su ie {OVI ts ot O48 Yr da i ft tl ne INSPECTION RELEASE NOTE TaN Ne. TRD-TERSDAROWPLMP2OO1 Dae 307100 41.0. TOV SUD CLIENT DATA Cotartone Wan Oa Gos Pale Led Bulnhor Contato (lent TOV SOD) | IND-13952 Projet Nae 7. Ws: ndan OFA Gas Pat ied Bundshar Cui Person Cistonar | Wr. ADsek Gown ‘TUV SUD Coordinator ‘Mr. Sanjay Singh 70, SUPPLIER! SUBSUPPLIER DETAIL Tare Ws Varian PL Toes Block No 72, abused Vil otha Taka Kal Ost Goneinogar ON. 8 at LOINo]OXGPLZD2LOFPE PpelALLO¥4 Date: 2.08200, #0. Sts Pat OF Date ofits 1200 1011200, 30, REFERENGE DOCUMENT (raving! QAP Speticaon No. Description Doe. No. Rev. | App.Code | Approved By i mcs LOI No: IOAGPLZ0.21/LOFPE . ©) | MSIOAGPL to Pipe/ALLIO14 Dated: 22-09-2020 | | IPL He er Payeyare + TOAGPLVISHKHAOHREV.o0z020 2 | "Poeserperl . WsoRGAL renee ozt082t08 70. TTEMS INSPECTED Taig | Ten Decor roay | tapceiay | Ares ) 20mm OD x SOR 11 PE 60 Polyethylene Pipes 9000 Meter ‘9000 Meter oT Miruanisr(t cols 2uemy | MH | Uecws’ | \ascas ape of 133 For any suggestions/complaint please write to ‘Qual Industryservices@tuv-sud in" een een Seana ee =o mw" sear aeContinuation sheet of IRN -IND-013362/AHDIVIPLUMPI2O(01 Date: 30.11.2020 bet oases: Colne | ——Dassion 75a, Ta napee sy | amxresoxsonin | ORPUDZILOIFEPRSMLIOTT | ae ay L MOPE Pipe (3"* Lot) (Bulandsehar 9000 Meter) i (45: Cole x 200) Meter) Details of Inspection Activities : 1} Rav irl es Cates, ype tpot reveal ur noe 2) Rental 1) AS per QAP Sr, No, Zo 7: Witnessed Conventional densiy, Melt Mass fow rate, OT (Thermal tabi), Volatile conten test & Pigment dispersion test of Raw material of PEBD Grade M3441, Batch No, 1120212) 120216 as per QAP and found satstactry. b) Inprocess inspection QAP Sr No. 11 to 16 (randomly witnessed ) 41) Visualinspecton of pipes or color of pipes and found satisfactory 2) Internal & Extemal surface of pipes randomy checked fr visual appearance and found smooth, Clean and {re rom Cavities, scares and other surface defects. Hence visual inspection found satisfactory. 3) Dimensions inspection of pines (mean outside ameter, Ovalty, wal thickness, Length) checked as pet QAP Requirements and found within acceptable iit 4) Marking randomly checked as pe requirement and found in order. ©) Final inspection QAP S* No. 25,27 to 33 witnessed on 3 selected col samples) 41) Wiinessed Hycro test for 165 Hrs, at 80°C) Loading & Unloading for 3 selected samples, Found Sat 2) As per QAP: Winessed Heat reversion tst, Conventional density, Melt Mas flow rte, OT (Thermal tai), Volatile content test, Tensile yield strength test & Elongation at break test s per reference standard and found ‘esuits meet with the requirements. - Hence sted tests found satisfactory. st of Carton Instruments: Reviewed carton ceria of instrument spe below abe. Instrument Sr.No. /IDNo./- | NABL | Calvaton 1m bet Testing Equipmert Model No. __| Accredited | Due Date 1 | Vernier Caper (Digital) 0 150 mm 451101081 “nior2¢ | z Vernier Calpe. 