Classification | Internal

Document Submittal Form

Document
Contractor submittal 13-122001-4800000206-NAP-ELE-ITP-000006
no.

Contract no. 4800000206/018 Date 11-Dec-2022

To PMC NEOM/AECOM

Rev
Document no. Type Description Action required
no.
Inspection 4800000206/018 - CONSTRUCTION OF Approval Comments
PROJECT (ITP) FOR INSTALLATION
13-122001-4800000206-NAP-ELE- & Test Plan
OF HDPE PIPES IN CONCRETE & 01
ITP-000006 with UNDERGROUND FOR ELECTRICAL Other
Information
Checklist SYSTEM

Contractor authorized signatory

Name Issmat Alsabbagh Date 11-Dec-2022

Signature

PMC’s comments

Exception as noted revise

No exception taken Revise and resubmit
Status code and resubmit for record
Rejected Review not required Issued for Construction

Engineer’s name Date

Signature

Received by Contractor
Name Date

Signature

Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 1 of 9

 INSPECTION TEST PLAN

4800000206/018 - CONSTRUCTION OF
PROJECT (ITP) FOR INSTALLATION OF
HDPE PIPES IN CONCRETE &
UNDERGROUND FOR ELECTRICAL SYSTEM

13-122001-4800000206-NAP-ELE-ITP-000006 Rev 01, Dec-2022

Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 2 of 9

Classification | Internal

Document history

Revision code Description of changes Purpose of issue Date

01 First Issue For Approval 11-Dec-2022

Document approval

Prepared by Reviewed by Approved by

Name Ahmad Awartani Issmat Alsabbagh Houssam Nakouzi

Job Title Senior QA / QC QA/QC Project Manager Project Director

Electrical Engineer

Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 3 of 9

 Contents
1. INSPECTION TEST PLAN………………………………………..……………………….5

Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 4 of 9

Classification | Company General

INSPECTION AND TEST PLAN FOR INSTALLATION OF HDPE PIPES IN CONCRETE AND
UNDERGROUND FOR ELECTRICAL SYSTEM
NEOM QUALITY MANAGEMENT SYSTEM Main Contractor: Nesma & Partners Co. Ltd.
CONSTRUCTION OF PROJECT (ITP) FOR INSTALLATION OF HDPE PIPES
IN CONCRETE & UNDERGROUND FOR ELECTRICAL SYSTEM Sub-Contractor: NA
Contract Rev.
Contract No.: 4800000206/018
Title: Sindalah Island–Superstructure Works for Yacht Club Building at Cluster 2 ITP No.: 13-122001-4800000206-NAP-ELE-ITP-000006
No.:
01 Date: 11-DEC-2022

Level of Participation Points

S Controlling Document/ Acceptance
Activity Phase Inspection / Test Method SUB Remark
No. Reference Standard Criteria Main NEOM
Con. PMC
Con. Q&E
If Applicable
1 Document Review
1.1
Material Submittal Approved Material Submittal
As per approved material
R R R R
submittal

1.2 IFC & Shop Drawings Approved shop drawing As per approved shop drawing R R R R

As per approved method of

1.3 Method of Statement Approved method of statement
statement
R R R R

1. NEOM-NEN-SCH-005.
Project specifications:
Quality Control Procedure for Installation 13-122001-4200000002-RAM-
1.4 ELE-SPC-000002_02
As per Approved QCP R/H R/H R/H R/H
and Sealing of HDPE PIPES AND FITTINGS.
Section 260543
2- Schedule Q

2 Receiving Material
NPIC-E-001 NEOM ETSD shall be notified on start of this
Receiving of HDPE pipes and Fittings Visual
2.1 Approved Material Submittal H H H H activity.
inspection
Storage, handling, and preservation of HDPE Schedule Q –Appendix C paragraph C05 NPIC-E-001 H Weekly inspection by contractor QC through WIR
2.2 H W W
pipes and fittings Visual inspection
3 Installation
Installation of HDPE pipes with fittings: The 1. Project Specification: NPIC-E-001 NEOM ETSD shall be notified on start of this
13-122001-4200000002-RAM- activity.
Pipe Sleeve routing as per approved survey ELE-SPC-000002_02
3.1 report and approved WIR Visual inspection Section 260543
H H H H
2. NEOM-NEN-SCH-005
3- Schedule Q
Cleaning and sealing conduit/pipe end Visual 1- Project Specification: NPIC-E-001 NEOM ETSD shall be notified on start of this
inspection 13-122001-4200000002-RAM- activity.
ELE-SPC-000002_02
3.2 Section 260543
H H H H
2- NEOM-NEN-SCH-005
3- Schedule Q
Warning Tape Installation Visual Inspection 1- Project Specification: NPIC-E-001 NEOM ETSD shall be notified on start of this
13-122001-4200000002-RAM- activity.
ELE-SPC-000002_02
3.3 Section 260543
H H H H
2- NEOM-NEN-SCH-005
3- Schedule Q

4 Pre-Commissioning
1- Project Specification: NEOM ETSD shall be notified on start of this
13-122001-4200000002-RAM- activity.
ELE-SPC-000002_02
Mandrel Test Visual Inspection Visual Section 260543 H
4.1 NPIC-E-001 H H H
inspection 2- NEOM-NEN-SCH-005
3- Schedule Q

ITP Approval Signature

Legend:
S: Responsible for carrying out random surveillance of
H: Contractor must not proceed without approval. R : Responsible for reviewing certification or reports. W: Responsible for / and witnessing all inspection or test.
inspection or test/Random Check.

