Submittal Transmittal Detailed, Grouped by Each Number
LC3 (R-15-085-BF-0)
Project # RUH-CP-1502
Tel: Date:
Fax:
3/8/2016
Transmitted To:
Reference Number: 0483
Hadi Omar Harb SSEM P.O. Box 6341 Al Rashid Tower, Tower, 5th Floor Floor Al Ma'athar Ma'athar Street 11442 Riyadh Tel: 4625511 Fax: 4627804
Transmitted By:
Qty
Submittal Package No
Description
1
0120 - 013300 - D1 - 1
Method Statement for Formworks, Rebars, Cast-In-Situ Concrete(Pouring, Embedments, Curing)
Due Date
Transmitted For
Delivered Via
Action
Package Action
Reviewed Exceptions Noted
Tracking Number
Hand
Items
Qty
Description
001
1
Method Statement for Formworks, Rebars, Cast-In-Situ Concrete(Pouring, Concrete(Pouring, Embedments, Curing)
Cc:
Paul Teague AECOM P.O. Box 58806 4 Floor, Tower 4, Tatweer Tower 11515 Riyadh Tel: Fax:
Company Name
Notes
Contact Name
Item Action
Reviewed - Exceptions Noted
Copies
Notes
Remarks
Reviewed Exceptions Noted, Resubmission Required. 1. Please see attached. Best Regards,
Signature Prolog Converge
Printed on: 3/9/2016
Prolog KKIA
KINGDOM KINGDOM OF OF SAUDI ARABIA
G ENERAL ENERAL AUTHORIT AUTHORITY O F CIVIL C IVIL AVIAT AVIA TION C O NSTRUCTION RUCTION O F LO LO AD C ENTER -3
Signed Date Page 1
KINGDOM KINGDOM OF OF SAUDI ARABIA
G ENERAL ENERAL AUTHORIT AUTHORITY O F CIVIL C IVIL AVIAT AVIA TION C O NSTRUCTION RUCTION O F LO LO AD C ENTER -3 M ETHOD HO D ST STA TEMENT EM ENT FOR FO R FO RMWO RM WORKS RKS,, REBA RS, RS, C A ST-IN-SITU C O NC RETE (PO URING, URING , EM EM BEDM BEDMENT ENTS, C URING) URING)
First
Rev.
A
Iss Issue
Date Da te::
B
17.01.1 17.01.16 6
18.02.16 18.02.16
C ONTRACT RACT #: R-15-085-BF-0 DOC DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
METHOD STA STA TEMENT FOR FORMWORKS, REBARS, CAST-INSI CA ST-INSITU TU CONCRETE (POURING, EMBEDMENT EMB EDMENTS, S, CURING) 1.The page header shall also include KKIA logo in the following sequence from left to right - GACA, KKIA, AECOM AECOM & SSEM. SSEM. SSEM may opt to place their company logo below the first three mentioned logos. 2.All appendices shall also show the correct (current) logos of GACA, KKIA and AECOM accordingly.
Project Quality Manager: Manager:
ENGR. Amr Ibrahim Metwally
Project Manager: Manager :
ENGR. HADI OMAR HARB
Page 1 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
CONTRACT#: R-15-085-BF-0
B
DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
18.02.16
Table of Contents 1.0
Purpo se ………………………………………………………………… ………………..03
2.0
Sco pe …………………………………………………………………………………….. 03
3.0
References and Standards …………………………………………………………… 03
4.0
Abb revi atio ns /Defini tio ns ……………………………………………………………..04
5.0
Work Progr am …………………………………………………………………………...04
6.0
Equip ment ………………………………………………………………………………..04
7.0
PPE Materials …………………………………………………………………………… 05
8.0
Manpow er Sch edule …………………………………………………………………… 05
9.0
Respon si bil it ies of Key Person nel ………………………………………………….. 06
10.0
Conc reti ng Method olo gy ………………………………………………………………07
11.0
Quali ty Requir ements …………………………………………………………………. 12
12.0
Health and Safety ……………………………………………………………………….13
Ap pen di ces Ap pen di x 1.0- Job Ris k As ses sm ent ………………………………………………..15 Ap pen di x 1.1- Carpen try Wor ks ……………………………………………………...15 Ap pen di x 1.2- Form wo rk s …………………………………………………………… 17 Ap pen di x 1.3- Steel Cut ti ng and Ben di ng …………………………………………. 19 Ap pen di x 1.4- Conc ret e Work s ……………………………………………………….21 Ap pen di x 2.0- Related ITP ……………………………………………………………. 23 Ap pen di x 3.0- Check li st ………………………………………………………………. 25 Ap pen di x 4.0- Prof or ma Wor k Perm it ……………………………………………….27
Page 2 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
1.0
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
PURPOSE The purpose of this method statement is to provide description of procedure and method for the execution of for construction of reinforced concrete structure, the LC-3 Building and related structures. This include the fabrication/installation of formworks and reinforcing bars, the pouring of cast in situ concrete, and repair of newly casted concrete. As well as the necessary materials to ensure health and safety of employees with the requirement stipulated in the Contract Documents, as well as those in Saudi Construction Specifications (ASTM and SASO-ISO)
2.0
SCOPE This method statement covers the task related to construction of reinforced concrete building. This include but is not limited to : raft or strip foundations, retaining walls, columns, girders, suspended and slab on grade, concrete duct banks, manholes, other equipment supports and foundation.
