Replacing TSE Transmission Lines From Manfouha Pump Station To Al-

Project Title ‫اﺳﻢ اﻟﻤﺸﺮوع‬ Project No. ‫رﻗﻢ اﻟﻤﺸﺮع‬

Haier And Dirab , And Linking Them To Existing Facilities
Client ‫اﻟﻤﺎﻟﻚ‬ Saudi Irrigation Organization Contract No. ‫رﻗﻢ اﻟﻌﻘﺪ‬
Fouad Al Saleh & Khaled Al Dhowalia Co.Enviromental Engineering
Consultant ‫اﻹﺳﺘﺸﺎري‬ Site No. ‫رﻗﻢ اﻟﻤﻮﻗﻊ‬
Consultants
Contractor ‫اﻟﻤﻘﺎول‬ Zahran Maintenance and Operation
IR Number
L4-STATION1980-STATION2080-RFI-4
‫ر ﻗ ﻢ ﻃ ﻠ ﺐ ا ﻟ ﻤ ﻌﺎﻳ ﻨ ﺔ‬
IR Issue Date
2023-12-28 08:37:48
‫ﺗﺎرﻳ ﺦ ر ﻓ ﻊ ﻃ ﻠ ﺐ ا ﻟ ﻤ ﻌﺎﻳ ﻨ ﺔ‬
Request For Inspection Form (RFI) Date of Inspection
‫ﻧ ﻤ ﻮ ذ ج ﻃ ﻠ ﺐ ﻣ ﻌﺎﻳ ﻨ ﺔ‬ ‫ا ﻟ ﻤ ﻮ ﻋ ﺪ ا ﻟ ﻤ ﻄ ﻠ ﻮ ب ﻟ ﻠ ﻤ ﻌﺎﻳ ﻨ ﺔ‬ 2023-12-28
‫) ) ا ﻟ ﺘﺎرﻳ ﺦ‬
Time of Inspection
‫ا ﻟ ﻤ ﻮ ﻋ ﺪ ا ﻟ ﻤ ﻄ ﻠ ﻮ ب ﻟ ﻠ ﻤ ﻌﺎﻳ ﻨ ﺔ‬ 09:30:00
‫))اﻟﻮﻗﺖ‬
The PMO is notified for the WORK INSPECTION of the following: ‫ﻳﺘﻢ إﺧﻄﺎر إدارة اﻟﺒﺮﻧﺎﻣﺞ ﺑﻔﺤﺺ اﻟﻌﻤﻞ ﻟﻤﺎ ﻳﻠﻲ‬
Submitted By Fouad Al Saleh & Khaled Al Dhowalia Co.Enviromental
Zahran Maintenance and Operation To: ‫ إﻟﻰ‬:
‫ﺗ ﻢ ا ﻟ ﺘ ﻘ ﺪﻳ ﻢ ﻣ ﻦ ﻗ ﺒ ﻞ‬ Engineering Consultants

Discipline ☐ Geotechnical
‫ﺟﻴ ﻮﺗ ﻘﻨ ﻲ‬
☑ Survey ‫ﻣﺴﺎﺣﺔ‬ ☐ Civil/Str. ‫إﻧﺸﺎﺋﻲ‬/‫ﻣﺪﻧﻲ‬ ☐ Architectural ‫ﻣﻌﻤﺎري‬
‫اﻟ ﺘ ﺨ ﺼ ﺺ‬

☐ Electrical ‫ﻛﻬﺮﺑﺎء‬ ☐ Mechanical ‫ﻣﻴﻜﺎﻧﻴﻜﺎ‬ ☐ Landscape ‫ﻻﻧﺪ ﺳﻜﻴﺐ‬ ☐ Other ‫ﻏﻴﺮ ذﻟﻚ‬

Description of Work
‫و ﺻ ﻒ ا ﻷ ﻋ ﻤﺎ ل‬ ‫ دﻛﺘﺎﻳﻞ ﻣﻦ‬600‫ اﺳﺘﻼم ﻗﺎع اﻟﺤﻔﺮ ﻟﻠﻤﻮاﺳﻴﺮ ﻗﻄﺮ ال‬ST 2040 - ST 1980
‫ا ﻟ ﺘ ﻲ ﺳ ﻴ ﺘ ﻢ ﻣ ﻌﺎﻳ ﻨ ﺘ ﻬﺎ‬

