOR APPROVAL

Owner’s reply on
□ Approved
□ Approved with comments
□ Comments

INSPECTION AND TESTING PLAN

FOR CIVIL WORK

11, 20, 21, 22, 24,26/85 updated and QCF added or changed
according ot inspection stages

D I STR I .

OWNER E

PM
89 SHEETS WITH COVER
CM/CE

QA/QC

BUSINESS

COST
R SCH
E
V PROCESS

I C 03.06.2020
EQIPMENT
S
I B 28.08.2020
MACHINE
O
N A 10.04.2020 FURNACE
S On the Not on the APP’D APP’D
NO DATE DESCRIPTION REFERENCE NO. control control PIPING
list list SECTION PROJECT TEAM
ORDER NO. 563500 ELECT.

OWNER INST
PROJECT TEAM: GPUFP
CIVIL
APPROVED Bangladesh Chemical Industries Corporation
CONST
CONTRACTOR
PROCURE
Mitsubishi Heavy Industries, Ltd
SECTION QA/QC Gr. SUBCONT
CHINA NATIONAL CHEMICAL ENGINEERING & CONSTRUCTION
APPROVED
CORPORATION SEVEN, LTD
PROJECT
MHI E

SITE
Ghorasal Polash Urea Fertilizer Project
JAPAN EXPORT On the Not on the CONTRACTOR DWG. No. REV.
CONTROL Control List Control List SPARE

6488C AA80-000-00-00100 C
DRAWN DATE 06-June-2021 TOTAL
 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

INSPECTION AND TESTING PLAN

FOR CIVIL WORK

DOCUMENT APPRAISAL STAMP

REVIEWER'S NAME SIGN DATE

REVIEW GRADE

Result Code Description

A Accepted

C Proceed with exceptions to next submission and Revision

R Do Not Proceed - Revise as noted and Resubmit

Acceptance in any of these categories in no way relieves the Contractor/Supplier of its responsibility for
the due & proper performance of the Works in accordance with the Contract/Purchase Order

PROJECT MANAGER SIGN-OFF:

NAME DATE:

Rev. Description of Approved By

Rev. Date Prepared By Checked By Approved By
No. Revision (Employer)

00 10.04.2020 Issue for Review Xiong Youyi Wang Huaizhong

01 28.08.2020 Issue for Review Xiong Youyi Wang Huaizhong
02 06.06.2021 Issue for Review Xiong Youyi Wang Huaizhong
 CONTENT
1. SCOPE ............................................................................................................... 1

2. DEFINITIONS ................................................................................................... 1

3. REFERENCE ..................................................................................................... 1

4. ABRREVIATIONS AND CODES .................................................................... 1

4.1 Inspection Point ......................................................................................... 1

4.2 ITP Code ................................................................................................... 2

5. RESPONSIBILITY ............................................................................................ 2

5.1 CC7 shall be responsible for: ..................................................................... 2

5.2 Responsibility of QA/QC Manager ............................................................ 3

5.3 Responsibility of Qualified Inspector ........................................................ 3

6. PLANNING AND PROCEDURE ...................................................................... 3

7. INSPECTION FLOW ........................................................................................ 6

8. REQUEST FOR INSPECTION ......................................................................... 6

9. INSPECTION RECORD.................................................................................... 7

10.INSPECTION REPORT ................................................................................... 8

10.1 Document Review Items............................................................................ 8

10.2 Inspection Report ...................................................................................... 8

11.INSPECTION AND TEST STATUS ................................................................ 9

12.APPENDIX ....................................................................................................... 9
 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

1. SCOPE

This procedure is provided for control of the construction of Field work inspection

and test (hereafter called 'Inspection') to verify that civil works are being located, and

the civil works must in compliance with the latest construction drawings, instructions,

procedures and other applicable documents for Ghorasal Polash Urea Fertilizer project.

2. DEFINITIONS

Project Ghorasal Polash Urea Fertilizer Project （GPUFP）

Owner Bangladesh Chemical Industries Corporation

Consortium Leader Mitsubishi Heavy Industries, LTD

China National Chemical Engineering & Construction
Consortium party
Corporation Seven, Ltd
Construction teams Organized and managed by CC7

3. REFERENCE

Project contract and related quality management documents

MHI related quality management procedures and documentation

ASME, ASTM and related specification

Chinese Standards

4. ABRREVIATIONS AND CODES

4.1 Inspection Point

“R”- Review: This indicates a document review.

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

“○”-Every time: means always need to be attended.

“△”-Discretion: means attendance is required if it is judged to be attended.

“-”-None: means it doesn’t need inspection or witness or surveillance.

4.2 ITP Code

No. Discipline Code ITP Code Inspection/Test Stage
1 CVS 001 Survey
2 CVS 002 Piling
3 CVS 003 Earth Work
4 CVS 004 UG Piping Work
5 CVS 005 Rebar
6 CVS 006 Form Work
7 CVS 007 Anchor Bolt and Embedded Items
8 CVS 008 Concrete Material and Placing
9 CVS 009 Paving and Road
10 CVS 010 Drainage/Trench Work
11 CVS 011 Pits & Pool
12 CVS 012 Fence Work
13 CVS 013 Chemical Resistance Lining/Painting Work
14 CVS 014 Roof
15 CVS 015 Steel Structure Erection
16 CVS 016 Fireproof Concrete Work
17 CVS 017 Plumbing
18 CVS 018 HVAC
19 CVS 019 HVAC Electrical

5. RESPONSIBILITY

5.1 CC7 shall be responsible for:

5.1.1 Establishing and maintaining the inspection plan.

5.1.2 Inspection in accordance with applied procedure.

5.1.3 Submitting the inspection records and results required to verify conformance to

specified requirements.

5.1.4 Qualification of inspection personnel.

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

5.1.5 Control of the inspection, measuring and test equipment used for inspection.

5.1.6 CC7 shall be responsible for supervision and management of Construction Teams.

5.2 Responsibility of QA/QC Manager

QA/QC Manager shall be responsible for coordination relating to inspection

among the MHI、BCIC and CC7 for control of witness inspection and for evaluating

its records and results to verify conformance to specified requirements.

5.3 Responsibility of Qualified Inspector

The Qualified Inspector of CC7 shall be responsible for witnessing the inspection

performed at specified points. Inspector of CC7 shall be responsible for review of

records and results to verify conformance to the specified requirements.

6. PLANNING AND PROCEDURE

6.1 CC7 shall establish the inspection plan, which must conform to requirements specified

in the Construction Quality Requirements and shall specify the inspection items

described in the list of Field inspection items into the quality plan depending on

required quality level of each item.

6.2 CC7 shall submit the inspection plan to MHI&BCIC for review and formal approval

at the planning stage of construction.

6.3 During the construction phase, additional plans may be made if necessary, CC7 and

MHI shall jointly review the additional submitted plans for new inspection item.

6.4 The main activities for civil to be controlled on field are as follow:

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

*Survey

*Piling

*Earth Work

*UG Piping Work

*Rebar

*Form Work

*Anchor Bolt and Embedded Items

*Concrete Material and Placing

*Paving and Road

*Drainage/Trench Work

*Pits & Pool

*Fence Work

*Chemical Resistance Lining/Painting Work

*Roof

*Steel Structure Erection

*Fireproof Concrete Work

*Plumbing

*HVAC

*HVAC Electrical

The purpose of each individual ITP is to define and specify the required level of

Quality Control for the involved work main steps and related involvement of

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

concerned parties, the above list may not be exhaustive and could be added to in

consideration of Project Control needs, additionally method statements, ITP

check/punch lists could and will be utilized as necessary.

6.5 Any deviations or exceptions to any of the inspection and test points of the ITP

shall be resolved, agreed and approved by CC7's QA/QC departmen

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

7. INSPECTION FLOW

Inspected by CC7 and all Punch Closed

RFI Issued by CC7 engineer

Record by QA/QC Department

Rejected
Received by MHI/Owner

Inspected by CC7, MHI and Owner

Accepted, Signature and Stamp

Scanned and Saved

8. REQUEST FOR INSPECTION

8.1 The QA/QC department will collect the RFI prepared by all engineers and send it to

MHI and Owner. CC7 shall carry out inspection independently and close all punch

issued by CC7 before sending RFI to MHI and Owner.

