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REFINERY TANK FARM

PACKAGE 6

Document No. Doc. Type Discipline System JOB No.

SA-JER-TFAAA-PSCL-507497 PRC CNS P 3000235438

Digitally signed by Mohamed


Commented on page no 8. Fazlullah

Accepted with comment. Mohamed DN: cn=Mohamed Fazlullah,


o=Package-6, ou=Electrical
Engineer,

Fazlullah email=fazlullah.mohammed@sa
torp.com, c=US
Date: 2011.03.26 16:30:54
+03'00'

Revision
Remarks Issued Date Return Date
No.
00 Issued for Review 27-AUG-2010 30-SEP-2010
01 Issued for Acceptance 03-OCT-2010 23-NOV-2010
02 Issued for Construction 15-FEB-2011

ADRIAN ERMITA CARLOS BULILAN ROBERT PRAKASH


Prepared By Checked By Approved By Issued By

IMPORTANT:

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form, or by means of electronic,
mechanical, photocopying, recording, or otherwise, without the written permission of Rotary Engineering Limited.
REFINERY TANK FARM
PACKAGE 6

Revision History

Revision Revision date Page Scope of Revision

!" #$ %
!" &&

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

TABLE OF CONTENTS

1. SCOPE .........................................................................................................................4

2. REFERENCE DOCUMENTS .......................................................................................4

3. DEFINITIONS ...............................................................................................................6

4. RESPOSIBILITIES .......................................................................................................6

5. METHODOLOGY .........................................................................................................7

6. QUALITY CONTROL AND QUALITY ASSURANCE ..................................................9

7. MACHINERY AND RESOURCES ................................................................................9

8. SAFETY EQUIPMENTS .............................................................................................10

9. HEALTH, SAFETY AND RISK ASSESSMENTS .......................................................10

10. JOB SAFETY ANALYSIS OR RISK ASSESSMENT..................................................11

11. ATTACHMENTS ........................................................................................................12

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

1.0 SCOPE

This Scope is to derive the methodology for the Installation of LV and MV Motor works to be performed for the
construction of tank farms for SAUDI ARAMCO TOTAL REFINING & PETROCHEMICAL COMPANY
(SATORP) in package 6 at Al-Jubail, Kingdom of Saudi Arabia, in order to qualify and comply with all the
company standards.