3.0
REFERENCES AND STANDARDS Construction of reinforced concrete building will be in accordance with the following standards: 3.1 Saudi Arabia Construction Specification. 3.2 Employers requirements, Materials Specification 3.3 Approved with Comments (AWC) design and construction drawings. 3.4 ACI-117 3.5 ACI-318 3.6 ACI-347R 3.7 ACI-304R 3.8 ACI-305R 3.9 ASTM-C39 3.10 SASO SSA2 3.11 SASO SA 224
Page 3 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
4.0
5.0
First
Rev.
Issue
Date:
A
B
17.01.16
18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
ABBREVIATION/DEFINITION PM
Project Manager
PQP
Project Quality Plan
QIP
Quality Inspection Plan
QA&QC
Quality Assurance & Quality control
MS
Method Statement
PPE
Personal Protective Equipment
HSE
Health, Safety & Environment
PPE
Personal Protective Equipment
ECO
Environmental Control Officer
CR
Construction Regulation
EMP
Environmental Management Plan
OHSA
Occupational Health and Safety Act
SO
Safety Officer
EO
Environmental Officer
WORK PROGRAM Construction of the building comprise of: 5.1 Two level building with floor area approximately 5,500 sq. m. 5.2 Construction of generator room, 1500 sq. m. with individual support for the equipment. 5.3 Control room area with provision for LV and MV- panel controls. 5.4 Construction of duct banks for the associated power, communication, waterlines and plumbing lines.
6.0
EQUIPMENT The contractor (SSEM) will provide the following equipment throughout the project, quantities will be determined by actual site demand. Equipment will be inspected prior to mobilization and shall hold valid insurance certificates, as well as certified/competent operators.
Page 4 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A
CONTRACT#: R-15-085-BF-0
B
17.01.16
DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
18.02.16
Type of Equipment Concrete Transit mixers Concrete Pumps Portable Concrete Vibrator Boom trucks Water Truck Bar Benders Bar Cutters Circular Saw (Table Type) Portable electric grinders Portable electric jigsaws Misc. hand tools
Units (No.) Depend on conc. volume 1 2 1 1 2 2 2 4 4 1 lot
Table I. Equipment Intended for Concrete constr uction works. 7.0
PPE MATERIAL S Personal Protective Equipment (PPE) should be provided in order to perform all works in accordance with the safety procedures and taking into consideration the importance of proper preventive measures to ensure safety in the performance of work. Type of Equipment Safety Helmet Safety Boots/Shoes Safety Glasses Safety Masks Coveralls High Visibility Vests Hand Gloves Fall Arrester Safety Harness Table II. Person al Protect ive Equipment Intended fo r Concrete Constru ctio n Works.
8.0
MANPOWER The workforce including foremen, operators, and technicians shall be well qualified with third party certificates wherever applicable/relevant.
Subcontractors for different trades shall be deployed depending on demand, to cover up shortfalls and to cope up with the construction schedule.
Page 5 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
CONTRACT#: R-15-085-BF-0
B
DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
18.02.16
CONTRACTOR (SSEM) Construction Manager Site Engineer QC- Engineers Surveyor Safety Engineers Civil Foreman Carpenters Steel fixers Mason Scaffolders Equipment Operators Safety officers Flagmen First Aider Laborers Table III. Manpow er for Concrete Constru ctio n Works. 9.0
RESPONSIBILITIES OF KEY PERSONNEL 9.1
Constr ucti on Manager The Construction Manager will plan and expedite for the continuous supply of resources to cope up with the project demand and schedule. The construction manager will keep record of the progress of work. He will report to the project manager on matters affecting completion of project. He will give direct orders to the site engineer for the effective implementation of work program.
9.2
Site Engin eer The Site Engineer will be in charge for the supervision and implementation of all concrete construction works as required in the specifications and drawing, especially in giving orders to Site foremen. Site engineer is also in charge for the preparation of daily, weekly and monthly reports. He will coordinate with the QC-engineer on matters concerning Inspection request and attend to final inspection together with SSEM QC-engineer and the owners’ Engineer.
Page 6 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
9.3
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Quality Contro l Engineer The QC Engineer will be responsible for compliance of work to the reference contract drawings, specifications and other QA/QC conditions required by The Engineer. He will monitor daily activities and notify concerned parties when works deviates from the standard. He will issue proactive notification when needed to prevent non-compliance works.
9.4 Site Foreman The Site Foreman will be in charge for the supervision and implementation of various stages of concrete construction works, as instructed by the Site engineer. He will be responsible for the execution of works in compliance to approved drawing and contract specifications. Foreman shall also keep record of all work schedules, work production and daily safety issues. 9.5
Site Surveyor The Site Surveyor will be in charge for the setting out for building corners, elevation and make the vertical/horizontal reference at site. He will stake out for lines and elevations of underground utilities construction and will prepare reports for excavation and backfilling works.
10.0 CONCRETING METHODOLOGY 10.1 Sequence of Work The following are the sequence of work in the construction of Cast-in Situ Concrete: 10.1.1
Fabrication and installation of form works.