8.2 Document no. of Request for Inspection (RFI) shall be controlled as following.
GPUFP-XX-XX-XXXX
① ② ③

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

① Area
Code Area Code Area
00 Common Area/System AM Ammonia Area/System
UR Urea Synthesis Area/System UG Urea Granulation Area/System
CO CO2 Recovery Area/System UT Utility Area/System
OF Offsite Area/System

② Work Code:
Code Description Code Description Code Description
CVS Civil Works BD Building IN Instrument
ME Mechanical EL Electric PA Painting
PI Piping IS Insulation FI Fire Proofing
TK Tank PR Pre-commissioning MI Miscellaneous

③ Serial No. 0001～9999

9. INSPECTION RECORD

QC inspector shall perform the inspection required to verify conformance. QC

inspector shall prepare and maintain the records of inspected items. Inspection records

shall as a minimum identify the following:

* Item tag, name and quantity

* No. of reference specification or drawing

* Date of inspection

* Name of inspector or operator

* Name of witness inspectors of the MHI and OWNER

* Type of inspection

* Registers number of measuring and test equipment or a data recorder used

* Results of acceptability or rejection

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

* Reference to information or action taken in connection with nonconformance (If any)

* Name of person evaluating results

Professional engineer and quality inspector shall evaluate the inspection results

against acceptance criteria to verify conformance of an item to the specific

requirements, and sign and date on the records for an acceptable item. For an

unacceptable item, Subcontractor shall re-inspect after solving the causes of un-

acceptance.

10. INSPECTION REPORT

10.1 Document Review Items

updated
10.1.1 All inspection stages which has QCF forms linked with it, CC7 QAQC shall

prepare the inspection records within one working day after the inspection.

10.1.2 Qualified CC7's Inspector shall evaluate the inspection records and certificates

against acceptance criteria to verify conformance of an item to specified

requirements.

10.1.3 Only for an unacceptable item, QC inspector or Construction Supervisor shall

immediately notify its reason to the Construction crews.

10.2 Inspection Report

10.2.1 Professional engineer shall prepare the inspection report of each inspection and

test item based on Inspection and Test Plan.

10.2.2 Qualified CC7's Inspector shall file and maintain the approved inspection report.

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 Ghorasal Polash Urea Fertilizer Doc. No.
CC7-GF-QAC-
Project CVS-ITP-001-01
Inspection and Testing Plan Rev. No. 02
for Civil Works Rev. Date. 06.June.2021

11. INSPECTION AND TEST STATUS

11.1 QC inspector shall establish the control status of inspection and test with indicators

such as marking, stamps, tags, labels or records to the product of service that has

passed the required inspection and test, is released for next processing.

11.2 The procedure for identification established by Subcontractor should specify the

inspection authority responsible for putting or withdrawing identification, status

marks and indicators used.

11.3 QC Inspector/Construction Supervisor shall monitor to ensure that Construction

Teams shall implement the inspection and test status.

12. APPENDIX

The following appendices shall be formed form a part of this procedure.

ATTACHMENT 1：Request for inspection

ATTACHMENT 2：Request for Inspection Summary

ATTACHMENT 3：Inspection and Test Plan

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 REQUEST FOR INSPECTION

Ghorasal Polash Urea Fertilizer Project

Discipline: RFI No.:

Inspection Date:

Precise Unit/Location:

Discipline Inspection Activity

Civil Tank Material Alignment

Structural Painting/Coating Survey Grouting

Architectural Insulation Piling Cable Test

Building Control System Earth Work Loop Test

Electrical Fireproofing Concreting Site/Shop Visit

Instrumentation Safety Welding WQT

Mechanical Common Line Check New PQR

√ Piping Others Pressure Test Others

Noted:
If it is related, the “√”will be marked.
No Item No./Description Insp. Scope Area/ Location Date, Start Time Duration

Attachment Required

Inspection Checklist Survey Report Calibration Certificate Delivery order (DO)

IFC Drawing Test Report Vendor Manual Other
Results
Acceptable Acceptable with comments Not Acceptable
Signature
CC7 MHI BCIC Vendor/Other

Name

Position

Signature

Date

10 / 86
 Civil/Structure

Mechanical/Rotating
SUMMARY OF FIELD INSPECTION (DAILY BASIS)
Piping

Instrument

Project：Ghorasal Polash Urea Fertilizer Project Electrical

Date of Inspection: Sheet No.: of . Insulation/Painting/Fireproofing

Inspection Points
No. Items to Be Inspected Q’ty Area/Block Location Time Person in Charge Remarks
CC7 MHI BCIC 3rdP

Prepared by:
Date:

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
Survey
1.

Base Line & Boundary Transit, Steel

1.1 Control Survey All 1/10,00 0 ○ △ － FCV003
Corners Tape
10mm√s (S: Surveyed
1.2 Level Survey Elevation Level All ○ △ － FCV003
Distance, Km)
Transit, Steel
1.3 Construction Survey Location & Elevation All 1/10,000 & 10mm s ○ △ － FCV003
Tape & Level
As Per
1.4 Benchmarks Location & Elevation Transit 1/10,000 & 10mm s ○ ○ － FCV002
Requirements

2. Piling

Mill Sheet /Surface

2.1 Material Check Each Delivery Documents/Visual R R R FCV001
condition

2.2 Location Survey Setting Out All ±2.5 cm ○ △ － FCV003

2.3 Pile Placing Tension Load As per Drawing All Test Pile As per Drawing ○ ○ △ FCV004
D/4 or 10 cm Whichever
Location Steel Tape All ○ ○ － FCV003
Smaller
Penetration Testing
2.4 (Check Pile Welding Crackle or defect PT 10% Pile connected ○ ○ － Test Report
Joint)
Dynamic Test Bearing Capacity and As per Method FCV006 PDA
2.5 5% of work pile As per Method Statement ○ ○ －
(PDA) integrity Statement Test Report
Static Load Test
Bearing Capacity and As per Method As per pile Dia /
2.6 (compression / As per Method Statement ○ ○ － Test Report
integrity Statement Tension pile
Tension)
FCV005 Pile
Pile final position / D/4 or 10cm whichever Head Cut-off Pile
2.7 Location / Elevation Scale All ○ △ －
Pile Head Cut-off small / ±2.5 cm FCV007 As-Built
Record

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner

3. Earth Work

Purchased and 1 Test per

3.1 Atterberg limits ASTM D4318 L.L≦40% ○ ○ － Test Report
existing soil material 5,000m3
1 Test per
ASTM D4318 PI≦25% ○ ○ － Test Report
5,000m3
FCV008
3.2 Excavation Elevation Level Each Excavation ±1.5 cm ○ △ － Excavation
inspection
Fill, Backfill, 1 Test per Cohesive Soil
3.3 Material ASTM D4318 ○ △ － Test Report
Banking 5,000m3 L.L≦40%
1 Test per
ASTM D4318 PI≦25% ○ △ － Test Report
5,000m3
Min.1 Test per
Compaction (Under ASTM D1557, ≧9 5% Measured by FCV053
foundation or 1 ○ △ －
Foundations) 6938 RI(ASTM D6938) Compaction Test
Test per 200m2.
ASTM D1557, Test Above Compact Every FCV053
○ △ －
6938 Each Layer 150~300mm Compaction Test
Compaction (Other Than ASTM D1557, ≧90% Measured by FCV053
1 Test per 200m2 ○ △ －
Above) 6938 RI(ASTM D6938) Compaction Test
ASTM D1557, Test Above Compact Every FCV053
○ △ －
6938 Each Layer 150~300mm Compaction Test
FCV010
Finish Grade Elevation Level Every 400 m2 ±3 cm ○ △ － Backfilling
inspection
4. UG Piping Work
FCV008
Level of Excavated Final Bed level+ ≥
4.1 Excavation As per Drawing Every 24m ○ △ － Excavation
Bottom 150mm
inspection
FCV008
Random
Trench Width As per Drawing ≥pipe OD +400 mm ○ △ － Excavation
Position
inspection

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
ASTM D1557, 1 Test per Cohesive Soil
4.2 Pipe Bed Material ○ △ R Test Report
6938 5000m3 L.L≦40%
ASTM D1557, 1 Test per
PI≦25% ○ △ R Test Report
6938 5000m3
FCV003 Field
Level of Pipe Bed As per Drawing Every 24m ≥ -2.5cm ≤ 0cm ○ △ R
Survey
Compaction
ASTM D1557, ≥ 90% Measured by RI FCV053
*Compact Every Every 100m ○ △ R
6938 (ASTM D6938) Compaction Test
150~300mm
ASTM D1557, Test Above Compact every FCV053
○ △ R
6938 Each Layer 150~300mm Compaction Test
ASTM D1557, 1 Test per Cohesive Soil
4.3 Back filling Material ○ ○ R Test Report
6938 5000m3 L.L≦40%
ASTM D1557, 1 Test per
PI≦25% ○ ○ R Test Report
6938 5000m3
ASTM D1557, ≥ 90% Measured by FCV053
Back filling Compaction Every 100m ○ △ R
6938 RI(ASTM D6938) Compaction Test
ASTM D1557, Test Above Compact Every FCV053
○ △ R
6938 Each Layer 150~300mm Compaction Test
5. Rebar
Mill Sheet or
5.1 Rebar Quality Every Lot As per Drawing ○ ○ △ FCV001
Tensile Test
Each Foundation
5.2 Rebar Assembly Dia, Spacing Visual, Scale As per Drawing ○ ○ △ FCV011
and Structure
Splice, Anchorage Scale As per Drawing ○ ○ △ FCV011