2.0 REFERENCE DOCUMENTS

2.1 SA-JER-TFAAA-RELC-595430, Purchase Requisition for LV and MV Motor Installation System

2.2 SA-JER-TFAAA-RELC-594763, Purchase Requisition for Cable Gland

2.3 JERES-A-105 Noise Control

2.4 JERES-A-112 Meteorological and Seismic Design Data

2.5 JERES-B-068 Electrical Area Classification

2.6 JERES-C-101 Basis Design of Data

2.7 JERES-J-604 Protective Instrumentation for Rotating Machinery

2.8 JERES-P-100 Basic Power System Design Criteria

2.9 JERES-P-111 Grounding

2.10 JERES-P-114 Power System and Equipment Protection

2.11 JERES-P-116 Switchgear and Control Equipment

2.12 JERES-J-902 Electrical Systems for Instrumentation

2.13 JERES-P-104 Wiring Methods and Materials

2.14 JERES-P-200 Document Management and Final Documentation Requirements

2.15 JERMS-P-7502 Induction Motors

2.16 JERMS-P-6502 Metal Enclosed Low voltage Switchgear Assembly

2.17 JERMS-P-6503 Indoor Control gear – Low Voltage

2.18 JERMS-P-6504 Indoor Metal Clad Switchgear 1 to 38kV

2.19 JERMS-P-6506 Indoor Control gear – High Voltage

2.20 JERMS-P-6513 Protective Devices

2.21 JERMS-P-6517 Adjustable Frequency Drive System: 1 kV and Above

2.22 JERMS-J-4625 Vibration Axial Position and Bearing Temperature.

2.23 JERSD-P-0092 Rev E Power System Typical Installation

2.24 Project Quality Plan

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

2.25 Safety and Medical plan

2.26 Schedule “D” & Sec. 11-14 of JER Contraction Safety Manual

2.27 Project Specifications & Standards

2.28 (QCS 2002) Materials Receiving Inspection Report

REFERENCE DRAWINGS

SA-JER-TF661-RELC-62-4773 Sheet 1/2 Single Line Diagram Tank Farm KEY SINGLE LINE DIAGRAM OF
HV AND LV SYSTEM North Area
SA-JER-TF661-RELC-62-4773 Sheet 2/2 Single Line Diagram Tank Farm KEY SINGLE LINE DIAGRAM OF
HV AND LV SYSTEM North Area
SA-JER-TF661-RELC-62-4929 Sheet 1/2 Single Line Diagram Tank Farm KEY SINGLE LINE DIAGRAM OF
HV AND LV SYSTEM South Area
SA-JER-TF661-RELC-62-4929 Sheet 2/2 Single Line Diagram Tank Farm KEY SINGLE LINE DIAGRAM OF
HV AND LV SYSTEM South Area

CODES AND STANDARDS

The following, but not limited to, codes and standards shall govern the Works Installation of Cable System.

• IEC 60034 Rotating Electric Machines

• IEC 60072 Dimensions and Output Series for rotating Electric Machines

• IEC 60079 Electrical Apparatus for Explosive Gas

• IEC 60529 Degree of Protection provided by Enclosures. IP65 degree of protection as defined by IEC
60529. Requirements and test criteria for IP21 degree of protection.

• IEC 61508 Functional Safety of Electrical / Electronic / Programmable Electronic Safety – Related Systems

• IEC 61511 Functional Safety – Safety Instrumented Systems for the Process Industry Sector

• IEC 61537 Cable Trays and Cable Ladders for Electrical Installations

• IEC 60255 Electric relays

• IEC 60269 Low-voltage fuses.

• IEC 60445 Basic and safety principles for man-machine interface, marking and identification –
Identification of equipment terminals and of terminations of certain designated conductors, including
general rules for alphanumeric system

• IEC 60446 Basic and safety principles for man-machine interface, marking and identification –
Identification of conductors by colours and numerals

• IEC 60664 Insulation coordination for equipment within low-voltage systems

• IEC 60755 General requirements for residual-current operated protective devices

• IEC 60414 Safety requirements of indicating & recording instruments


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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

3.0 DEFINITIONS

All the definitions mentioned in the JER Documents have priority over other standards and any deviation
of these standards shall be brought to attention of the COMPANY. It means to the company representative
for resolution.

All terms used in the development of this procedure are defined below:

• COMPANY - Saudi Aramco Total Refining and Petrochemical Company

• CONTRACTOR - Petrol Steel Company Ltd / Rotary Engineering Ltd

• PSCL - Petrol Steel Company Ltd.

• Shall - Indicates a mandatory requirement

• Should - Indicates a recommended practice

4.0 RESPONSIBILITIES:

4.1 The Project Manager shall ensure that all operations related to cable and conduit seal installation work
shall been risk assessed and necessary control measures have been implemented to carry out the task
in a safely manner.

4.2 The Construction or Site Manager shall Manage and control overall responsibility for site, QA/QC and
provide management commitment to the site quality plan.

4.3 The QA/QC Manager is ensuring all works is compliance with project procedures and ITP
requirements. Also to ensure the project quality management system’s documentation is prepared for
the project. Reviewing test plans if necessary to ensure adequate assurance is provided for
implementation of activities affecting quality. Ensure all documentations reported are audited to ensure
compliance with SATORP requirements. He responsible for developing and maintaining the authorized
QC signatories list.

4.4 The Contractor’s Construction Engineer shall review and confirm that all cable and conduit seal
installation are being implemented as per the activities stated in the method statement and in
compliance with the (SATORP) codes, standards and project specification.

4.5 The Contactor’s Supervisor shall supervise all Installation activities as required by the project
drawings and specifications. He shall prepare all the necessary permits in advance and get it approved
from the company designated representative for the execution.