012 300mm 10206728 voz [3 | Wistometr Gal End Digital Oto 25mm 5067000 | ‘ina | 4 Pi Tape 28 9 300 mm Da WSTC-1000081 “tot é PrTape 20'0 300mm Da. 515A 1062021 6 Mesrrg Tape Oo 15 Listes saioa02t | Bava Proetor (gl Protec) 1504 2102004 é Microscope He Pte EPL 200074 EDO | ‘vio Hyosiati Pressure Tesing Machine 9 Seat Orrvaeconeioe | woe w Col Water Bath DEPLEOIO DOTA —| Tao Fost Pressure Testing Machine 1 meee] DpPL201 2012097800701 | rao 12 Hot Water Bath (40*20*40)" ‘DPPL/2008-2009/109 12/10/2021 i Hol Water Both DRL ZINE 2017117430877 iaam2t it Notch Cuter CDPPL2011-20120698 2062024 [18 |" ero Degree Chamber (Deep feezer| —DPPU2010-20110346 ‘riot 6 Non Venta Hot Ar Oven PPL 2008-20911 saioa0at Top Load Dita alance with Denaly 7 ple 1452000051 ‘roa Wot 0sContinuation sheet of IRN :-IND-01S362/AHDIVIPLIMPI20/01 Date: 30.11.2020 ting Equipment "| Instrument Sr. No.7ID No.7 | NABL | Calibration | st: Model No. Accredited | Due Date [6 iyraulle Press 20 Ton (DPPL2009-2010336 yanorao2t } 19 Melt Fiow Index Tester (DPPL2008-2009/112 sirroraa2t 29 | _ Differential Thermal Analyzer (OIT DSc 4000 Pane Tester) 02 & N2 Gas Cylinder 52041120503 Tensile Testing Machine with Scale, Yes a sdb Cae ae OPPLI2008.20081115 snisor20e1 Zz ‘Dry & Wet Thermometer AMCIN03643 122021 | FA Giass Thermometer THOT [asioer2021 a Hydrometer 035077 ‘3/06/2024 Enclosure: 1. Test Reports 2. Raw Materal Test Certificates 3. Type test report 4__Insrument Calirtion summary sheet Detal of identification: f gagy TUV SUD Rubber stamp sticker pasted atthe end ofthe pipe's coll as * 133 1 Rubber Stamp Die Stang Inspection Status - (Acoapt Th Dispaich Recomended Action :-(1) Vendor shal lke utmost care while handling the product afer completion af nepecton, Distribution: 1 lent Supple sppion I Conrcig ice Pereming oie TUB Inspection Engineer Name sgn & stamp (ly M Patt Ganshyam Panchal fandya, Hardik R. Patel, Pawan Kushwah, Page 03 of 03sovtea fotooy eee meet eee Cree etme 1.0. TOV SUD CLIENT DATA Contract No. (Client to TUV SUD) | IND-017013 7 Contact Person of Customer Mr. Abhishek Chowfin — | oer ea oe P.O. Status MPat OFull - ee ae | room | Super TT. [iat See | pace scum aon S 2 pee rae 2021123.09.2020 - - WelongPt me TOithe fen Ta Deception ogy | epeceaay | seeped ay rar 2mm OD xSOR 11 PER) Povetivene Pipes | yon igr | “000Meter | 4000 Neer lI {or Jaunpur & Ghaziur (1 Cols 200 Meter) (20Cois) | (20Cois) ca | For any suggestions /complaint please write to “Qual Industryservices@tuv-sudin* fegensomen xp oe: nat sin To stosomasara. us (OER SRaree — eemagandin te ar Ba, Iikoe aa Tov’ Shite kee a, PrDatatot LOI Line Item No. Description P.O. Qty. Total Inspected Qty. wo —_| Brmxresoxson rs | ONPURIMOHFE FERAL | ae | OPE Pee Lol | ggg DARE CEAIN | ance ey Details of Inspection Activities : 1) Raval el Ctl, Tp test epat are evewednd urn ore 2) Rawle! 1) As per QAP Sr No, 2107: Witnessed Conventional deny, Melt Mass fow rate, OIT (Thermal Stabiy), ‘Volatile content test & Pigment dispersion test of Raw material of PEBO Grade M3441, Batch No, 112021211120216 as per QAP and found " Ins ‘St No, 111016 (andomiy witnessed ) 4) Visual inspection of pipes for color of pipes and found satisfactory 2) Inemal & External surface of pipes randomly checked for visual appearance and found smoot, Clean and free fram Cavities, scares and other surface detects. - Hence vsval inspection found satisfactory. 