Cover. Scale As per Drawing ○ ○ △ FCV011

6. Form Work
Each Foundation
Contact Surface Visual As per Drawing ○ ○ － FCV011
and Structure
Each Foundation
Dimension Scale As per Drawing ○ ○ － FCV011
and Structure

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner

7. Anchor Bolt and Embedded Items

Dia & Length Scale All As per Drawing ○ ○ － FCV012
Transit, Steel
Position (Anchor Bolt) All As per Drawing ○ ○ △ FCV012
Tape
Position (Embedded Transit, Steel
All ±2mm ○ ○ △ FCV012
Items) Tape
Top Elevation Level All ±0～+10mm ○ ○ △ FCV012

8. Concrete material and Placing

Manufacturer's
8.1 Concrete material Cement Every Lot - △ △ △ FCV001
Certificate
Aggregate ASTM C33 Every Lot ASTM C33 △ △ △ FCV001
Each Foundation
8.2 Concrete Pouring Compaction / Pouring Visual ACI 304 ○ △ △ FCV013
and Structure
Embedded Items Visual As per Drawing ○ △ － FCV013
Specified Finish Visual As per Drawing ○ △ － FCV013
Curing Visual ACI 308/318 ○ △ － FCV013
FCV014Concrete
Dimension Steel Tape ACI 117 ○ △ △
Pour Card
3
Every 110 m & FCV014Concrete
Slump ASTM C143 125mm～200mm ○ △ －
everyday Pour Card
Every 110 m3 & FCV014Concrete
Air Content ASTM C173 ≦2% ○ △ －
Everyday Pour Card
Every 110 m3 & FCV014Concrete
Compressive Strength ASTM C39 ≧Specified Strength ○ ○ △
Everyday Pour Card
Each Mix FCV014Concrete
Mix Proportion ASTM C94 As per Method Statement ○ ○ －
Design Pour Card
Surface Preparation ： FCV015Concrete
Concrete Protective
8.3 No Contaminants and Visual All As per Drawing ○ △ △ Protective
Coating
Laitance Coating
FCV015Concrete
Primer Application：
Visual All As per Drawing ○ △ △ Protective
Obtain clear sheen
Coating

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
FCV015Concrete
DFT: (to be verified with
Visual All As per Drawing ○ △ △ Protective
paint manufacture later)
Coating
9. Paving and Road
FCV003 Field
9.1 Subgrade Elevation Level Per 50m -5cm～+1cm ○ ○ ○
Survey
Transit, Steel FCV003 Field
Width Per 50m 0～5cm ○ ○ △
Tape Survey
ASTM D1557, ≧90% Measured by FCV053
Compaction Per 200 m3 ○ ○ ○
6938 RI(ASTM D6938) Compaction Test
ASTM D1557, Test Above Compact Every FCV053
○ ○ △
6938 Each Layer 150~300mm Compaction Test
ASTM D1883,
CBR / Plate Load Test ○ ○ △ Test Report
1196
Base Course and FCV003 Field
9.2 Elevation Level Per 50m -1.5cm～+1cm ○ ○ △
Sub-base Survey
Transit, Steel FCV003 Field
Width Per 50m 0～5cm ○ ○ △
Tape Survey
FCV003 Field
Thickness Level, Scale Per 50m 12mm～±0 ○ ○ ○
Survey
ASTM D1557, ≧95% Measured by FCV053
Compaction Per 200 m3 ○ ○ ○
6938 RI(ASTM D6938) Compaction Test
ASTM D1557, Test Above Compact every FCV053
○ ○ ○
6938 Each Layer 150~200mm Compaction Test
FCV003 Field
9.3 Surface Slope Level Per 25m ±5mm ○ ○ △
Survey
Transit, Steel FCV003 Field
Width Per 25m 0～5cm ○ ○ △
Tape Survey
FCV003 Field
Thickness Level, Scale Per 25m -5mm～±0 ○ ○ △
Survey
As Directed by
Material (Bitumen Type) As per Drawing Temp >500C, MC 70 ○ △ △ FCV001
MHI
9.4 Prime Coat
As Directed by
Application As per Drawing 0.8 to 1.2 Kg / m2 ○ △ ○ FCV016
MHI

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
Temp >1400C, Asphalt
Content -4.5% to 6.5%,
Material (Asphalt) As per Drawing Each Load ○ △ △ FCV001
Asphalt Wearing Asphalt Penetration
9.5
Course Grade- 60 - 100
96% of Marshal Density
Application As per Drawing Daily ○ △ ○ FCV016
Level Diff < 6mm
As Directed by
Material (Bitumen Type) As per Drawing Temp >750C, RC 250 ○ △ △ FCV001
MHI
9.6 Tack-Coat
As Directed by
Application As per Drawing 0.2 to 0.4 Kg / m2 ○ △ ○ FCV016
MHI
FCV017 Road
As Directed by Shoulder
9.7 Road Shoulder Material As per Drawing Max Size -75mm ○ △ －
MHI Inspection
Checklist
10. Drainage/Trench Work
Material Test Manufacturer's
10.1 Vendor Data Sheet Each Batch ○ △ － FCV001
Certificate Certificate
Survey and Setting Location of Point, FCV003 Field
10.2 Visual Each Location As per Drawing ○ △ －
Out Coord, Survey
FCV018 Drainage
Installation As Indicated in the Trench
10.3 Visual Each Location As per Drawing ○ △ －
Inspection Drawing installation
inspection

11. Pits & Pool

updated
As Per FCV019 Gravity
11.1 Leakage Inspection Leakage Retain Water As per Drawing ○ △ △
Requirements Leak Test

12. Fence Work

12.1 Materials Cement, Brick, etc. Document review Each Batch Certificate R R R FCV001

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 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner

Survey and layout Base Line & Boundary FCV003 Field

12.2 Total station All 1/10,000 & 10mm s ○ △ △
coordinates Corners Survey
FCV008
Excavation
Excavation and
12.3 Compaction& Elevation Visual All As per Drawing ○ △ △ inspection
Compaction
FCV010
Backfilling
FCV020
Dimensions and FCV021
Masonry/Plastering/ Visual/Measureme
12.4 Verticality /No All As per Drawing ○ △ △ FCV022 Coated
Coated Barbed Wire nt
defects/Tighten Barbed Wire
installation

12.5 Gate Installation Functionality Visual All As per Drawing ○ △ △ FCV023

FCV024 Final
12.6 Final walk down Completeness Visual Package No Outstanding Items ○ ○ ○ Inspection Report
for the fence
13. Chemical Resistance Lining/Painting Work

13.1 Material As per requirement Visual All Document/Certificate R R R FCV001

Roughness, Dustiness, FCV025 Metal

13.2 Surface Preparation Surface, and Visual All As per requirement ○ △ △ Surface
environment temperature Preparation
FCV026 Layer of
13.3 Layer of coating Thickness Thickness Gauge All As per requirement ○ △ △ Coating
Inspection Record
Bubbling, Inclusions (Of
FCV027 Coating
13.4 External appearance Foreign Objects) and Visual All As per requirement ○ ○ ○
Inspection Record
Mechanical Damages
14. Roof
updated and QCF changed
18 / 86
accordingly
 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
FCV028
Retaining and As Per
14.1 Waterproofing Leakage As per Drawing ○ △ ○ Waterproofing
Sprinkling Water Requirements
Leak Test Record
15. Steel Structure Erection
Quality Taking-Over of
As per Drawing/No
15.1 Fabricated Steel Mill Sheet /Visual All ○ ○ △ FCV001
damage
Materials at Site
Foundation Preparation
As per Method Foundation and Pad FCV003 Field
15.2 and Pad plate inspection All ○ △ －
Statement Elevation Survey
and level check
FCV055 Anti-
Anti-skidding Agent
updated skidding Agent
15.3 Anti-skidding Agent Visual As Per Specified ○ ○ －
Applying Applying
Inspection Record
FCV029 High
As per Method
High Strength Bolt Strength Bolt
15.4 Statement ASTM All Completely Tightened ○ △ －
Tightening Tightening
F2280
Inspection Record
As per Drawing FCV030Welding
15.5 Weld Connection All As per Drawing ○ ○ －
(Visual/UT) Inspection

Transit, Steel FCV031

15.6 Erection Tolerance All As per Table-1 ○ ○ －
Tape Level Plumbing Record

As per Method
15.7 Grouting Statement ASTM All Non-shrink Grouting ○ △ － FCV032 Grouting
C109/C348/C940
FCV033
No Damage/≧
15.8 Paint to Structure Visual/DFT All ○ ○ △ Structural Steel
Spec.(Thickness)
Checklist