Location ‫ﻣﻜﺎن اﻟﻤﻌﺎﻳﻨﺔ‬ Block No ‫رﻗﻢ اﻟﻤﺒﻨﻲ‬ Level ‫اﻟﻄﺎﺑﻖ‬ Element to be inspected ‫اﻟﻌﻨﺎﺻﺮ اﻟﻤﺮاد ﻣﻌﺎﻳﻨﺘﻬﺎ‬ Attachments ‫اﻟﻤﺮﻓﻘﺎت‬

4 ‫ ﺧ ﻂ‬- ‫ ﺧ ﻂ رﺋ ﻴ ﺴ ﻲ‬- ‫دﻳ ﺮ ا ب‬ STATION1980-STATION2080

Contractor’s Site Engineer ‫)ﻣﻬﻨﺪس اﻟﻤﻮﻗﻊ )اﻟﻤﻘﺎول‬

Signature ‫اﻟ ﺘ ﻮ ﻗ ﻴ ﻊ‬ Date 2023-12-28 ‫ا ﻟ ﺘﺎرﻳ ﺦ‬
Name khaled saied ‫اﻻ ﺳﻢ‬

Checked By Contractor’s QA/QC Engineer

‫ﺗ ﻢ ﻓ ﺤ ﺺ ا ﻷ ﻋ ﻤ ﺎ ل ﻣ ﻦ ﻗ ﺒ ﻞ ﻣ ﻬ ﻨ ﺪ س ﺿ ﻤ ﺎ ن و ﻣ ﺮ ا ﻗ ﺒ ﺔ اﻟ ﺠ ﻮ د ة ﻟ ﻠ ﻤ ﻘ ﺎ و ل‬ ☑ YES ‫ﻧﻌﻢ‬ Signature ‫اﻟﺘﻮﻗﻴﻊ‬
Is the work ready for PMO’s Inspection
‫ﻫ ﻞ ا ﻷ ﻋ ﻤ ﺎ ل ﺟ ﺎ ﻫ ﺰ ة ﻟ ﻤ ﻌ ﺎ ﻳ ﻨ ﺔ إ د ار ة اﻟ ﺒ ﺮ ﻧ ﺎ ﻣ ﺞ‬
Name khaled saied ‫اﻻ ﺳﻢ‬ ☐ No ‫ﻻ‬

☐ Geotechnical
‫ﺟﻴ ﻮﺗ ﻘﻨ ﻲ‬
☑ Survey ‫ﻣﺴﺎﺣﺔ‬ ☐ Civil/Str. ‫إﻧﺸﺎﺋﻲ‬/‫ﻣﺪﻧﻲ‬ ☐ Architectural ‫ﻣﻌﻤﺎري‬

Response of
Consultant’s ☐ Electrical ‫ﻛﻬﺮﺑﺎء‬ ☐ Mechanical ‫ﻣﻴﻜﺎﻧﻴﻜﺎ‬ ☐ Landscape ‫ﻻﻧﺪ ﺳﻜﻴﺐ‬ ☐ Other ‫ﻏﻴﺮ ذﻟﻚ‬
Engineer ‫رد ﻣﻬﻨﺪس‬
‫ا ﻻ ﺳ ﺘ ﺸﺎر ي‬
Inspection done
As per profile excavation levels are ok

☑ Approved
‫ﻣ ﻮا ﻓ ﻘ ﺔ‬
☐ Approved as Noted
‫ﻣ ﻮ ا ﻓ ﻘ ﺔ ﻣ ﻊ ﻣ ﻼ ﺣ ﻈﺎ ت‬
☐ Revise and Resubmit
‫ﻣ ﺮ ا ﺟ ﻌ ﺔ و إ ﻋﺎ د ة ﺗ ﻘ ﺪﻳ ﻢ‬
☐ Rejected
‫ﻣﺮﻓﻮ ض‬
Inspected by Consultant’s Authorized Person ‫ﺗﻤﺖ اﻟﻤﻌﺎﻳﻨﺔ ﻣﻦ ﻗﺒﻞ اﻟﺸﺨﺺ اﻟﻤﺨﻮل ﻣﻦ ﻗﺒﻞ‬
‫ا ﻻ ﺳ ﺘ ﺸ ﺎر ي‬ Approved by Consultant’s Project Engineer ‫ﻳﻌﺘﻤﺪ ﻣﻦ ﻗﺒﻞ ﻣﻬﻨﺪس اﻟﻤﺸﺮوع ﻟﻼﺳﺘﺸﺎري‬