10.1.2
Fabrication and installation of steel reinforcements.
10.1.3
Installation of anchor bolts, block-outs and other embedment to concrete when needed.
10.1.4
Form closure and installation of supports
10.1.5
Pouring of ready mix concrete.
10.1.6
Preparation of concrete sample specimen for testing purposes.
10.1.7
Finishing and curing of concrete.
10.1.8
Stripping of formworks.
10.1.9
Repair of minor concrete imperfection.
Page 7 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
10.2 Formworks 10.2.1
Forms shall be substantial and sufficiently tight to prevent leakage of mortar from the concrete. Contractor shall use sufficient nailing, bolting, welding, shoring, whalers, form clamps and forming of adequate strength to contain the fluid concrete without noticeable deflection, leaning or bulging
10.2.2
Forms shall be properly braced or tied together to maintain position and shape. Forms shall be built to resist the pressures to which they will be subjected and to limit deflections to a practicable minimum within the specified tolerance.
10.2.3
Formwork shall be anchored to the shores below so that movement of any part of the formwork system will be prevented during concreting
10.2.4
Block outs, inserts, sleeves, anchors, water stops and other embedded items shall be properly identified, positioned and secured in the forms to resist all forces while concrete is being placed and hardens.
10.2.5
Old forms shall be thoroughly cleaned of all dirt, mortar and foreign matter and coated with a release agent before each use.
10.2.6
A polyethylene sheet shall be placed beneath and around the sides of concrete that is placed against soil where bitumen or coal tar epoxy cannot be applied.
10.2.7
A polyethylene sheet, minimum 0.15mm thick, shall be placed beneath slabs on grade and other concrete structure when shown in the drawing.
10.2.8
Water stops shall be provided in joints where watertight construction is required. Location and type of water stops shall be as shown on construction drawing.
10.2.9
Expansion joint filler strips shall be made from fiber board securely bound together by a suitable asphaltic binder.
10.2.10 Well trained manpower shall be deployed as the height of formworks increases. 10.2.11 Erecting formwork frames should be erected in a progressive manner to ensure both the installers safety and the stability of the overall structure. 10.2.12 Braces should be attached to the frames as soon as practical. As erecting the frames continues, designated access ways should be indicated by using bunting or by other means. 10.2.13 Provide the side bracing or other edge protection is installed progressively and as soon as enough material has been raised up.
Page 8 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
10.2.14 Framing is carried out in accordance with on-site design documentation and manufacturers’ instructions. 10.3 Steel Reinfo rc ements 10.3.1
Forms shall be inspected and checked before the reinforcing steel is placed to the dimensions and locations on the structural plans.
10.3.2
The minimum concrete cover shall be measured from the outer most rebar (tie bar), that shall be provided for reinforcement of cast-in-place concrete structures as indicated in the drawings.
10.3.3
Reinforcing steel rebar shall be correct in size, quantity, layout, spacing, position as per the contract drawing
10.3.4
Reinforcing Steel lap splice lengths for each bar size shall be as detailed for each size as shown on the Contract Drawings.
10.3.5
Welding of reinforcement shall not be allowed unless authorized by The Engineer or called for specifically on the Contract Drawings.
10.3.6
Provide necessary and safe scaffolding / platform as the height increases for steel reinforcement installation.
10.3.7
Dowel bars and anchorage shall be as per approved drawing and specifications and be maintained whenever necessary.
10.3.8
All reinforcement must be cleared to ensure that it is free from oil, dust and deleterious materials.
10.4 Anch or bolt s and Embedded Items 10.4.1
Anchor bolts and embedded items shall be set accurately, using templates.
10.4.2
Anchor bolt projection above the top of concrete is computed as follows: Single Nuts: Thickness of grout + thickness of base plate (or height of anchor bolt chair above the top of grout) + 1.5 x diameter of anchor bolt. Double Nuts: Thickness of grout + thickness of base plate (or height of anchor bolt chair above the top of grout) + 2.5 x diameter of anchor bolt.
Page 9 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A
B
17.01.16
18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
10.5 Form Closur e Inspectio n 10.5.1
Reference markers shall be installed on the formwork shores to detect formwork movements during concreting
10.5.2
Wedges used for final alignment before concrete placement shall be secured before placing concrete.
10.5.3
Formwork shall be anchored to shoring to prevent any movement of any part of the formwork during concreting.
10.5.4
Closure of form joints, settlement of blinding slabs, shrinkage of lumber, elastic shortening and deflections of form members shall all be countered prior to concrete placement.
10.6 Conc rete Pouring 10.6.1
Concrete pouring shall be done after pre-placement inspection and authorization to proceed by The Engineer.
10.6.2
Temperature, slump of ready mix concrete shall be checked upon arrival at site.
10.6.3
Experienced form watchers shall be provided during concrete placement to detect form displacement or the beginning of failure.
10.6.4
Re-tempering of concrete after initial setting is prohibited.
10.6.5
Concrete that has partially hardened or been contaminated by foreign materials shall not be deposited in the structure.
10.6.6
Concrete shall not be dropped freely where reinforcing will cause segregation nor where it would fall freely from a height not allowed by the specifications.