16 Fireproof Concrete Work

19 / 86
 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner

Manufacturer's
16.1 Material Fire-proofing Coating Every Lot Certificate △ △ △ FCV001
Certificate
FCV034
Visual/ No Damage/≧
16.2 Fireproof Concrete Appearance/DFT All ○ ○ ○ Fireproofing
Measurement Spec.(Thickness)
Check List
17. Plumbing
FCV035
Visual/water
17.1 Plumbing Installation and Flushing All No Leakage ○ ○ ○ Plumbing
flushing
Checklist
FCV036 Pressure
17.2 Utility Leakage Pressure Test All No Leakage ○ ○ ○
Test Report
FCV037
17.3 Drain Leakage Full Water Test All No Leakage ○ ○ ○ Plumbing/Piping
System Leak Test
18. HVAC
FCV038 HVAC
18.1 Temperature Performance Test Each Room ±2℃ ○ ○ ○ Functional
Testing Checklist
Air Volume Performance Test Each Room ≧Design Air Volume ○ ○ ○ FCV038
FCV039
Duct, Damper, Installation/Testin
18.2 Installation As per Drawing All Connection ○ △ －
Diffuser g of HVAC
Accessories
FCV040
Refrigerant
18.3 Refrigeration piping Installation As per Drawing All Pressure Test ○ △ － Piping Layout and
Support
Installation
FCV041 Indoor &
Indoor & Outdoor
18.4 Installation As per Drawing All Stability ○ △ － Outdoor Unit
Unit
installation
Visual Inspection/ FCV042 HVAC
18.5 Exposure Test Installation Insulation or All Leakage Property ○ △ － Duct work
Exposed Duct Testing
20 / 86
 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
FCV043
18.6 Ventilation Installation As per Drawing All Stability ○ △ － Ventilation
Installation
FCV044
Insulation of
Insulation for
18.7 Installation As per Drawing All Defect & Gap Free ○ △ － HVAC Ducts
Ducting & Piping
Pipes and
Equipment
Testing & Air Balance & FCV045 HVAC
18.8 Operation As per Drawing All ○ △ －
Commissioning Performance Inspection Record
19. HVAC Electrical updated and QCF added accordingly
FCV048 Control
and Relay Panels
Inspection
HCP, HPDP
19.1 Installation As per Drawing All Performance ○ △ － Checklist
Installation Check
FCV049 Power
Panel Inspection
Checklist
FCV046 Cable
Cabling & Tray
19.2 Installation As per Drawing All Performance ○ △ － Installation
Installation Check
Checklist
FCV046 Cable
Cable Termination Arrangement, Wire
19.3 As per Drawing All Performance ○ △ － Installation
Inspection Marking & Termination
Checklist
FCV047
Insulation
Insulation
Resistance Test and
19.4 Resistance & Continuity As per Specified All Performance ○ △ － Resistance Test
Continuity
and Continuity
Inspection
Inspection
FCV056 Voltage
Voltage and Phase
19.5 Voltage & Phase As per Specified All Performance ○ △ － and Phase Check
Check
Record
FCV038 HVAC
19.6 Function Test Function As per Specified All Performance ○ △ － Functional Check
List
21 / 86
 Test & Witness Requirement
Tolerance or Check
No. Work Category Quality Control Item Inspection Frequency Report
Point
Method CC7 MHI Owner
Prepared by (CC7): Approved by (MHI): Approved by (OWNER): Rev. No.& Date: R: Review
○: Every Time
△: Discretion
―: None

22 / 86
 Ghorasal Polash Urea Fertilizer Project (GPUFP)

updated
Project GPUFP

Quality Control Forms List ITP No. 6488C AA80-000-00-00100

Inspection Stage Civil Works

No. QCF No. Description Rev. Remark

1 FCV001 Material Receiving Report (MRR) 0

2 FCV002 Survey Report (Benchmarks) 0

3 FCV003 Site Survey Report (Civil Works) 0

4 FCV004 Pile Driving Inspection Record 0

5 FCV005 Pile Head Cut-Off 0

PDA Field Operation Process Control
6 FCV006 1
Record
7 FCV007 Pile As-Built Record 0

8 FCV008 Excavation Inspection 0

9 FCV009 Soil Density Test Log 0

10 FCV010 Backfilling Inspection 0

11 FCV011 Reinforcing & Formwork Inspection 0

12 FCV012 Anchor Bolt / Embedded Inspection 0

13 FCV013 Concrete Inspection Record 0

14 FCV014 Concrete Pour Card 0

15 FCV015 Concrete Protective Coating 0

16 FCV016 Asphalt Concrete Compaction 0

17 FCV017 Road Shoulder Inspection (Civil Works) 0

18 FCV018 Drainage Trench Installation Inspection 0

19 FCV019 Gravity Leak Test 0

20 FCV020 Masonry Work (Building Finishing) 0

21 FCV021 Plastering Work (Building Finishing) 0

Coated Barbed Wire Installation
22 FCV022 0
Inspection
Windows and Doors Work
23 FCV023 0
(Building Finishing)
Final Inspection Report for The Fence
24 FCV024 0

25 FCV025 Metal Surface Preparation 0

23 / 86
26 FCV026 Layer of Coating Inspection Record 0

27 FCV027 Coatings Inspection Record 0

28 FCV028 Water Proofing Leak Test Record 0

High Strength Bolt Tightening
29 FCV029 0
Inspection Record
30 FCV030 Welding Inspection 0

31 FCV031 Plumb Record 0

32 FCV032 Grouting 0

33 FCV033 Structural Steel Inspection 0

34 FCV034 Fireproofing Check List 0

35 FCV035 Plumbing Checklist 0

36 FCV036 Pressure Test Report 0

Plumbing/Piping System Leak Test
37 FCV037 0
(Building Works)
38 FCV038 HVAC Functional Test Checklist 0

39 FCV039 Installation/Testing of HVAC Accessories 0

Refrigerant Piping Layout and Support
40 FCV040 0
Installation
41 FCV041 Indoor & Outdoor Unit Inspection 0

42 FCV042 HVAC Duct Work Testing 0

43 FCV043 Ventilation Installation Checklist 0

Insulation of HVAC Ducts Pipes and
44 FCV044 0
Equipment
45 FCV045 HVAC Inspection Record 0

46 FCV046 Cable Installation Checklist 0

Insulation Resistance Test and
47 FCV047 0
Continuity Inspection
Control and Relay Panels Inspection
48 FCV048 0
Checklist
49 FCV049 Power Panel Inspection Checklist 0

50 FCV050 Compression/Tension Field Data Sheet 0

51 FCV051 Lateral Field Data Sheet 0

PIT Field Operation Process Control
52 FCV052 0
Record
53 FCV053 Compaction Test 0

54 FCV054 Trial compaction 0

Anti-skidding Agent Applying
55 FCV055 0
Inspection Record
56 FCV056 Voltage and Phase Check Record 0

24 / 86
 GPUFP Material Receiving Report(MRR)
FCV001
PROJECT ◇PHOTOGRAPH◇

MRR No. MRR-M0001 Witness

Package No. P5002-0572 CC7's BCIC

Date 2020/10/27 Subcon

Material Condition:

[ü ] No Issue

Create MER, if material is as follows:

[ ] Packing opened at customs clearance

[ ] Packing damaged before arrival at site

[ ] Packing damaged after arrival at site

[ ] Shortage

[ ] Over

[ ] Others
( )

MRR No. MRR-M0002 Witness

Package No. P5002-0557 CC7's BCIC

Date 2020/10/27 Subcon

Material Condition:

[ü ] No Issue

Create MER, if material is as follows:

[ ] Packing opened at customs clearance

[ ] Packing damaged before arrival at site

[ ] Packing damaged after arrival at site

[ ] Shortage

[ ] Over

[ ] Others
( )
25 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV002 Rev.0
Survey Report RFI No.
(Benchmarks) Report No.
Report Date
Inspection Checklist, Specification, Or Drawing Used as Reference:
Results: Follow-up Required  Satisfactory 
Description of Item/Work Inspected/Observed:
Written Measured Calculated Identify Failures
FDN Typed Standard Value (A)
Value (B) Deviation (A-B) Results
Northing
Easting
Elevation
Northing
Easting
Elevation
Northing
Easting
Elevation
Northing
Easting
Elevation
Northing
Easting
Elevation
Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

26 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage: Area/Location

Form No. FCV003 Rev.0
Site Survey Report RFI No.
(Civil Works)
Report No.
Report Date
Work Scope
□ Site Preparation □ Piling
□ Road and Paving □ Drainage
□ Earth Work □ Fence and Gate
□ Concrete □ Structural Steel
□ Building □ Landscape
□ Other Works:
Reference Document / Equipment
1 Drawing No. Rev. No.
2 Specification Rev. No.
3 Survey Instrument Model Serial. No.
4 Calibration Validity Date
Document list
No. Survey Item Item Description Remarks
1
2
3
4
Comments:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