Name: ‫ﻋ ﻤﺎ د اﻟ ﺪﻳ ﻦ ﺷﺎ ﻫ ﺪ‬ ‫اﻻ ﺳﻢ‬ Name: ‫ا ﺣ ﻤ ﺪ ﻧ ﺒ ﻴ ﻞ اﺑ ﻮ ﻏ ﺮﺑ ﻴ ﺔ‬ ‫اﻻ ﺳﻢ‬

Signature ‫اﻟ ﺘ ﻮ ﻗ ﻴ ﻊ‬ Signature ‫اﻟ ﺘ ﻮ ﻗ ﻴ ﻊ‬

Date 2023-12-31 ‫ا ﻟ ﺘ ﺎر ﻳ ﺦ‬ Date 2023-12-31 ‫ا ﻟ ﺘ ﺎر ﻳ ﺦ‬

Received By Contractor
Name ‫اﻻ ﺳﻢ‬ Date ‫ا ﻟ ﺘﺎرﻳ ﺦ‬ Signature ‫اﻟ ﺘ ﻮ ﻗ ﻴ ﻊ‬
‫ﺗ ﻢ ا ﻻ ﺳ ﺘ ﻼ م ﻣ ﻦ ﻗ ﺒ ﻞ اﻟ ﻤ ﻘ ﺎ و ل‬

Approval of items does not relieve the contractor from his obligation to comply with the requirements of the contract’s plan and
‫اﻟ ﻤ ﻮا ﻓ ﻘ ﺔ اﻟ ﻤ ﺘ ﻀ ﻤ ﻨ ﺔ ﻓ ﻲ ﻫ ﺬا اﻟ ﻨ ﻤ ﻮ ذ ج ﻻ ﺗ ﻌ ﻔ ﻲ اﻟ ﻤ ﻘ ﺎ و ل ﻣ ﻦ اﻟ ﺘ ﺰا ﻣ ﻪ ﺑ ﺎ ﻻ ﻣ ﺘ ﺜ ﺎ ل ﻟ ﻤ ﺘ ﻄ ﻠ ﺒ ﺎ ت ﺧ ﻄ ﺔ اﻟ ﻌ ﻘ ﺪ‬
Note: project specification. ‫ﻣﻼﺣ ﻈﺔ‬
‫ ﻳ ﻘ ﻮ م ﻣ ﻤ ﺜ ﻞ ا ﻻ ﺳ ﺘ ﺸ ﺎ ر ي ﺑ ﺎ ﺳ ﺘ ﻼ م اﻟ ﻄ ﻠ ﺐ و ﺗ ﻮ ﻗ ﻴ ﻌ ﻪ وإ ﻋ ﺎ د ة ﻧ ﺴ ﺨ ﺔ وا ﺣ ﺪ ة إﻟ ﻲ اﻟ ﻤ ﻘ ﺎ و ل‬. ‫و ﻣ ﻮا ﺻ ﻔ ﺎ ت اﻟ ﻤ ﺸ ﺮ و ع‬
Consultant’s Representative is to acknowledge receipt by signing and returning one copy to the Contractor

Rev001

‫ ﻧﻈﺎم ادارة اﻟﻤﺸﺎرﻳﻊ‬- 2024 © ‫ﺷﺮﻛﺔ ﻓﺆاد اﻟﺼﺎﻟﺢ وﺧﺎﻟﺪ اﻟﻀﻮﻳﻠﻊ ﻟﻺﺳﺘﺸﺎرات اﻟﻬﻨﺪﺳﻴﺔ و اﻟﺒﻴﺌﻴﺔ‬ L4-STATION1980-STATION2080-RFI-4