10.6.7
Concrete shall be discharged as near as possible to its final position to avoid segregation due to re-handling or flowing.
10.6.8
Placed concrete shall be consolidated by mechanical vibration equipment supplemented by hand spading, rodding or tamping.
10.6.9
After completing placing and finishing operations, efforts must continue to protect concrete from high temperatures, direct sunlight, low humidity, and drying winds.
10.6.10 Concrete paving shall have control joints or construction joints located shown in the contract drawing.
Page 10 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
10.6.11 Paving or slab construction joints not specified on the Contract Drawings, shall be located at column centerlines and at intermediate intervals approved by The Engineer. 10.6.12 Paving or slab construction joints not specified on the drawings, shall meet all requirements for architectural concrete matching the grade and type of finish present in the adjacent concrete. 10.6.13 Contraction or isolation joints shall be provided to divide structurally plain concrete members into flexural discontinuous elements. (ACI 318M, Sec. 2.2.3.1). 10.7 Concrete Finishing and Curing Inspection 10.7.1
Initial floating shall be completed after concrete placement.
10.7.2
The second floating operation shall take place after initial set but before final set has occurred (usually performed using a power trowel with float shoes or a pan attached).
10.7.3
The use of any floating or troweling machine that has a water attachment for wetting the concrete surface during finishing shall be prohibited.
10.7.4
Maximum total dissolved solids in water used for moist curing shall not exceed 1000 parts per million.
10.7.5
Water curing shall be continuous until the compressive strength has reached 70% of the specified strength, but not less than 7 days after placement.
10.7.6
Continuous water cure can be provided by covering with wet burlap and plastic; the saturated burlap shall be covered with a polyethylene sheet vapor barrier, minimum 0.15 mm (150 microns) in thickness.
10.7.7
Where appearance is important, concrete curing by 0.15 mm polyethylene film shall be avoided; film over damp burlap may be used (ACI 308, Sec. 2.4.2.1)
10.8 Stripping of Formw orks 10.8.1
Unless otherwise specified in the project specifications, formwork and shoring shall be left in place to support the mass of concrete in beams, slabs and in-place structural members until the specified concrete strength f'c is attained. (ACI 301, Sec. 2.3.2.5) Note: The preferred method of determining stripping time is by testing test cylinders that are cured on-site or testing concrete strength in the field.
10.8.2
When finishing is required, remove forms as soon as removal operations will not damage concrete. (ACI 301, Sec. 2.3.2.1)
Page 11 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
10.8.3
Repairs and treatment on minor concrete damage shall be started immediately. (ACI 301, Sec. 2.3.2.5).
10.8.4
Forms removal (stripping) shall be based on concrete's achieving minimum strength requirements as set forth by the design engineer as verified by sample cylinders compressive strength results.
10.9 Cast-In-Place Concrete Final Acceptance 10.9.1
All concrete surfaces in direct contact with earth shall be coated with two coats of coal tar or bitumen coating consisting of two coats coal tar epoxy coating system for Immersion Service or Bituminous Paint for Moderate Temperatures in Buried or Immersion Service. Overall dry coating thickness shall be from 325μm to 605μm.
10.9.2
All surface defects such as cracks or honey-combing shall be filled with mortar consisting of 1 part Portland Cement of the type specified for the job and 2.5 parts fine sand and ground in smooth with a trowel or carborundum grind stone float. (ACI 515.1R, Sec. 3.2.1) Note: Proprietary compounds may be used in lieu of mortar in accordance with the manufacturer's recommendations and with prior approval of The Engineer.
10.9.3
Finns, protrusions or similar irregularities projecting from the concrete shall be removed back to the surface by chipping, brush hammering, needle gunning or wire brushing. (ACI 515.1R, Sec. 3.2.4)
10.9.4
Sharp offsets in the concrete caused by formwork misalignment, shall be mechanically abraded to provide gradual and smooth transitions between offset surfaces. (ACI 515.1R, Sec. 3.4.2)
10.9.5
After finishing and curing operations all exposed construction joints, control joints, expansion-contraction joints or other types shall blend into and match with the existing adjacent concrete finishes (ACI 301, Sec. 5.3.3)
11.0 QUALITY REQUIREMENTS To ensure the quality control of reinforced concrete construction works, a third party laboratory technician will be at site to check the following: 11.1 Temperature of ready mix concrete upon arrival at site. 11.2 Concrete workability by checking concrete slump. 11.3 Preparation and proper curing/preservation of concrete sample specimen. 11.4 Check proper mixing proportion and procedure for application of proprietary compounds for concrete repairs and surfacing.
Page 12 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 METHOD STATEMENT FOR FORMWORKS, REBARS, C AST-IN-SITU CONC RETE (POURING, EMBEDMENTS, C URING)
First
Rev.
Issue
Date:
A
B
17.01.16
18.02.16
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
11.5 Check for surface preparation and thickness of coating application. 12.0 HEALTH AND SAFETY During the progress of works, the necessary welfare facilities shall be provided at the project site. The workers shall be provided with safe drinking water, toilets, place to eat their food and place to store their clothes. Tower lights will be used during night time works and is essential for the safety of workers, the equipment and the proper execution of work. Barriers around construction area shall be installed. 12.1 ISSUES 12.1.1
The HSE engineer has the responsibility for providing help advice to the supervisor who is responsible for the work safety.