27 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV004 Rev.0
Pile Driving Inspection Record RFI No.
Report No.
Report Date
Pile Data Hammer Data Design data
Drawing No./Rev. Make Working Load
Pile No. Model Required Blows
Type of Pile Stroke Driving formulas
Dia.(Top) Type Drop Height
Pile
Dia.(Tip) Ram weight
Size
Length Rated Energy
Casting Date(Age) Action
Driving Record
Date & Time(Start) Grade(Elev) Cut-Off(Elev/Length)
Pile
Date & Time(Stop) Last 10 Blows(Actual)
Top(Elev)
Pile Tip Last 10 Blows(max as per
Weather Condition
(Elev) set calculation)
Depth Blows per Drop Depth Blows per Drop Depth Blows per Drop
(m) Meter Height (m) Meter Height (m) Meter Height

Splicing Data
Result
No. Inspection Item Specification Remarks
Accept Reject
1 Splice Joint Cleaning Piling specification Joint Type：
2 Welding Joint(Visual) AWS D1.1 Welder No：
3 Splice Painting/Coating Piling specification
Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date

28 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV005 Rev.0
RFIN No.
Pile Head Cut-Off Report No.
Report Date
Pile Data Hammer Data Design Data
Drawing No./Rev Make Working Load
Type of Pile Model Required Blows
Manufacturer Stroke Driving Formula
Driving Record
Point Cut-off
Last Blow
S/N Pile No. Size Date Driven Coordinates Elevatio Elevatio Remarks
Count
n n

signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

29 / 86
 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Form No. FCV006 Rev. 1.

PDA Field Operation Process Control Record RFIN No.

Report No.
Report
Date
Test instruments Type specifications Number
Pile type Pile diameter Date of detection
Inventory Design Strength of Pile
description Concrete
Pile length at
Pile number Pile length
measuring point
Height(m) Drop distance(m)
hammer
Area(m2) Material
Lifting mode Number of hits
Accelerometer1 Strain gauge1 Accelerometer2 Strain gauge2
Sensor Number

Remarks:
Pile length at
Pile number Pile length
measuring point
Height(m) Drop distance(m)
hammer
Area(m2) Material
Lifting mode Number of hits
Accelerometer1 Strain gauge1 Accelerometer2 Strain gauge2
Sensor number

Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date

30 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV007 Rev.0.
Pile As-Built Record RFIN No.
Report No.
Report Date
Reference Document / Equipment
1 Drawing No. Rev. No.
2 Survey Instrument Model Serial No.
3 Calibration Validity Date
Coordinate
No. Pile No. Design(A) Actual(B) Difference Remarks
meter meter C=B-A mm
N
1
E
N
2
E
N
3
E
N
4
E
N
5
E
Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

31 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV008 Rev. 0
RFIN No.
Excavation Inspection Report
No.
Report
Date
Inspection ACC REJ Remarks
A. Preparation
1. Survey and marking completed?
2. No existing facility is anticipated on the area to be excavated.
Where such adjacent or interfering facility or UG exist, proper
measures are observed to carefully carry-out excavation works.
B. During Excavation
1. Excavation is clear of foreign and loose material?
2. Excavation conforms to Design Drawings (Dimension, grade, elevation, etc).

3. Slopes shored and suitable sheeting provided as necessary?

4. Over excavation at footings are treated as per specification?
5. Where dewatering may be required, ensure that system
components are adequate to collect and discharge water away
from excavation.
C. FINAL CHECK
1. Final elevation or bottom of excavation graded to the
elevation and configuration as per related drawing?
2. Unstable soil in the slope is removed and slope properly prepared?
3. Marking/Flagging of open excavation provided?
4. Soil Density Test performed as required?
Comments:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

32 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage Area/Location
Form No. FCV009 Rev. 0
Soil Density Test Log RFIN No.
Report No.
Report Date
Test Results
Density Test No. Date Placement Represented
Result 1 ACC REJ Result 2 ACC REJ

33 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV010 Rev. 0
RFIN No.
Backfilling Inspection
Report No.
Report Date
Inspection ACC REJ Remarks
A. Preparation
1 Fill material is clean and conforms to requirement?

2. Area to be backfilled if clear of water, trash, and other foreign

debris?

B. During Backfilling/Compaction
1. Moisture control is properly carried-out as per current weather
Condition (if any)?
2. Fill and backfill layer (lift thickness) are uniformly compacted?

3. Fill and backfill in areas adjacent to structure, facility, piping,

Condition(if any)?

4. Compaction equipment used is suitable to the entire lift and fill

material being compacted?
C. Final Check

1. Final elevation or compacted surface graded to the elevation and

configuration as per related drawing?

2. Soil Density Test performed as required?

Remarks:

Signature

CC7 MHI BCIC

Name

Dept.

Signature

Date

34 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage: Area/Location

Form No. FCV011 Rev.0
RFI No.
Reinforcing & Formwork Inspection
Report No.
Report Date
Reference Dwg No.:
Inspection Item Tolerance Actual ACC REJ Remarks
Formation surface Condition As per Dwg.
Formation Level As per Dwg.
Layout As per Dwg.
Size Check As per Dwg.
Joint Check As per Dwg.
Reinforcing
Cover Check 0-10
Spacing ±10
Size(Concrete) 0-10
Chamfer As per Dwg.
Formwork Cleanliness Visual
Support Visual
Verticality
Template
Insert Plate
Clean Out As per Dwg.
Proposed finish level
Comments:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

35 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage: Area/Location

Form No. FCV012 Rev.0
RFI No.
Anchor Bolt / Embedded Inspection
Report No.
Report Date
Foundation Type:
Design Value Actual Value
Check Item Tolerance ACC REJ Remarks
(Mm) (Mm)

Comments:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

36 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV013 Rev. 0

Concrete Inspection Record RFIN No.

Report No.

Report Date

Location (coordinates):
Orientation:
Elevation:

Description ACC REJ Remarks

1. Verify form work, Construction and Control Joints

2. Verify rebar and covering, consolidation
3. Verify grounding/earthing
4. Verify embedment in place i.e. pipes, conduits
5. Verify anchor bolts fixed, measured and greased taped off
Material certificates checked, if applicable
6. Verify template (vessels, columns)
7. Verify weather protection
8. Verify curing duration and finish
9. Verify design mix
10. Verify test cube taken. Amount:
11. Patching/Pointing
12. Saw cut joints, Install joint sealant
13. Application if hardeners or dust proofing
14. Pour date
15. Formworks remove date:
16. Pour accepted

Signature
CC7 MHI BCIC

Name

Dept.

Signature

Date

37 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage: Area/Location

Form No. FCV014 Rev.0

Concrete Pour Card RFI No.

Report No.
Report Date
Planning Information
Originator Date
Pour Number Cu. Meters
Location Elevation
Design Mix Placing Temperature
Required Finish/Curing Air Content
Special Instructions Slump
Pre-Pour Release
Civil Date
Mechanical Date
Electrical Date
Survey Date
Quality Control Date
Pour
Weather：
Placement Started Date Time
Placement Completed Date Time
Cu. Meters Placed
Remarks:

Signature
CC7 MHI BCIC

Name

Dept.

Signature

Date

38 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV015 Rev. 0
RFIN No.
Concrete Protective Coating Report No.
Report Date
Description ACC REJ Remarks
1. Verify Surface Preparation ：No Contaminants and Laitance
2. Verify The primer application meets the requirements
3. Verify DFT meets the requirements

Note：

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

39 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV016 Rev. 0
Asphalt Concrete Compaction RFIN No.
Report No.
Report Date
Reference Document
1 Drawing No. Rev. No
2 Location Road No.
Test Items
Date: Type Mixture:
Location of Sample: Sample # of Test:
Contractor: Sample # of Standard:
Required Compact: % SP gr of Standard:
Degree of Compaction = Pavement Sp gr × 100= % Compaction
Standard Specimen Sp gr
Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

40 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV017 Rev. 0
Road Shoulder Inspection RFIN No.
(Civil Works) Report No.
Report Date
Drawing No. Rev. No.
Inspection Items ACC REJ Remarks
1. Materials used for Miscellaneous work conform to specs
2. Compaction of grade prior to installation
3. Alignment/Levelness
4. Compaction of grade prior to installation
5. Alignment/Levelness (No Sagging)
6. Sloping followed as per drawing
7. Shoulder surface finished as per drawing
8. Marking carried-out as per related Drawing
9. Signs installed as per related Drawing
10. Drain installed as per related Drawing
11. Joints sealed as per requirement
Notes:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

41 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV018 Rev. 0
Drainage Trench Installation Inspection RFIN No.
Report No.
Report Date
Drawing No.
Line No.
No. Inspection Items ACC REJ Remarks
1 Sub-grade, compacted, Elevation is acceptable
2 Drainage/Trench slope & Top-Level checking As per Drawing is
done
3 Cleanliness in Drainage/trench- Cracked boulders debris removed
etc.
4 The catch pit already completed as per requirements.