4.6 The Contractor’s Site Supervisor shall conduct regular toolbox meetings and explain the
requirements of PPE and other special needs to create a safe working environment. He is responsible
for achieving the target and the project milestones.

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
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4.7 The Contractor’s QA/QC Inspector shall closely monitor and assure all installation activities are
carried out as per (SATORP) QA/QC requirements and conduct frequent inspections and maintain all
records as required by project QA/QC Program.

4.8 The Contractor’s Safety Inspector shall closely monitor and assure that all works are carried out in
highly safe manner. Gearing the workers with full strength of safety protective equipment, preparation of
safety barricading and dust control screening wherever applicable in safe manner, safe workability of
equipment to be used and fulfilling any other additional safety needs as required during work
executions. He shall also check and ensure that only qualified personals are carrying out the equipment
and machinery related works.

4.9 The Contractor shall appoint their own safety manager and he shall conduct safety walk around the
site in weekly basis and prepare and submit a report to the company any accidents occurred shall be
informed immediately to the company and recorded accordingly.

5.0 METHODOLOGY

• Ensure that all relevant site condition and working practices are safe prior to work execution.

• Check and ensure all entire Work permits are obtained, i.e. Hot and Cold Permit, etc.

• Ensure that the materials are in accordance with the project specifications. Refer to the Material Receiving
Inspection Report - QCS 2002

• Verify and prepare all tools and equipment required for safe executions of work are available.

• The electric motors and other motor accessories will be transported to work site using a truck/trailer and
then stored in lay down area for E&I materials.

• Electric Motors shall be inspected for damages during transportation. Safe material handling procedure
shall be observed for the material transportation to site.

• Motors shall be stored indoor in a clean dry area. When indoor is not possible, the motor must be covered
with a tarpaulin. Tarpaulin shall not be tightly wrapped to allow captive air space to breathe, minimizing
formation of condensation.

• Heavy materials will be shifted to lay down area by using crane. Safe lifting procedure will be carried out
for this lifting.

• Electric Motors shall follow all the manufacturers’ recommendation for material preservation.

• Avoid jarring and/or dropping. Handle units with care to prevent damage to components or special
finishes.

• Inspect the rust preventive coating on all external machined surfaces, including shaft extensions. The
condition of the coating shall be checked periodically and surface recoated as needed.

• To prevent moisture accumulation, some form of heating must be utilized to prevent condensation. If

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

space heaters are supplied, they should be energized.

• Motors for outdoor installation shall be totally enclosed type. Motors for indoor application shall be totally
enclosed and of the drip proof guarded type.

• The insulation system shall be Class F minimum.

• RTD’s shall be monitored by the multipurpose motor protection package which shall be set to alarm on
high temperature.

• Motors rated 370KW (500HP) shall have bearing temperature monitoring.

5.1 SEQUENCE OF WORK

• Conduct tool box meetings and brief the worker the sequence of work, streamline their job for hazard
avoidance prior to work start. get clearance from related department Civil or steel structure ect.
• Ensure that all relevant site condition and working practices are observed safe prior to work execution. To
barricade necessary range of area to assure safety work environment by using safety barricading tape.
Confirm the location with related IFC drawing
• Mobilization of materials, equipments & machineries to the designated area by using manpower, cable
roller, cable puller and etc will be transporting to the site.

• To mobilise sufficient and adequate man power to carry out cable installation as per approved plan and
design.

• Check documentation for the Material Receiving of motor for any comments.

• Check motor information rating for its conformation to the data sheets specified by the Purchaser.

• Terminals of motors and controllers shall be suitably marked or colored where necessary to indicate the
proper connection.

• The motor and all of its auxiliary devices shall be suitable for and in accordance with the area classification
system specified by the Purchaser on the data sheets.

• Lifting lugs, through holes, or eyebolts shall be provided for lifting the motor.

• The frames and other metal exteriors of motors (except for insulated pedestal bearings) should be
grounded to limit their potential to ground in the event of accidental connection or contact between live
electrical parts and the metal exteriors.

• The connection of the motor to the power supply should be made by qualified personnel in accordance
with the diagram or other instructions furnished by the motor manufacturer.

