IR — INSPECTION REQUEST WEST QURNA |= SECTION-1 Contractor No.: AWQ0109 ExxonMobil Project Title: jcc Produced Water Treatment M109 LOCATION: ‘Antemina Batch | IRNO:IR No CE-CO028 | IRISSUE DATE: 05 February 2017 DISCIPLINE: Civil Plant SUBJECT: Witness INSPECTION REQUIRED DATE:06 February 2017 | TIME:10:00, REF.SPECIFICATION: 1QWA-FT-NSPDS-00-040103 REV.O CONCRETE DESIGN AND CONSTRUCTION : 1QWC-CE109i-CDFND-D7-0003 REV.1 FOUNDATION FOR PRODUCED WATER TANK BEF DAW NSE: 107-ABI681053 PLAN SECTION & DETAIL RFF. ITP: 1QWO-CE1082-CPOAC-00-0001 REV.C CIVIL INSPECTION AND TEST PLAN OTHERS REF.: {QW-CE1092-KRTST-O0-0004 REV.O CONCRETE MIX DESIGN TEST REPORT "ATTACHMENT /CHECK LIST IF ANY: NAME OF CONTRACTOR/SUBCONTRACTOR: CPECC/ALMADAR ‘Our request the inspection of the following works for certificate/witness that al tems has been properly executed in accordance with approved procedures, specifications, drawings and all items has been coordinated with future works. DISCRIPTION OF WORK TO BE WITNESS: ‘Sampling cement, gravel, sand and water as per the concrete mix to do all chemical and physical tests in AL-FAO Central lab. Request witness for taking these samples in Antemina Batch Plant. ‘COMMENTS: Meal idaey He Seng, Caccerreo Caccerrep with comments GresecreD Clwerkisnotready Clunacceptable inspection result see comments C1 Tick THis Box IF “NO” EMIL / SOC and if itis a “WITNESS” as per ITP, {by ticking this box means CPECC needs to produce all the related documents and sign / close this IR) SIGNATURE FOR NOTIFICATION/ ACKNOWLEGEMENT SUBCONTRACTOR oPece COMPANY oTwens PRINT NAME: PRINT NAME: PRINT NAME PRINT NAME Ammon fakhir | My Bang Yossein stant SIGNATURE: SENATURE 7 St "YE 6-2-2) vate: E-Feb G17 | pare: ‘SIGNATURE: pate: 6 ~~ Zo|7 _ | pate