Notes:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

42 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV019 Rev. 0
Gravity Leak Test RFIN No.
Report No.
Report Date
Drawing No.
Specification
Static Head Pressure: Holding Time:
Test Medium : Time Start: Time Finish:
Result
No. ISO No.
ACC REJ

Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

43 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV020 Rev. 0
Masonry Work RFIN No.
(Building Finishing) Report No.
Report Date
No. Item/Location Description Material Alignment Staggering Jointing Mortar Ratio
/Application ACC/REJ Remarks
A. Brick Work
1
2
3
4
5
B. Concrete Work
6
7
8
9
10
C. Other
11
12

Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

44 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV021 Rev. 0
Plastering Work RFIN No.
(Building Finishing)
Report No.
Report Date
No. Item/Location Description Surface Layer Interval Mortar Ratio Surface ACC/REJ Remarks
Preparation /Application Finish
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

45 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV022 Rev. 0

Coated Barbed Wire Installation Inspection RFIN No.

Report No.

Report Date

Drawing No.

Line No.

Description ACC REJ Remarks

1. Verify Masonry work is completed

2. Verify Fastening structure is preparation

3. Verify coated barbed wire Installation completion

4.

5.

Note：

Signature

CC7 MHI BCIC

Name

Dept.

Signature

Date

46 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV023 Rev. 0
Windows and Doors Work RFIN No.
(Building Finishing) Report No.
Report Date
No. Item/Location Description Installed to Product Surface Hardware Glazing ACC/REJ Remarks
Drawing Quality Finish
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

47 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage: Area/Location
Form No. FCV024 Rev.0
RFI No.
Final Inspection Report for The Fence
Report No.
Report Date
Drawing No.:
Item Inspection/Verification Checkpoints ACC REJ Remarks
1 Materials are in accordance with Design Documents.
2 All Non-conformance Reports are closed.
3 Walkdown is complete.

Remarks:

Signature
CC7 MHI OWNER
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

48 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV025 Rev. 0
RFIN No.
Metal Surface Preparation
Report No.
Report Date
Description ACC REJ Remarks
1. Verify weld areas for removal of weld flux, spatter, slivers and
other foreign objects.
2. Verify All oil & grease contamination have be removed.
3. Check whether the surface roughness meets the requirements.
4. Shall be carried out such that the surface being coated is free of
moisture, wind-borne or cleaning dust.
5. The ambient temperature and humidity meet the requirements.
Note：

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

49 / 86
 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Layer of Coating Inspection Record Form No. FCV026 Rev. 0

RFI No.
Report No.
□Primary Coat □intermediate Coat □Final Coat Report Date

Ambient Condition Confirmation

Pipeline No./
Painting System
Mechanical No.

Checking Date Air Temperature, ℃

Relative Humidity, % Application Method □Brush □Roller □Spray

Paint Information

Paint Manufacturer Brand Name

Paint Identification Date of Manufacture

Batch No. Term of Validity

Painting Application

□Dry Film Thickness Required Value Actual Value

□ACC □REJ
□Wet Film Thickness
mm mm

Remarks:

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 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV027 Rev. 0

Coatings Inspection Record RFIN No.

Report No.

Report Date

Type Object: Item Description of Check ACC REJ Remarks

□ Piping 1. Coating by approved manufacturer
□ Structural Steel 2. Surface preparation value
□ Equipment 3. Surface dry-free from condensation
4. Paint mixed, thinned and applied in
□ Tank Exterior accordance with manufacturer’s
specification
□ Tank Interior □ Brush □ Spray □ Roller
Object Location: 5. Primer in accordance with specification
□ Outdoors 6. Finish coat is acceptable
□ Indoors 7. Workmanship acceptable
Mon Tues Wed Thurs Fri Sat
Conditions:
AM PM AM PM AM PM AM PM AM PM AM PM
Relative humidity %
Substrate Temperature
Ambient Temperature
Dew Point
Batch No
Brand name Paint Coat No. FT Application Method DFT Average
A Base A Base

Signature
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Date

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 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV028 Rev. 0
RFIN No.
Water Proofing Leak Test Record
Report No.
Report Date
Leak Test Planning Information
Originator : Date
Location :
Request Holding Time : Leak Test Medium:
Leak Testing
Leak Test Started Time Leak Test Started Time Leak Test Started Time
Leak Test Completed Time Leak Test Completed Time Leak Test Completed Time
Comments:

Signature
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Name
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Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

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 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV029 Rev. 0
High Strength Bolt Tightening RFIN No.
Inspection Record
Report No.
Report Date

Work Name Location No./Device No.

Related Drawing No.

Torquing Wrench No. Calibration to:

Range of calibration Torturing Value

Axial Force of Bolt

1 2 3 4 5 Average Value Judgement

□ACC □REJ

Axial Force Criterial for Bolt (Average) Unit: Kg

Size of Bolts Grade of Bolts Normal Temperature (10~30℃) Abnormal Temperature (0~60℃)

M16 S10T 110~133 106~139

M20 S10T 172~207 165~217

M22 S10T 212~256 205~268

M24 S10T 247~298 238~312

M27 S10T 322~388 310~410

M30 S10T 394~474 397~496

Remarks:

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Signature
Date

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 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV030 Rev. 0
Welding Inspection RFIN No.
Report No.
Report Date
Items ACC REJ Remarks
1. Welds approved by welding inspector
2. Field coatings checked
3. Fireproofing inspections and tests complete
4. Final inspection complete

Comments：

Signature
CC7 MHI BCIC
Name
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Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

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 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV031 Rev. 0

Plumb Record RFIN No.

Report No.

Report Date

Equipment Used Serial No. Calibration date

Inspection Item Results
Item Description
ACC REJ
01 Correct dimension and size
02 Match of member
03 Correct grade & length of bolts
04 Correct size & bolts condition
Correct Installed the Beam and
05 bracing alignment, diagonal to meet
the required elevation.
Actual Vertical Actual Horizontal Results
Height Allow. Tolerance
Column No Reading (N/S) Reading(E/W)
(mm) (mm) ACC REJ
(mm) (N/S-Direction) (mm)

Remarks:

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55 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV032 Rev. 0
Grouting RFIN No.
Report No.
Report Date
Work Scope
□ Steel Structure (Equipment Structure, Piperack, Sleeper) □ Cooling Tower
□ Tower, Vessel, Exchanger □ Heater, Boiler, Stack
□ Air Fin Cooler □ Tank
□ Pump, Blower □ Electrical/Instrument Support/Frame
□ Compressor, Turbine □ Pipe Support
□ Other Item:
Grouting Checklist
Check Items ACC REJ Remarks
1. Proper watering of foundation carried-out.
2. Foundation to be grouted has been chipped properly as required?
3. Grouting material/mixture and type is as per project specs?
4. Proper tapering has been carried-out as per project specs?
5. No significant cracks observed after grouting works?
6. Vendor requirement regarding grouting of equipment has been
properly followed?
Comments：

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date
Picture as evidence during inspection
Before Grouting After Grouting

Picture 1 Picture 2 Picture 3 Picture 4

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 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV033 Rev. 0

Structural Steel Inspection RFIN No.

Report No.

Report Date

Inspection Item ACC REJ Remarks

1. Structural elements (main structure, bulkheads, decks, platforms/

walkways, grating, roof)- installed and checked against drawings

2. Structural elements - plumb, level, aligned

3. All structural supports installed per design and all temporary aids/
brackets removed

4. All temporary aids/ brackets/ steel removed

5. Anchor bolt nuts tight

6. Column base grouted

7. Bolted connections checked

8. Welded connections checked

9. Stairs, handrails, ladders, floor plates in place and per design

10. All penetrations installed, with sleeves/ kick plates of specified
size complete with drain holes as required
11. All welding and NDT work completed and cleared

12. Coatings applied; touch-up complete

Notes:

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57 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV034 Rev. 0

Fireproofing Check List RFIN No.

Report No.

Report Date

Drawing No.

Check items ACC REJ Remarks

Structural steel installation is completed

Surface preparation is to spec.

Remarks:

Signature

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Signature

Date

58 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV035 Rev. 0

RFIN No.
Plumbing Checklist
Report No.