.
Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 5 of 9
Classification | Company General

INSPECTION AND TEST PLAN FOR INSTALLATION OF HDPE PIPES IN CONCRETE AND
UNDERGROUND FOR ELECTRICAL SYSTEM
NEOM QUALITY MANAGEMENT SYSTEM Main Contractor: Nesma & Partners Co. Ltd.
CONSTRUCTION OF PROJECT (ITP) FOR INSTALLATION OF HDPE PIPES
IN CONCRETE & UNDERGROUND FOR ELECTRICAL SYSTEM Sub-Contractor: NA
Contract Rev.
Contract No.: 4800000206/018
Title: Sindalah Island–Superstructure Works for Yacht Club Building at Cluster 2 ITP No.: 13-122001-4800000206-NAP-ELE-ITP-000006
No.:
01 Date: 11-DEC-2022

Level of Participation Points

S Controlling Document/ Acceptance
Activity Phase Inspection / Test Method SUB Remark
No. Reference Standard Criteria Main NEOM
Con. PMC
Con. Q&E
If Applicable
Sub-Contractor (If Applicable) Main Contractor PMC NEOM Q&E
Name: Name: Name: Name:

Signature: Signature: Signature: Signature:

Date: Date: Date: Date:

GENERAL NOTES:
The first (3) of each inspection or testing activities listed require 100% participation of client site inspection personnel. After this period, client inspection may adjust the level of client participation based on the contractor's performance.
Hold: QA/QC team shall be notified of the schedule of inspection or test in advance. Inspection or test shall not be carried out without the QA/QC Team/Client representative in attendance.
Review: Required qualification/certification/reports shall be submitted for the QA/QC team review and approval.
Witness: QA/QC team shall be notified of the schedule of inspection or test in advance. If the QA/QC Team/Client representative doesn’t come on time for inspection, the activity can proceed.
Surveillance: QA/QC team to monitor work in progress without notice from the construction organization/Random check selection.

Legend:
S: Responsible for carrying out random surveillance of
H: Contractor must not proceed without approval. R : Responsible for reviewing certification or reports. W: Responsible for / and witnessing all inspection or test.
inspection or test/Random Check.

.
Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 6 of 9
Classification | Company General Use

INSPECTION CHECKLIST NPIC NUMBER DATE WIR NUMBER

INSTALLATION OF HDPE PIPES IN CONCRETE & NPIC-E-001 ELEC-

UNDERGROUND FOR ELECTRICLA SYSTEMS
PROJECT TITLE CONTRACT NUMBER CONTRACTOR

Sindalah Island–Superstructure Works for Yacht Club

4800000206/018 Nesma & Partners Co. Ltd.
Building at Cluster 2
ITEM
ACCEPTANCE CRITERIA REFERENCE PASS FAIL N/A RE-INSP
No.
DATE

A
MATERIAL RECEIVING / MATERIAL STORAGE AND HANDLING.
Fill Placement Inspection
Fill Placement
Fill Placement
Inspection
Fill

A1 The material shall be in accordance with approved material submittal, Project

project standards, schedules, lists and associated documents. Specification:
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
and Approved
MAT.
A2 Deliver ducts to Project site with ends capped. Store nonmetallic ducts Project
with supports to prevent bending, warping, and deforming. Specification:
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 1.5A
A3 Each length of HDPE pipes shall be clearly and durably marked at least NFPA-70, NEC-70
3m Article 353.120

A4 Material shall be new and unused and free of damages. Schedule Q

Appendix C
paragraph C4.1

A5 All product shall carry permanent marking by manufacturer Project

Specification:
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 2.2

B B B
B Compaction
INSTALLATION
Inspection
Compaction Inspection
Compaction
Compaction
Inspection
Co

B1 Slope: Pitch ducts a minimum slope of 1:300 down toward manholes and Project
handholes and away from buildings and equipment. Slope ducts from a Specification
high point in runs between two manholes to drain in both directions. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5A
B2 Curves and Bends: Use 5-degree angle couplings for small changes in Project
direction. Use manufactured long sweep bends with a minimum radius of Specification
1200 mm, both horizontally and vertically, at other locations, unless 13-122001-
otherwise indicated. 4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5B
B3 Joints: Use Approved joints in ducts and fittings and make watertight Project
according to manufacturer's written instructions. Stagger couplings so Specification
those of adjacent ducts do not lie in same plane. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5C
B4 Grout end of pipes into structure walls from both sides to provide Project
watertight entrances. Specification
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 7 of 9
Classification | Company General Use