12.1.2
No one shall be allowed to enter the construction site without wearing the proper PPE’s.
12.1.3
Ensure that there is sufficient scaffolding/platforms and safety harness/fall protection when working in heights.
12.1.4
Beware of slipping when using ladders in wet conditions.
12.1.5
Provide protective barriers, shield systems complying with applicable standards.
12.2 RESPONSIBILITIES 12.2.1
Safety Engineer 12.2.1.1 Conduct the safety induction course to all personnel involved in the work. 12.2.1.2 Monitor and supervise the risk assessment. 12.2.1.3 Ensure that necessary Permit to Work is available.
Page 13 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.2016
CONTRACT#: R-15-085-BF-0 DOC UMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
12.2.1.4 Ensure that the project’s method statement and risk assessment are understood, complied and applied in the worksite. 12.2.1.5 Ensure that all workers are provided with sufficient information regarding workplace hazards and planned control measures. 12.2.1.6 Ensure that necessary equipment (e.g. PPE, tools) is provided prior to start of works. 12.2.1.7 Ensure that all tools, equipment are certified and serviceable in accordance with the standard industry practice prior to use. 12.2.1.8 Ensure that adequate level of welfare arrangements are available in the worksite. 12.2.1.9 Daily inspection of health, safety and environmental compliance is carried out. 12.2.2 Safety Officer 12.2.2.1 Supervision of equipment handling, transportation and disposal of construction debris. 12.2.2.2 Ensure that relevant work permit is secured prior to start of work. 12.2.2.3 Ensure that equipment is operational and certified. 12.2.2.4 Ensure that all drivers/operators are qualified to operate the machines/equipment. 12.2.2.5 Regular inspection and maintenance of the equipment. 12.2.2.6 Perform other duties as instructed by the safety engineer.
Page 14 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING, EMBEDMENTS, C URING )
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
APPENDICES
Ap pen di x 1.0 Job Ris k A ss ess men t
Ap pen di x 1.1 Carpen tr y Wo rk s
Page 15 of 27
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
G ENERAL AUTHORITY O F CIVIL AVIATION C ONSTRUCTION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING, EMBEDMENTS, C URING )
First
Rev.
Issue
Date:
A 17.01.16
B 18.02.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Page 16 of 27
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Da te:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Ap pen di x 1.2 Form wor ks
Page 17 of 27
KINGDOM OF SAUDI ARABIA
GENERAL AUTHORITY OF CIVIL AVIATION CONSTRUCTION OF LOAD CENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL AUTHORITY OF CIVIL AVIATION CONSTRUCTION OF LOAD CENTER -3 FORMWORKS, REBARS, CAST-IN-SITU CONCRETE (POURING, EMBEDMENTS, CURING)
First
Rev.
Issue
Date:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENT NUMBER: LC3.KKIA-UN-MSM-GEN-CV-0021-B
Page 18 of 27
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Da te:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Ap pen di x 1.3- Steel Cu tt in g an d B end in g
Page 19 of 27
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Da te:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Page 20 of 27
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Da te:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Ap pen di x 1.4 Conc ret e Wor ks
Page 21 of 27
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3
KINGDOM OF SAUDI ARABIA
GENERAL A UTHORITY O F CIVIL AVIA TION C ONSTRUC TION OF LOAD C ENTER -3 FORM WORKS, REBARS, C AST-IN-SITU CONC RETE (PO URING , EMBEDMENTS, C URING )
First
Rev.
Issue
Da te:
A 17.01.16
B 18.2.2016
CONTRACT #: R-15-085-BF-0 DOCUMENTNUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
Page 22 of 27
Appendix 2.0- Related ITP
Appendix 2.0- Related ITP
CONSTRUCTION OF LOAD CENTER 3 (LC-3) AT KING KHALED INTERNATIONAL AIRPORT (KKIA) INSPECTION TEST PLAN FOR CIVIL WORKS CONTRACTOR: SAUDI SERVICES ELECTRO MECHANICAL WORKS. CO. (SSEM) (Close Joint Stock Company) CONTRACT NO.: R-15-085-BF-0
ITP Ref. No.: Sec No.:
TITLE: CIVIL WORKS
Sec Title.:
Activity No. 7 7.1 7.1.1 7.1.2 7.1.3 7.1.4
Activity Description
Test or Inspection Performed STRUCTURAL CEMENT CONCRETE CONSTRUCTION FORMWORK Check dimension of formwork for conformity to the drawings Check elevation and level
Check survey design date
Check stability of bracing , trying, shoring, false work and supports Check of cleanliness, surface smoothness and form oil coating
Visual Inspection Visual Inspection
Corner chamfering as per drawing requirements
Visual Inspection
Check stability and position of control joints
Visual Inspection
Re-bar Quality
7.2.2
Check size and spacing of re-bar and concrete cover as applicable and also ensure that air blowing is made to ensure clean surface
7.3
Test Required
Code/Spec/Etc.
Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works
SSEM CHECK SSEM CHECK SSEM CHECK SSEM CHECK SSEM CHECK SSEM CHECK
Acceptance Criteria
SSEM
Approved Construction Drawings Approved Construction Drawings
AECOM
Demonstrated Evidence Report/Checklist
RR
W
Checklist Form IC-C-007
RR
W
Checklist Form IC-C-007
Project Specification
RR
S
Checklist Form IC-C-007
Project Specification
H
S
Checklist Form IC-C-007
Project Specification
H
S
Checklist Form IC-C-007
Approved Construction Drawings
H
S
Checklist Form IC-C-007
Check embedded item for and free from damage Check installation of embedded items and proper support CONCRETE PLACEMENT
Check Rebar Chemical Composition, Tensile and Bending Compliance w/ (ASTM A 615)
Every 300tons/per size dia.
Factory Test/Third Party Test
Technical Specification Civil Works
Project Specification/Approved Material Submittal
RR
RR
Mill Certificate/Test report
Visual inspection
After assembly of Rebar
SSEM CHECK
Technical Specification Civil Works
Approved Construction Drawings/Bar bending Schedule
H
W
Checklist Form IC-C-007
Visual inspection Visual inspection Check Approved Concrete Mix Design Check Coarse/Fine Aggregate comply w/ (ASTM C 33) Check Approved Concrete Mix Design Witness checking of Slump (ASTM C 143) Witness checking of Yield, Air Content (ASTM C 138)
7.3.1
Concrete mix design
7.3.2
Concrete material quality
7.3.3
Check Concrete delivery for correct mix as per specification
7.3.4
Concrete slump Test
7.3.5
Concrete Yield, Air Content
7.3.6
Concrete making specimen in the field
7.3.7
Check movement and free dropping of concrete
Visual Inspection
7.3.8
Check for proper vibration while placing concrete
Visual Inspection
7.3.9
After installation of formworks After installation of formworks After installation of formworks After installation of formworks After installation of formworks After installation of formworks
Method of Verification
Reference Documentation
LAYING OF REBAR AND EMBEDDED ITEMS
7.2.1
7.2.4
Stage / Frequency
Check Visual/Survey Inspection
7.1.6
7.2.3
Date: October 2015
Inspection / Test Requirements
7.1.5
7.2
ISSUANCE: 01 REVISION: 00
Witness checking of sample cylinder (ASTM C31
Check result compressive strength (ASTM C39)
Compressive Strength Test
After assembly of Rebar After assembly of Rebar
SSEM CHECK SSEM CHECK
Prior to actual production get started
Third Party Test
daily
Third Party Test
Every Batch Ticket
Third Party Test
Every Truck Mixer
Third Party Test
Control Mix Twice Weekly Six test cylinder each day used for 28 days test additional test cylinder may be prepared for 7 days test (per 200cu.m.) During Concrete Placement During Concrete Placement Six test cylinder each day used for 28 days
Third Party Test
THIRD PARTY TEST
SSEM CHECK THIRD PARTY TEST
Note:
Project Specification
H
W
Checklist Form IC-C-007
Approved Construction Drawings
H
W
Checklist Form IC-C-007
Project Specification
RR
RR
Materials Submittal Report
Project Specification
S
S
Checklist Form IC-C-007
Project Specification
S
S
Checklist Form IC-C-007
W
W
Checklist Form IC-C-007
W
W
Checklist Form IC-C-007
Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works
Test Result Compliance w/ Project Specification Test Result Compliance w/ Project Specification
Technical Specification Civil Works
Test Result Compliance w/ Project Specification
W
W
Checklist Form IC-C-007
Project Specification
S
S
Checklist Form IC-C-007
Project Specification
S
S
Checklist Form IC-C-007
Test Result of 6 tests cylinder at 28 days shall be
RR/W
RR
Material Test Report
Technical Specification Civil Works Technical Specification Civil Works Technical Specification Civil Works
SSEM CHECK
N/A – NOT APPLICABLE
ABBREVIATIONS:
Technical Specification Civil Works Technical Specification Civil Works
W-
WITNESS PONT
S –
SURVEILLANCE
H –
HOLD POINT
RR – REVI EW OF REPORT
AECOM- Consultant SSEM-
Contractor Page 23 of 27
Page 1 of 2
Appendix 2.0- Related ITP
CONSTRUCTION OF LOAD CENTER 3 (LC-3) AT KING KHALED INTERNATIONAL AIRPORT (KKIA) INSPECTION TEST PLAN FOR CIVIL WORKS CONTRACTOR: SAUDI SERVICES ELECTRO MECHANICAL WORKS. CO. (SSEM) (Close Joint Stock Company) CONTRACT NO.: R-15-085-BF-0
ITP Ref. No.: Sec No.:
ISSUANCE: 01 REVISION: 00
TITLE: CIVIL WORKS
Sec Title.:
Date: October 2015
Activity No.
Activity Description
Inspection / Test Requirements Test or Inspection Performed
Stage / Frequency
Reference Documentation Test Required
Code/Spec/Etc.