Report Date

Inspection Item ACC REJ Remarks

Verify the use of correct plumbing materials

1. Sanitary waste and vent system

2. Acid waste and vent system

3. Potable water system

4. Instrument air system

5. Plumbing fixtures and equipment

Verify plumbing installation per design documents

6. Hangers and supports

7. Piping

8. Joints

9. Valves

10.Fixtures

11.Hydrotesting

12.Correctness to codes, regulations

Notes:

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Date

59 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV036 Rev. 0
Pressure Test Report RFIN No.
Report No.
Report Date
Test Package No.： Description:
P. &I.D. No.(s) R P. &I.D. No.(s) R P. &I.D. No.(s) R P. &I.D. No.(s) R

ISO No. Sht. R ISO No. Sht. R ISO No. Sht. R

Test Condition
Test Medium Chlorine Content
Test Media/Metal Temp Min. Max. Actual
Ambient Temp. Min. Actual
Test Pressure Min. Max. Test Pressure Min. Max.
Holding Time: Min. Actual
Test Gage M.T.E. Date Last Test Gage Low High
Number: M.T.E. Calibrated: Range: Low High
CC7 MHI BCIC
Signature Date Signature Date Signature Date
Pre-Test Walkdown Complete:
NDE, PWHT, PMI (if required)
Complete/Accepted:
Verification of Satisfactory Test Results
Verification of Line Restoration
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

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 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV037 Rev. 0
Plumbing/Piping System Leak Test RFIN No.
(Building Works) Report No.
Report Date
Work Scope
□ Plumbing □ Down Pipe
□ Drainpipe □ Other
Test Method
Test Medium Test Pressure Duration Remarks
□ Leak Test
□ Full Water Test
□ Flow Test
□ Ball Test
□ Other
Check List
Inspection ACC REJ Remarks
B. Leak/Full Water Test
1.Joint sealing and other requirements completed.
2.Leak test carried-out as per above method and result is acceptable
3.Drain out completed as necessary.
4.Cleaning of internal is carried-out satisfactorily after test.
5.Protection/cover provided (temporary or permanent) as precaution.
(Check if cover may be required to be installed for open ends)
C. Flow or Ball Test
1.Sealing and other required works completed
2.Flow direction is as per requirement
3.No blockage observed along the flow path
4.Cleaning of internal is carried-out satisfactorily after test.
5. Protection/cover provided(temporary or permanent) as precaution.
(Check if cover may be required to be installed for open ends)
Remarks:

Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date

61 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV038 Rev. 0
RFIN No.
HVAC Functional Test Checklist
Report No.
Report Date
No. Description ACC REJ Remarks
1 Specified equipment installed in accordance with
manufacturer’s drawings and specifications.
2 Blowers/Fan/Ventilators working properly
3 Electrical/Instruments
4 Filters are cleaned and free of damage
5 Heating/Cooling Temperature measured and tested
6 Dryers are working properly
7 Compressor functioning properly
8 Outdoor/Indoor unit operational
9 Thermostat functioning
10 Drain pan and connection
11 Dampers working properly
12 Duct supports installed per specifications.
13 Balancing and adjusting completed and controls systems
adjusted.
14 Ceiling diffusers checked.
15 Systems checked for completeness
16 Controls and switches in working condition
17 Unit vibration control
18 CFM of Unit maintained as per required capacity and space
19 Measured & record flow
20 Check proper operation of humidifier
21 All the connection to unit installed
22 Check full load appears (FLA) as per manufacture required.

Remarks:

Signature
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Name
Dept.
Signature
Date
62 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV039 Rev. 0

Installation/Testing of HVAC Accessories RFIN No.

Report No.

Report Date

No. Description ACC REJ Remarks

1 Check the material is as per approved drawing

2 Check the support are properly fixed and level as per drawing

3 Check the material free from damages

4 Check the connection of the duct and duct accessories are

properly clipped or sealed
5 Ensure the nameplate/identification tags of the equipment as per
requirement
6 Check the installation as per manufacturer recommendation
Volume dampers shall be located a minimum of two duct sizes
7
away from fittings
Branch ducts with a minimum length of 2 equivalent duct
8 diameters, shall be required for all diffusers, registers and
grilles direct attachment to main duct not allowed.
9 All fan wheels shall be statically and dynamically balanced in
accordance with AMCA Standard 204-05.
10 Ducts shall be terminated at the fire damper sleeves or the
damper frames.
Testing

1 Check the equipment working properly

2 Ensure the item is free of damages

Remarks:

Signature
CC7 MHI BCIC

Name

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Signature

Date
63 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV040 Rev. 0
RFIN No.
Refrigerant Piping Layout and Support
Installation Report No.
Report Date
No. Description ACC REJ Remarks
1 All duct work completed &connections sealed properly
2 Check search light required powered (min 500 watts)
3 Light test should be done proper darkness
4 Duct entire surface free of debris and dust
5 Duct leak test method
6 Duct leak test conducted and find : Accepted/Rejected
7 Check smoke fan housing proper fixed.
8 Identify ductwork section to be tested.

9 Check ductwork Section proper sealed / Seal All Openings (except

one )
10 Check Pressurize ductwork to specified level
11 Check & Measure flow required to maintain duct pressure
12 Check % of Flow requirements

13 Function test Blower with speed control (VFD) to generate range

of pressure/flow
14 Pressure instrument (manometer) is celebrated
15 Check smoke generator Maximize & minimum Flow Range
16 Calculates Leakage rate based on duct square feet input

Signature

CC7 MHI BCIC

Name

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Signature

Date

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 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV041 Rev. 0

Indoor & Outdoor Unit Inspection RFIN No.

Report No.

Report Date

Inspection Item ACC REJ Remarks

1. Verify nameplate data.

2. Verify preservation integrity.

3. Verify foundation and foundation bolts meet specified

requirements.

4. Verify installation tolerance have been met.

5. Verify grouting meet specifications.

6. Verify all internals are correctly installed.

7. Verify all shipping devices have been removed.

8. Verify all vents, drains, instrument connections, etc., are installed

in accordance with equipment trim isometrics.

9. Verify alignments of piping connections are correct.

10.Verify coating system meets specified requirements.

11.Verify insulation meets specified equipment.

12.Verify prior to final closing for internal cleanliness.

13.Verify all ladders, platforms, stairways, and walkways are

correctly
Notes:

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Signature

Date

65 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage：

Area/Location

Form No. FCV042 Rev. 0

HVAC Duct Work Testing RFIN No.

Report No.

Report Date

Inspection Item ACC REJ Remarks

1. All duct work completed &connections sealed properly
2. Check search light required powered (min 500 watts)
3. Light test should be done proper darkness
4. Duct entire surface free of debris and dust
5. Duct leak test method
6. Duct leak test conducted and find
7. Check smoke fan housing proper fixed.
8. Identify ductwork section to be tested.
9. Check ductwork Section proper sealed / Seal All Openings
(except one)
10.Check Pressurize ductwork to specified level
11.Check & Measure flow required to maintain duct pressure
12.Check % of Flow requirements
13.Function test Blower with speed control (VFD) to generate range
of pressure/flow
14.Pressure instrument (manometer) is celebrated
15.Check smoke generator Maximize & minimum Flow Range
16.Calculates Leakage rate based on duct square feet input
Notes:

Signature
CC7 MHI BCIC

Name

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Signature

Date

66 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV043 Rev. 0
RFIN No.
Ventilation Installation Checklist
Report No.
Report Date
Equipment Description:
Drawing No.
Specification No.
Vendor Drawing No.
Inspection Item ACC REJ Remarks
1. Assembly
2. Orientation
3. Elevation
4. Shimming and Grouting
5. Final Alignment and Rotation
6. Bolting and Anchoring
7. Instrumentation
8. Insulation
9. Protection
10.Cleaning, Lubrication, Adjustment, Packings
Vessel Internals Check
Item No. Horizontal & Plumb Tightness All Parts Operable Cleanliness Remarks

Signature
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Name
Dept.
Signature
Date
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 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV044 Rev. 0

Insulation of HVAC Ducts Pipes and RFIN No.

Equipment
Report No.

Report Date

No. Description ACC REJ Remarks

Check the insulation materials are in accordance with
1 the approved material for types, thickness ,density and
finish

2
Ensure all material are free from damages, debris and
dust

3
Ensure all material is stored properly in dry condition and
dust free

4
Check the insulation is applied in accordance with the
approved MS and drawing details

5
Check the insulation is correctly aligned, lapped and
adequately bonded
6 Check the vapor sealing has been correctly applied
7 Check the vapor seal around the support and anchor
8 Check the field applied jacket is properly done
9 Duct joints shall be sealed prior to insulation.

Exterior insulated ductwork shall be provided with

10 aluminum jacketing manufactured in accordance with
ASTM B209/B209M.

Signature

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Name

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Signature

68 / 86
Date

69 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage：
Area/Location

Form No. FCV045 Rev. 0

HVAC Inspection Record RFIN No.

Report No.

Report Date

No. Inspection/Verification Checkpoints: ACC REJ Remarks

1 Materials are in accordance with Design Documents.

2 Air conditioning checklist complete.

3 Internal accessories complete.

4 Leak testing complete.

5 Temporary blank-offs removed.

6 Connections between duct and equipment complete/acceptable.

7 All Non-conformance Reports are closed.

8 Walkdown is complete.

9 Other Inspection/Verification Activities performed as follows:

Remarks:

Signature

CC7 MHI BCIC

Name

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Signature

Date
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 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV046 Rev. 0

Cable Installation Checklist RFIN No.