3) Dimensions inspection of pipes (mean ouside diameter, Ovalty, wall thickness, Length) checked as per QAP Requirements and found within acceptable limit. 4) Matkng randomly checked as per requirement and found in order. ©) Final inspection 25,27 10 3 witnessed on 3 selected col samples) 41) Witnessed Hydro test (for 185 Hrs. at 80°C) Loading & Unloading for 3 selected samples, Found Saistactry 2) As per QAP: Winessed Heat reversion test, Conventional ens, Melt Mas flow rate, OT (Thermal Sti), ‘Volatile content test, Tensile yeld strength test & Elongation at break test as per reference standard and found ‘results meet with the requirements. - Hence listed tess found satisfactory. List of Calibration Instruments: Reviewed calibration certifcates of instumens as per below table ; Instrument No No.) WABL | albrafon ai eee EPR Mode! No. Accredited | Due Date | Weir Caper Dia Oi 150m ‘S108 sinner Z| —~Verer Calpe Oto 20m 106725 inane | 3 ‘Micrometer (Ball End Digital) 0 to 25 mm. 65067000 4102/2021 ‘ Pape 281 300m Da HiSTC-00006% ‘upeat Tape 2.0 30m IBA 15082001 6 Haan Tape O15 Mir Uist ss102021 T— | ~Botl Proc nl rot ‘501 raria2t z Hsescope Ha Pale Pen. 20071 ERD 204 | Patera esse Tsing Mec | ppm zr0r08 wro20a1 40. Cold Water Bath DPPL/2010-2011/0340 ie 43/10/2021 Faia Pressure Tesing acne 1 nae] oPeLeot-20r20a7so7ot | ‘ozo 12 ‘Hot Water Bath (40%2040)" ‘DPPL/2008-2009/109 j2nor021 8 a Water Bah DPPLani6.2017 174302877 ‘aro02t it Noth Cuter OppLaor.20120688 | ‘ae202t 15_| Ze Degree Chanter (sep Fazer | —DPPLEITO:20 1036- ‘aonnat 16—|-NonVentod Hot Ar Oven PPL 08-2001 ‘0021 Top Lond Dea Blancs wih Desi 1 a esz0n261 ‘won0a1 133Continuation sheet of RN IND-OTTOTSIAHDIVIPLIMPI20°01 Dat: 30.11.2020 | Instrument Sr.No./ID No./ | NABL | Calibration St. No, Testing Equipment asa Nis ‘anata Da Dine 8 Hydraulic Press 20 Ton ‘DPPL2009-2010/336_| yanoro2t 19 Melt Flow Index Tester DPPL2008-2000/1 12 snooze a Differential Thermal Analyzer (OTT DSC 4000 ‘norma | __ Tester) 02 & N2 Gas Cylinder 52081120503 Tensile Testing Machine with Scale, Yes a Diao Cae eeh ‘DPPL2008-2008/115 1111012021 @ Dry & Wet Thermometer AMCI003643_—— | TMzR02F 2 Glass Thermometer THOT 15/06/2021 Ey Hydrometer 035077 1970672024 Enclosure: 1. Test Reports 2. Raw Material Test Certificates 3. Type lest report 4_Insiument Calibration summary sheet etal of identification: TUV SUD Rubber stamp sticker pasted atthe end ofthe pipe's coll as * 1 Rubber Stam = Die Stamp [Inspection Status = elAccept Tr Dispatch ‘Recomended Action: (1) Vendor shall take utmost care while handing the product aller completion of Mspecton Distribution: © Clent Cl Suppler/Sub supplier Ch Contacting ofice Et Performing ofice Inspector Inspection Engineer Name sign & stamp - Ua Ganshyam Panchal sant Pandya, Hardik R. Patel, Pawan Kushwah, Page 03 of 03‘TOV SUD Sou sa Of Sol har Road Sh Nk. «An Ea -Mantal 00872 INSPECTION RELEASE NOTE TRN No. IND-01701S/ARONIPLMP?2001 Date: 30.11.2020 1.0. TUV SUD CLIENT DATA | ie (Customer Name Ms indian Oi-Adani Gas Pate Limited Alahabad Outer Contract No. (Ctentio TOV SUD) | IND-017015 i Projet Name 7 No Ms. indan Oi-Adani Gas Pate Limited, Alahabad Outer Cave