Acceptance Criteria
test additional test cylinder may be prepared for 7 days test 7.4
Method of Verification SSEM
AECOM
Demonstrated Evidence Report/Checklist
at least 25.0 N/mm2 (Average of 6 Cylinder
FINISHING AND CURING
7.4.1
Check for Curing as per specification requirements
7.4.2
Check formed surfaces for finish
7.4.3
Repair surface defects as per approved procedure
7.4.4
Check joints and application of filler and sealant
ABBREVIATIONS:
Approved Materials compliance w/Project Specification
S
S
Checklist Form IC-C-007
Technical Specification Civil Works
Project Specification
S
S
Checklist Form IC-C-007
H
W
Checklist Form IC-C-007
H
S
Checklist Form IC-C-007
Check Approved Materials for curing
After placement of Concrete
SSEM CHECK
Technical Specification Civil Works
Visual Inspection
After Dismantling of Concrete Forms
SSEM CHECK
As per Approved Material supplier procedure for Repair Visual Inspection
After Dismantling of Concrete Forms
SSEM CHECK
Technical Specification Civil Works
Approved Materials compliance Method Statement /Project Specification
After Dismantling of Concrete Forms
SSEM CHECK
Technical Specification Civil Works
Project Specification
N/A – NOT APPLICABLE
Note: Page 2 of 2
W-
WITNESS PONT
S –
SURVEILLANCE
H –
HOLD POINT
RR – REVI EW OF REPORT
AECOM- Consultant SSEM-
Contractor Page 24 of 27
Appendix 2.0- Related ITP
CONSTRUCTION OF LOAD CENTER 3 (LC-3) AT KING KHALED INTERNATIONAL AIRPORT (KKIA) INSPECTION TEST PLAN FOR CIVIL WORKS CONTRACTOR: SAUDI SERVICES ELECTRO MECHANICAL WORKS. CO. (SSEM) (Close Joint Stock Company) CONTRACT NO.: R-15-085-BF-0
ITP Ref. No.: Sec No.:
TITLE: CIVIL WORKS
Sec Title.:
Activity No.
ISSUANCE: 01 REVISION: 00 Date: October 2015
Inspection / Test Requirements
Activity Description
Test or Inspection Performed
Stage / Frequency
Test Required
Code/Spec/Etc.
Acceptance Criteria
test additional test cylinder may be prepared for 7 days test 7.4 7.4.1 7.4.2
Method of Verification
Reference Documentation
SSEM
AECOM
Demonstrated Evidence Report/Checklist
at least 25.0 N/mm2 (Average of 6 Cylinder
FINISHING AND CURING Check for Curing as per specification requirements Check formed surfaces for finish
7.4.3
Repair surface defects as per approved procedure
7.4.4
Check joints and application of filler and sealant
Check Approved Materials for curing
After placement of Concrete
Visual Inspection
After Dismantling of Concrete Forms
As per Approved Material supplier procedure for Repair Visual Inspection
S
S
Checklist Form IC-C-007
Technical Specification Civil Works
Project Specification
S
S
Checklist Form IC-C-007
H
W
Checklist Form IC-C-007
H
S
Checklist Form IC-C-007
Technical Specification Civil Works
SSEM CHECK
After Dismantling of Concrete Forms
SSEM CHECK
Technical Specification Civil Works
Approved Materials compliance Method Statement /Project Specification
After Dismantling of Concrete Forms
SSEM CHECK
Technical Specification Civil Works
Project Specification
N/A – NOT APPLICABLE
ABBREVIATIONS:
Approved Materials compliance w/Project Specification
SSEM CHECK
Note:
W-
WITNESS PONT
S –
SURVEILLANCE
H –
HOLD POINT
RR – REVI EW OF REPORT
AECOM- Consultant SSEM-
Contractor Page 24 of 27
Page 2 of 2
Appendix 3.0- Checklist
CONSTRUCTION OF NEW LOAD CENTER-3 AT KING KHALED INTERNATIONAL AIRPORT
STRUCTURAL CEMENT CONCRETE CONSTRUCTION IC Checklist No.: 085-IC-C-007
Project: Construction of New Load Center-3 Contract No.: R-15-085-BF-O Facility Name: Drwg. No. / Line No.: Work / item for Inspection: Item
1
2
3
Activity
Formworks dimensions and elevation conforming to the drawing Check stability of bracing , trying, shoring, false work and supports Check of cleanliness, surface smoothness and form oil coating
ITP Ref. No.: 085-ITP-C-8.0 Sec: Area/Location:
SSEM Engr.
SSEM QC
GACA/AECOM Representative A R N/A
Corr. Sign Off
Remarks
Appendix 3.0- Checklist
CONSTRUCTION OF NEW LOAD CENTER-3 AT KING KHALED INTERNATIONAL AIRPORT
STRUCTURAL CEMENT CONCRETE CONSTRUCTION IC Checklist No.: 085-IC-C-007
Project: Construction of New Load Center-3 Contract No.: R-15-085-BF-O Facility Name: Drwg. No. / Line No.: Work / item for Inspection: Item
Activity
1
Formworks dimensions and elevation conforming to the drawing Check stability of bracing , trying, shoring, false work and supports Check of cleanliness, surface smoothness and form oil coating Corner chamfering as per drawing requirements Check Compaction density of CTB Check stability and position of control joints Check Re-bar Quality Check size and spacing of rebar and concrete cover as applicable and also ensure that air blowing is made to ensure clean surface Check quality and installation of embedded materials Check Concrete delivery for correct mix as per specification Visual inspection of finished CTB Concrete slump Test Concrete making specimen in the field Check movement and free
2
3
4 5 6 7 8
9 10 11 12 13 14
ITP Ref. No.: 085-ITP-C-8.0 Sec: Area/Location:
SSEM Engr.