Report No.

Report Date

Cable No.

Drawing No.

Verify the following are acceptable ACC REJ Remarks

1. Cable length adequate

2. Cable preparation proper

3. Termination lug correct Size/type

4. Crimping tool correct

5. Permanent cable I.D. correct

6. Terminals torqued in accordance with specification

7. Wire size, type, and color correct

8. Correct polarity of conductors

Comments：

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Signature

Date

71 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV047 Rev. 0

Insulation Resistance Test and Continuity RFIN No.

Inspection Report No.
Report Date

Tag Description Tag No.

Test Equipment Test Voltage

Related Drawing No.

Panel No. Wire or Cable Insulation

Wire Cable Rated
Circuit No. Resistance Initials
Tagging Voltage
Feeder No. Quantity Size From To (Megohms)*

Signature
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Signature

Date

72 / 86
 QUALITY CONTROL FORM

Inspection / Test Stage： Area/Location

Form No. FCV048 Rev. 0

Control and Relay Panels Inspection RFIN No.

Checklist Report No.
Report Date
Inspection Items ACC REJ Remarks
1. Panel ground wire installed
2. Internal cooling fan
3. Forced ventilation
4. Nameplates complete
5. Internal device labels complete
6. Terminal strips labeled
7. NEMA construction (I, 3R, etc.) of enclosure
8. Field wire markers complete
9. Unused knockouts plugged
10.Convenience outlet phased
11.Internal lighting complete
12.Floor entrances sealed
13.Touch up painting completed

14.Annunciator wiring bundled and formed to allow removal of a single

print wiring without shutdown. Future points are not blocked.

Comments:

Signature
CC7 MHI BCIC

Name

Dept.

Signature

Date

73 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage： Area/Location
Form No. FCV049 Rev. 0

Power Panel Inspection Checklist RFIN No.

Report No.
Report Date
Inspection Items ACC REJ Remarks
1. Remote trip installed
2. Panel directory complete
3. All nameplates complete
4. Ground bus installed
5. Ground bus tied to plant ground grid
6. All mechanical interlocks operational
7. Unused knockouts plugged
8. Floor anchors installed
9. Grouting complete
10.Touch up painting complete
Provide the data and complete the following:
1. Incoming Feeder Size
2. Main Disc. or Fuse Rating
3. Vertical Bus Rating
4. Vertical Bus Type
5. Megger at 1000V
6. Megger at 1000v Ground
7. Feeder Fuse Type

Comments:

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74 / 86
 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Form No. FCV050 Rev. 1.
Compression/Tension Field Data Sheet RFIN No.
Report No.
Report
Date
Pile ID
Jack Type specifications ID
□Pressure gauges □Pressure sensors Type ID
Displacement sensor
Type specifications ID
□Percentage
Calibration coefficient for jacks
P(MPa)=( )*F(kN)+( )
(pressure sensors);
Series 1-2 3 4 5 6 7 8 9 10
Load (kN)
Equipment status Inspector / Date
Type of test Single pile Test load（kN）
Pile type Pile diameter (mm)
Design Strength of
Test pile status Pile length (m)
Pile Concrete
Test elevation Status of pile head
□Anchor pile reaction device
Reactive devices
□Reactive device for load (pressurizing platform)

Remarks: The above form column is filled out according to the actual situation, if not, draw "/"
Signature
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Dept.
Signature
Date
75 / 86
 QUALITY CONTROL FORM
Inspection / Test Stage Area/Location
Form No. FCV051 Rev. 0
Lateral Field Data Sheet RFIN No.
Report No.
Report Date
Pile ID: Regression Equation:
Testing Type: Lateral Load Test Test Method: Dial of Pile: Pile Type: Length:
Dial of Piston(cm): Area of Piston(cm2): Design Load(KN): Max Test Load(KN):
Test Starting date: Test Completion Date: Max Settlement(mm): Net Settlement(mm):
Casting Date: Date of Calibration: Dial Gauge(M1)= Dial Gauge(M2)=
Load Observed Actual Settlement
% of Design Load on Test Time Interval Cumulative Average of Actual
Date Application Pressure M1 M2 Remarks
Load Pile(KN) (Min) Time(Min) Settlement(mm)
Time (Mpa) (mm) (mm)

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 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Form No. FCV052 Rev. 1.

PIT Field Operation Process Control Record RFIN No.

Report No.

Report Date

Test Type Design Strength of Pile Concrete

Pile diameter Design pile length

Total number of piles Number of piles tested

Treatment of pile head

Testing instruments Type specifications Number

Coupling
Sensor Model Specifications Number
agent
Equipment status Inspector / Date

Data Storage Directory

Detecting piles and abnormal description

Remarks：

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Signature

Date

77 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV053 Rev. 0
Test Date
Compaction Test
RFI No.
Report No.
Report Date
Test method
Equipment
Wet Density Moisture Dry Density Max. Dry Density Compaction
No. Test Position
(g/cm3) Rate(%) (g/cm3) (g/cm3) (%)

Remarks:

CC7 MHI BCIC

Name
Dept.
Signature
Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

78 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV054 Rev. 0
Test Date
Trial compaction
RFI No.
Report No.
Report Date
Test Qty. 1 2 3
h1
h2
Depth(mm)
(h1+h2)/2
Moisture Rate (%)
Test Item Design Value Actual Value
L.L
Critical Moisture Rate P.L.
P.I.
Max. Dry Density (g/cm3) —
Values
Optimum Moisture Rate (%) —
Remarks:

L.L.: Liquid Limit P.L.: Plastic Limit P.I.: Plastic Index

Name Dept.
Signature Date
Picture as evidence during inspection

Picture 1 Picture 2 Picture 3

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 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Anti-skidding Agent Applying Form No. FCV055 Rev. 0

Inspection Record RFI No.

Report No.

Report Date

Location/Area

Related Drawing No.

Component No.

No. Item to Check Result Remark

No Welding Slag, Foreign Material is Observed from Friction

1 □ACC □REJ □N/A
Surface and Roughness of Friction Surface Accepted
Anti-skidding Agent Shall be Shaken and Stirred before
2 □ACC □REJ □N/A
Application

3 Temperature of Friction Surface Shall be Less Than 60℃ □ACC □REJ □N/A

Anti-skidding Agent is Spread on the Surface Uniformly and

4 □ACC □REJ □N/A
the Thickness of Application is in the Range of 0.1~0.2mm.

Note: In principle, no metallic luster shall be observed after one time application. If there is still metallic
luster on the sprayed surface, please spray the part once more.

Comments:

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80 / 86
 QUALITY CONTROL FORM

Inspection/Test Stage: Area/Location

Form No. FCV056 Rev. 0
Voltage and Phase Check Record RFI No.
Report No.
Report Date

Tag Description Tag No.

Circuit No. Related Drawing

No. Verify the following are acceptable in accordance with design documents: Result Remark

1 Cable size type, location, installation and routing

2 Cable bend radius is as specifications and cable jacket free of kinks

Cable termination supports and support spacing is as drawings and
3
Specifications
4 Cable installation neat and evenly spaced

5 Cable free of surface damage

6 Termination Kit/Materials installed is as Manufacturer’s instructions

7 Document DC High Potential Test (hypot)

Cable Terminated is as equipment manufacturer’s instructions, including
8
torquing of bolted connections.
Left to Right

9 Check phase location and marking: Top to Bottom

Front to Rear
Comments:

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81 / 86
 QUALITY CONTROL FORM
Inspection/Test Stage: Area/Location
Form No. FCV057 Rev. 0
Functional Test Checklist RFI No.
Report No.
Report Date
Location Area System No.

Related Drawing No.

No. Description of Item to be Checked Result Remark

Specified equipment installed in accordance with manufacturer’s
1
drawings and specifications.
2 Blowers/Fan/Ventilators working properly
3 Electrical/Instruments
4 Filters are cleaned and free of damage
5 Heating/Cooling Temperature measured and tested
6 Dryers are working properly
7 Compressor functioning properly
8 Outdoor/Indoor unit operational
9 Thermostat functioning
10 Drain pan and connection
11 Dampers working properly
12 Duct supports installed per specifications.
13 Balancing and adjusting completed and controls systems adjusted.
14 Ceiling diffusers checked.
15 Systems checked for completeness
16 Controls and switches in working condition
17 Unit vibration control
18 CFM of Unit maintained as per required capacity and space
19 Measured & record flow
20 Check proper operation of humidifier
21 All the connection to unit installed
22 Check full load appears (FLA) as per manufacture required.
Signature
CC7 MHI BCIC
Name
Dept.
Signature
Date

82 / 86