• Inspect physical and mechanical condition of motor.

• Check correct application of manufacturer'


s recommended lubricants.

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

• Inspect anchorage, and grounding.

• Check tightness of accessible bolted electrical connections in accordance with manufacturer'


s published
data.

• Check for damaged and missing parts.

• Check the screens, guards and other personnel protective devices are in place.

• Check that all foreign material is removed and inspect for cleanliness.

• Check the motor is properly installed and aligned to the load.

• Cable Installation shall be as per SA-JER-TFAAA-PSCL-508082 - Work Method Statement for Cable
System.

• Inspection and Installation check shall be recorded on QCS-5005 LV and MV Motor Installation.

6.0 QUALITY CONTROL AND QUALITY ASSURANCE

The quality of the works shall be in line with the SATORP standards. Required tests shall be performed at
each stage of works execution and the report shall be prepared and submitted to the company representative
for final approval.

6.1 INSPECTION AND TESTING PROCEDURE

Inspection and Testing Procedure shall be as per company approved SA-JER-TFAAA-PSCL-317495 -


Inspection and Test Plan for LV and MV Motors and SA-JER-TFAAA-PSCL-507218 – Precommissioning and
Commissioning of LV and MV Motors.

7.0 MACHINERY AND RESOURCES

• Basic electrical hand tools

• Cable cutter

• Measuring tape

• Cable stand with shaft

• Cable marker (insulation tape)

• Walkie talkie

• Lifting gears / shackles (certified)

• Ladders

• Scaffolding

• QA/QC Inspector

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
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PACKAGE 6

• Construction (Electrical and Instrument) Engineer


• HSE Officer

8.0 SAFETY EQUIPMENTS

• Safety shoes

• Safety helmet

• Safety glass

• Safety harness (for working at height more than 2 metres)

• Approved body wear/uniform

• Hand gloves

9.0 HEALTH, SAFETY AND RISK ASSESSMENT

The health and safety shall perform a splendid role in all construction activities to ensure that all the works are
carried out in a safe manner and creating a healthy environment. The individuals especially in related with
health and safety and complying with the SATORP safety standards shall perform the duties. Appropriate
work permit shall be applied in accordance to the requirements of Schedule “D” and Section II-14 of the JER
Construction Safety Manual.

9.1 A safety officer or a safety coordinator shall be present at site full time during the execution of works
and also to clarify the safety related issues.

9.2 Daily toolbox meetings shall be conducted as mandatory requirements to describe and discuss the
safety related issues.

9.3 The works shall be risk assessed and proper guidance should be managed before implementation of
every individual activities.

9.4 Following safety requirements shall be fulfilled.

9.4.1 Safety barricade shall be provided wherever necessary.

9.4.2 Necessary safety signboards shall be provided at work places as required by safety Standards.

9.4.3 All workers shall be provided with job specific Personal Protective Equipment.

9.4.4 Safety flickering lights shall be provided for vehicles working on long-time hours especially on night
hours.

9.4.5 The approving authority shall inspect all equipment checklists for machineries related to the activities
prior before commencing the works.
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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
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PACKAGE 6

9.4.6 Working equipment shall be equipped with amber lights, horns, safety guards, etc. as required and
mentioned in safety manuals.

9.4.7 Any incident at site shall be immediately reported to company and recorded.

9.4.8 Weekly safety statistics reports and safety performance reports etc. shall be repaired and recorded.

9.4.9 Daily safety task assignment shall be prepared.

9.4.10 Man shelters shall be provided to protect the workers from adverse climatic condition, i.e. sand
storm, high temperature.