INSPECTION CHECKLIST NPIC NUMBER DATE WIR NUMBER

INSTALLATION OF HDPE PIPES IN CONCRETE & NPIC-E-001 ELEC-

UNDERGROUND FOR ELECTRICLA SYSTEMS
PROJECT TITLE CONTRACT NUMBER CONTRACTOR

Sindalah Island–Superstructure Works for Yacht Club

4800000206/018 Nesma & Partners Co. Ltd.
Building at Cluster 2
Para 3.5D

B5 Building Wall Penetrations: Make a transition from underground duct to Project

rigid steel conduit at least 3 m outside the building wall without reducing Specification
duct line slope away from the building, and without forming a trap in the 13-122001-
line. Use fittings manufactured for duct-to-conduit transition. 4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5E
B6 Sealing: Provide temporary closure at terminations of ducts that have Project
cables pulled. Seal spare ducts at terminations. Use sealing compound Specification
and plugs to withstand at least 1.03-MPa hydrostatic pressure. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5F
B7 Pulling Cord: Install 445-N test nylon cord in ducts, including spares. Project
Specification
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5G
B8 Separator Installation: Space separators close enough to prevent sagging Project
and deforming of ducts, with not less than 4 spacers per 6 m of duct. Specification
Secure separators to earth and to ducts to prevent floating during 13-122001-
concreting. Stagger separators approximately 150 mm between tiers. Tie 4200000002-
entire assembly together using fabric straps; do not use tie wires or RAM-ELE-SPC-
reinforcing steel that may form conductive or magnetic loops around ducts 000002_02
or duct groups. Section 260543
Para 3.5H
B9 Minimum Space between Ducts: 75 mm between ducts and exterior Project
envelope wall, 50 mm between ducts for like services, and 100 mm Specification
between power and signal ducts. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5 H6
B10 Depth: Install top of duct bank at least 600 mm below finished grade in Project
areas not subject to deliberate traffic, and at least 750 mm below finished Specification
grade in deliberate traffic paths for vehicles, unless otherwise indicated. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5 H7
B11 Stub-Ups: Use manufactured duct elbows for stub-ups at poles and Project
equipment and at building entrances through the floor, unless otherwise Specification
indicated. Extend concrete encasement throughout the length of the 13-122001-
elbow. 4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5 H8
B12 Stub-Ups: Use manufactured rigid steel conduit elbows for stub-ups at Project
poles and equipment and at building entrances through the floor. Specification
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5 H9
B13 Couple steel conduits to ducts with adapters designed for this purpose, Project
and encase coupling with 75 mm of concrete Specification
13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 8 of 9
Classification | Company General Use

INSPECTION CHECKLIST NPIC NUMBER DATE WIR NUMBER

INSTALLATION OF HDPE PIPES IN CONCRETE & NPIC-E-001 ELEC-

UNDERGROUND FOR ELECTRICLA SYSTEMS
PROJECT TITLE CONTRACT NUMBER CONTRACTOR

Sindalah Island–Superstructure Works for Yacht Club

4800000206/018 Nesma & Partners Co. Ltd.
Building at Cluster 2
Section 260543
Para 3.5 H9. a

B14 Stub-Ups to Equipment: For equipment mounted on outdoor concrete Project

bases, extend steel conduit horizontally a minimum of 1500 mm from Specification
edge of base. Install insulated grounding bushings on terminations at 13-122001-
equipment. 4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.5 H9. b
B15 Warning Tape: Project
Bury warning tape approximately 300 mm above all concrete-encased Specification
ducts and duct banks. Align tape parallel to and within 75 mm of the 13-122001-
centerline of duct bank. Provide an additional warning tape for each 300- 4200000002-
mm increment of duct-bank width over a nominal 450 mm. Space RAM-ELE-SPC-
additional tapes 300 mm apart, horizontally. 000002_02
Section 260543
Para 3.5 H10

B B B
C Compaction
Pre-Commissioning
Inspection
Compaction Inspection
Compaction
Compaction
Inspection
Co

C1 Inspection of duct system, by pull aluminum mandrel or other approved Project

device with diameter 80% on inside diameter of duct, is to be pulled Specification:
through the duct and is to pass through without getting stuck. 13-122001-
4200000002-
RAM-ELE-SPC-
000002_02
Section 260543
Para 3.9 A2
REMARKS: Note: Other inspection criteria’s which is not in this list & applicable as per site condition shall be referred to the technical
specifications & Approved drawings.

REFERENCE DOCUMENTS:
material submittal, IFC, approved shop drawings and project specification.

Contractor / Third-Party PMC / NEOM Q & E

Construction Representative* PMC Representative
Work is Complete and Ready for Inspection:
Name, Initials and Date:
Name, Signature and date
QC Inspector Neom Q & E

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

Document No: 13-122001-4800000206-NAP-ELE-ITP-000006 Rev No: 01 Page 9 of 9