Peron of Corer [We tihk own ; TOVSUD Coordinator Mr. Sania Soh | 20, UPPLIER/ SUBSUPPLIER DETAIL Name [Wes isha rigaton Pv. Location Block No.792, Sabaspur Road, Vi: Mtbhoyan, Taluka: Kalo, Dist: Gandhinagar. P.ONo, & Date LOI No. IOAGPL20-21N.OFPE PiplALLION4 Dated: 2200-200. al 7.0 Stas BPet_OFul Date of vis | 4.11.2020 to 19112020, 18.1,2020 to 23.11.2020, 30.14.2020 3.0, REFERENCE DOCUMENT (Orawing/ QAP /Specication) No. | Description Doc. No. Rev. App. Code | Approved By [PREPS | oxcruusnonoiRevaonr 2 | Poesasperis eee ) - Ms 10AGAL “40. 1TEMS INSPECTED Tale | eon ora 4 | AMRODESDRITPERO Pobabvene FP | op weer | Tae | Teo eer | L {or Alahabad Outer (1 Cail= 200 Meter) (28Cois) | (68Cois) _] Page ot of 63 For any suggestions/complaint please write to “Qual Industryservices@tuv-sud.in” eid Oe: Capon oe: Ena: ede atin Isso rea Pu Tsien nsehecut —wowineadin TW fom Shae ‘ae Va io ana Sina feet a Pon nea? hae‘Continuation sheet of IRN - IND-01701S/AHDIVIPLIIMPI20/01 Date: 30.11.2020 Daal ot apeton: : TOiLine tem No, Deseipin 70.0, Tetalinspected a —_| @amxeesoxson it | ORPURDZIAOHPE PORATION | ea ae MOPE Pipe (3* Lot) (Atohabed outer 730 Meter) _| (28 Cos x200 Meter) i its 1) Raw Watera Test Crates, Type est report ar revened an four nore, |) RawMateria 1) AS per QAP Sx No, 2to7: Witnessed Conventional density, Melt Mass fw rate, OIT (Thermal Stability), Volatile content test & Pigment dispersion tet of Raw material of PE8O Grade M441, Balch No. 1120212/1120216 as per QAP and found satstactry. ») Inspection ‘111016 (randomly witnessed ) 41) Visual inspection of pipes for color of pipes and found satisfactory, 2)_Intemal & Extemal surface of pipes randomly checked fr visual appearance and found smooth, Clean and {ree from Cavites, scares and other surface defects. - Hence visual inspection found satisfactory. 3). Dimensions inspection of pipes (mean outside dameter, Ovaty, wal thickness, Length) checked as per QAP Requirements and found within acceptabe lit, 4) Marking randomly checked as per requirement and found in order, ©) Final inspection QAP Sr No. 25,27 to 33 (witnessed an 3 selected col samples) 4) Witnessed Hydro test (or 165 Hrs. at 80°C) Loading & Unloading for 3 selected sample, Found Satisfactory, 2) sper QAP: Witnessed Heat reversion test Conventional density, Melt Mass fw rat, OIT (Thermal Stability) ‘Volatile content test, Tensile yeld strength test & Elongation at break test as per reference standard and found results meet withthe requirements. - Hence listed tess found satisfactory. ist of Calibration Instruments: Reviewed caltratin certains 2s per below ble Instrument r.No./IDNo./ | NABL | Calibration Sr.No, Testing Equipment Model No. Accredited | Due Date 4 Vemier Caliper (Digital) 0 to 150 mm 151101081 4110/2021 z Vemir Calpe. 