9.4.11 Potable water source shall be provided for adequate numbers for workers.

9.4.12 Work place to be tidied before leaving as to ensure safely work environment always has been
remain.

10.0 JOB SAFETY ANALYSIS OR RISK ASSESSMENT

Possible
N Work Accident / Existing Risk Control Additional Risk
Hazard
o Activity Health and (if any) Control
Person at risk

Pinch point Cut finger Correct PPE


Transport of
Hit by swinging Boom Crashed hand Lifting Supervisor Safe work practice in
1 Motor –Pump
Hand Injury Body Injury Watchman performing lifting
skid
Body Injury Barriers

Ensure the crane


operator is qualified,
approved and with valid
certificate to operate.
Ensure lifting capacity
and working range and
radius are checked prior
Erratic movement
to lifting activities.
resulting in damage of
properties and materials Ensure the area are
Ensure only competent
barricaded to prevent un
signal man is allowed to
Overloading authorize entry
give signal to the crane.
Lifting Collapse of load due to Serious body Ensure that no lifting
injuries Ensure each lifting gear
operation of improper slinging of loads operation shall be
2 Motor – Pump
has a valid load test
performed when the load
Collapse of load during Property and certificates and is free
Skid material damage exceed the safe working
lifting operation due to from defects.
loads of the crane
defective and in
Weigh and center of
appropriate lifting gear Ensure warning signs are
gravity of the load must
installed
Damage to properties due be determined prior to
to swinging during lifting slinging to minimize
swing of load upon lifting.
Tag lines to be used for
hoisting load to prevent
undue swing or
movement of the load.
Lifting supervisor to
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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM
PACKAGE 6

conduct JSA prior to


lifting

Finger crushed Only Certified cable


Termination from crimping,
3 Hand injury, Body Injury Manually Use of chain block splicer and terminator
and
carrying weight shall do the task.
crimping of cables

11.0 ATTACHMENT

QCS-5005 LV and MV Motor Installation

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SA-JER-TFAAA-PSCL-507497 Rev.02 WORK METHOD STATEMENT FOR LV AND
MV MOTOR INSTALLATION
REFINERY TANK FARM PACKAGE 6

DOCUMENT TITLE FORM NUMBER DATE APPROVED JOB NUMBER

CHECKLIST: LV and MV Motor Installation QCS-5005 3000235438

PROJECT TITLE CONTRACTOR / SUBCONTRACTOR

EQUIPMENT ID NUMBER(S) EQUIPMENT DESCRIPTION EQPT CODE SYSTEM ID PAGES

LAYOUT DRAWING NUMBER REV. NO. PURCHASE ORDER NUMBER LOCATION

SCHEDULED INSPECTION DATE & TIME ACTUAL INSPECTION DATE & TIME QTY INSP. MH's SPENT TRAVEL TIME

PSCL ITP NUMBER PSCL ACTIVITY NUMBER

PSCL INSPECTION LEVEL CONTRACTOR INSPECTION LEVEL

ITEM
ACCEPTANCE CRITERIA REFERENCE FAIL PASS REINSPECTION DATE
No.
A. DOCUMENTATION REQUIREMENTS

Check documentation for the Material Receiving of motor for any


A1 Schedule Q
comments.
Check motor information rating for its conformation to the data sheets
A2 Schedule Q
specified by the Purchaser.

Terminals of motors and controllers shall be suitably marked or colored


A3 JERES - P - 113
where necessary to indicate the proper connection.

Control circuits devices with screw-type pressure terminals used with 14


A4 AWG or smaller copper conductors shall be torque to a minimum of 0.8 JERES - P - 113
N.m (7 lb-in.) unless identified for a different torque value.

Where wires pass through an opening in an enclosure, conduit box, or


A5 barrier, a bushing shall be used to protect the conductors from the edges JERES - P - 113
of openings having sharp edges.

Motors shall be located so that adequate ventilation is provided and so


A6 that maintenance, such as lubrication of bearings and replacing of JERES - P - 113
brushes, can be readily accomplished.

Open motors that have commutators or collector rings shall be located


A7 JERES - P - 113
or protected so that sparks cannot reach combustible material.

The arrangement of the equipment, including number of bearings,


terminal housings, conduit, piping, and auxiliaries (including the rotating
A8 elements of the exciter, the field discharge resistor, and synchronizing JERES - P - 113
controls as applicable) shall be provided with adequate clearance areas
and safe access for installation, operation and maintenance.