SSEM QC
GACA/AECOM Representative A R N/A
Corr. Sign Off
Remarks
Page 25 of 27
Appendix 3.0- Checklist
Appendix 3.0- Checklist
CONSTRUCTION OF NEW LOAD CENTER-3 AT KING KHALED INTERNATIONAL AIRPORT
dropping of concrete 15 Check for proper vibration of concrete 16 Check for compressive strength of concrete 17 Check for proper curing of concrete 18 Repair of surface defects as per approved procedure 19 Check joints and application of filler and sealant GACA/AECOM Representative Remarks:
SSEM QC Representative Sign: Name: Date:
Legend: A=Acceptable; R=Rejected; N/A=Not Applicable
GACA / AECOM Representative Sign: Name: Date:
Page 26 of 27
Appendix 4.0- Proforma Work Permit SSEM-HSE/PERMIT/002/M07-11, Rev0.1, July2011
Appendix 4.0- Proforma Work Permit SSEM-HSE/PERMIT/002/M07-11, Rev0.1, July2011
FORMWORKS, REBARS & CAST-IN-SITU CONCRETE WORK PERMIT DATE: ______________________PERIOD: __________________TO:__________________PERMIT NO.:_______________ EQUIPMENTS: _______________________________________________________WORK AREA: ______________________ DESCRIPTION OF WORK:_________________________________________________________________________________
NAME OF THE ORIGINATOR: COMPANY:
DEPARTMENT:
SIGNATURE:
COMPLEMENTARY PERMITS
PERFORMING AUTHORITY
YES
NO
N/A
DRIVING IN UNAUTHORISED AREAS
NAME: SIGNATURE & DATE: CONTACT NO:
CLEARANCE FROM YERP AUTHORITY CLEARANCE FROM ROYAL COMMISSION CLEARANCE FROM OTHER DEPARTMENTS
RISK ASSESSMENT
SAFETY PRECAUTUONS YES
NO
YES
N/A
ELECTRICAL ISOLATION
PERSONAL PROTECTIVE EQUIPMENT (P.P.E) BARRICADES AND WARNING SIGNS
METHOD STATEMENT / JSA
AREA IS SUITABLE FOR CONCRETE REPAIR WORK
ENOUGH ACCESS/EGRESS
ADDITIONAL ILLUMINATION PROPER ACCESS ACCESS/EGRESS CLEAR FROM OBSTACLES FIRE EXTINGUISER / FIRE WATCHMAN LIFE LINES/ SAFETY HARNESS BREATHING EQUIPMENT EMERGENCY RESCUE TEAM AVAILABLE.
SUFFICIENT SCAFFOLDING/PLATFORMS AREA CLEAR FROM COMBUSTIBLE SUBSTANCES ANY OTHER WORKS ADJACENT ISOLATION FROM OTHER WORKS
SLOPING OR SHIELDLING PROVIDED
AREA CLEAR FROM TOXIC GASES
NO MATERIAL KEPT NEAR THE EXCAVATION
EXISTING TEMPORARY OR PERMANENT UTILITIES SUITABLE EQUIPMENT AND TOOLS AVAILABLE
GAS CYLINDERS KEPT OUT FROM THIS AREA
NO
N/A
WORKERS AWARE OF HAZARDS AND PRECAUTUONS TO BE TAKEN
OTHER REQUIREMENTS (IF NECESSARY)
DECLARATION (to be filled by Performing Authority) And Competent Person I, UNDERSIGNED HAVE CHECKED THE AREA AND COMPLIED TO ALL SAFETY PRECAUTIONS AND RISK ASSESSMENT AND WILL CARRY OUT ACTIVITY WITH APPROVED METHOD STATEMENT
NAME:
SIGN:
NAME:
SIGN:
PERMIT VALIDITY (to be filled by Site Manager/Engineer) THE ABOVE WORK HAS BEEN APPROVED AND SHALL BE CARRIED OUT SAFELY. IT HAS TO BE ENSURED THAT THE EMPLOYEE EXECUTING THE JOB HAS A COPY OF THE PERMIT AT ALL TIMES DURING THE WORK.
NAME:
SIGNATURE:
DATE:
PERMIT CLEARANCE (to be filled by HSE/Safety Representative) I DECLARE THAT ALL WORK UNDER MY CONTROL HAS NOW BEEN COMPLETED AND THE AREA HAS BEEN CLEARED AND THAT ALL TOOLS AND OTHER EQUIPMENT HAVE BEEN REMOVED
NAME:
SIGNATURE:
DATE:
PERMIT CLOSED (to be filled by Performing Authority) THE ABOVE WORK WAS COMPLETED SAFELY AND THE WORK PERMIT SHALL BE CANCELLED
NAME:
SIGNATURE :
DATE:
NAME:
SIGNATURE:
DATE:
Yellow- Site
Blue - HSE office
SAFETY DEPARTMENT: White - Client Office
Page 27 of 27