The frame support or supports shall be provided with two pilot holes for
dowels. The holes shall be as near the vertical as is possible and shall
be located to provide adequate space for field drilling, reaming and
A9 JERES - P - 113
placement of dowels. Unless otherwise specified, only the supports or
mounting feet on the drive end of horizontal motors shall be doweled.
Vertical motors shall have a rabbeted fit to the base and two dowels.

The motor and all of its auxiliary devices shall be suitable for and in
A10 accordance with the area classification system specified by the JERES - P - 113
Purchaser on the data sheets.

Lifting lugs, through holes, or eyebolts shall be provided for lifting the
A11 JERES - P - 113
motor.

The frames and other metal exteriors of motors (except for insulated
pedestal bearings) should be grounded to limit their potential to ground
A12 JERES - P - 113
in the event of accidental connection or contact between live electrical
parts and the metal exteriors.

The connection of the motor to the power supply should be made by


A13 qualified personnel in accordance with the diagram or other instructions JERES - P - 113
furnished by the motor manufacturer.

The equipment (including auxiliaries) shall be suitable for the specified


A14 JERES - P - 113
operating condition.

The electrical components and installations shall be suitable for the area
A15 JERES - P - 113
classification specified by the purchaser on the data sheets

Page 1 of 2
A16 Inspect physical and mechanical condition of motor. JERES - P - 113

A17 Check correct application of manufacturer's recommended lubricants. JERES - P - 113

A18 Inspect anchorage, and grounding. JERES - P - 113

Check tightness of accessible bolted electrical connections in


A19 JERES - P - 113
accordance with manufacturer's published data.

When applicable, perform special tests such as air gap spacing and
A20 JERES - P - 113
pedestal alignment.

A21 Check for damaged and missing parts. JERES - P - 113

A22 Check the motor is suitable for the area classification. JERES - P - 113

Check the screens, guards and other personnel protective devices are in
A23 JERES - P - 113
place.

A24 Check that all foreign material is removed and inspect for cleanliness. JERES - P - 113

A25 Check the motor is properly installed and aligned to the load. JERES - P - 113

A26 Equipment Grounding shall comply with JERES-P-111 JERES - P - 111

A27 Check preservation measures Schedule Q

A28 Punchlist cleared and signed closed Schedule Q

B. REMARKS

REFERENCE DOCUMENTS:
1. Schedule G -- Material, Tools and Equipment
2. Schedule Q -- Quality Requirements
3. NEC - National electrical Code
4. JERES-P-104 - Wiring Methods and Materials
5. JERES-P-113 Motors and Generators
6. JERES -P-111 Grounding

NOTES:
1. Approved - Acceptable to the authority having jurisdiction (Company representative)
2. Identified - Recognizable as suitable for the specific application by a qualified testing laboratory (i.e., listing and/or labeling).
3. Listed - Equipment and materials included in a list published by an approved qualified organization concerned with evaluation of products
or services, that maintains periodic inspection of production of listed equipment or materials or periodic evaluation of services, and whose listing states
that the equipment, material, or services either meets appropriate designated standards or has been tested and found suitable for a specified purpose.
4. Labeled - Equipment or materials to which has been attached a label, symbol, or other identifying mark of an approved qualified organization concerned
with product evaluation, that maintains periodic inspection of production of labeled equipment or materials, and by whose labeling the manufacturer
indicates compliance with appropriate standards or performance in a specified manner.
Contractor / Third-Party SATORP
Construction Representative* PMT Representative
Work is Complete and Ready for Inspection:
T&I Witnessed QC Record Reviewed Work Verified
Name, Initials and Date: Name, Initials and Date:

QC Inspector PID Representative


Work / Rework May
Performed Inspection T&I Witnessed QC Record Reviewed Work Verified
Proceed
Name, Initials and Date: Name, Initials and Date:

QC Supervisor Proponent and Others


Quality Record Approved:
T&I Witnessed QC Record Reviewed Work Verified
Name, Organization,
Name, Sign and Date:
Initials and Date:

*Person Responsible for Completion of Quality Work / Test: Y=YES N=NO F=FAILED

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