0 300 mm 0206728 0220, 3 ‘Micrometer (Ball End Digital) 0 to 25 mm 65067000 4102/2021 t i Tape 2810300 nm Dia wWSTC-1000081 “aot 5 PiTape 2010300 mm Da. 1515 15082021 é esr Tape Oo 15 Mt Visies sai0a02t T | Bove Protector (ingle Protec 1501 “art 3 Micrwscop Hot lie BRS 2074 TED ‘rroz24 Fiat Pressure TesingVachine 9 cain DePUzo0e-2000/108 vee | ioe w Cold Water Bath — DEPLIOTO DOT O3aD waive! os Pressure Tesing Machine 11 | Roms nT pean 0100878070 ‘oan 2 Til Water Bath (e200 DPLTHIB-209TIO0 Toro 3 Hot Water Bath DBPL 2016-20171 74302877 ‘tog i Notch Cuter DPPLZOTE 2020608 2062021 15 _| Zao Depee Chamber (Deepfreeze) DPPU00.20" 0346 | ‘rio 16 Non-Venilated Ht Ar Oven (PU208-200111 yoni Topload Deal Blane wih Dnsiy a cae as2000251 ‘sotS) ‘Continuation sheet of IRN = IND-O1701S/AHDVIPLIIMPIZOIO1 Date: 90.11.2020 _ . Instrument Sr. No./IDNo./ | NABL | Calibration pA) Hevea Exe rent Model No. Accredited | Due Date @ Hydraulic Press 20 Ton ‘DPPL/2009-20107336 ‘r2rt072021 19 ‘Melt Flow index Testor (DPPL/2008-2000/112 ‘1/1072024 Diferental Thermal Analyzer (OTT ‘DSC 4000 2 Tester) 02 & N2 Gas Cyiinder 52041120603 ees Tensile Testing Machine wih Scale Yes a Deseo oe ‘0PPL2008-20091115 ‘nirar2021 2 Dry & Wet Thermometer AMGIOOREAS Tae B — Giass Thermometer THI ([esiosraoet (er Hydrometer 035077 13/06/2021 Enclosure Test Reports 2. Raw Material Test Certificates 3. Type test report 4._Insrument Calbation summary sheet Detal of identification: ‘TUV SUD Rubber stamp sticker pasted at the end ofthe pipe's coll as * 133 Rubber Stary Die Stan, Inspection Status Dispatch ‘Recomended Action - (1) Vendor shall fake utmost care while handing the product aller comnplion ol hepecion, Distribution: @1 Clent Cl Supplr/Sub supple. Cl Contracing offce Performing ofice Inspection Engineer Name sign & stamp Jay > Pandya, Hardik R. Patel, Pawan Kushwah, Ganshyam Panchal, Page 03 of 03‘Sone owe USO St Asa OS Vir ond SA a Mamba 4072 INSPECTION RELEASE NOTE TRN No. IND-017039/AHDVIPLIJMP 2001 Date: 30.11.2020 4.0. TOV SUD CLIENT DATA Customer Name Ms. Indian OibAdani Gas Piva Limited, Thrissur. Contract No. (Client to TUV SUD) | IND-017039 Project Name /No. Mis. indian OilAdani Gas Private Limited, Thrissur Contact Person of Customer Mr Abhishek Chowfin ‘TOV SUD Coordinator Me. Sanjay Singh 20. SUPPLIER! SUBSUPPLIER DETAIL Name Ms isha rigalon Pid Location Block No 782, Sabespur Roe, Vil: Motbhoyen, Taluka: Kao, Dist Gandhinagar P.ONo. & Date LOI No. IOGPL/20-211LOFPE PipelALLION Dated: 2208-2000, 7.0, Sats [Pat _O Ful Date of vis 14.11.2020 to 1311,2020, 19.14.2020 to 23.11.2020, 3.112020 '30, REFERENCE DOCUMENT (Orawing/ GAP / Speciation) No. Description Doe. No. Rev. | App. Code | Approved By ; Taig LOIN: TOAGPL0-27LOLPE J ~ | NSOAGELT© sil Ppe/ALLO'4 Dated 2-09.2020, | VL ‘AP for Pahetyiene TOAGPUVISHAHADUREV-0072020- 2 Pipes as per IS - : | ‘Mis JOAGPL veer 2021723082020 40, 1TEMS INSPECTED eeioar | ear Item Description Poy | Inspected ary | Accepted aly mm ODx SORT PE 80 Poyeivene pes | 21000 Meter — | ~2i000Weter 2 tetsu (ica aeay |New | These | HO a Inspector 133 Pm amen Somaseenaen ama Tov‘Continuation sheet of IRN - IND-017030/AHDIVIPLIMPI20/0Y Date: 30.11.2020 i ot nsactn LOI Line Nem No. (Description P.O. dy. ‘Total inspected Qty. x1 | Aramxresoxson ss | ONPUDZILOIFE FWA | ac pore eeuae (Trissur 21000 Meter) pie Geek don Actes: 1) Rav rl Te Cen, Type et pt eevee urd noe 2) Rawr 1) BSD O87: No, 217: Wines Contin es, Met as ow OT etal Sab), Volatile content test & Pigment cispersion test of Raw material of PE8O Grade M441, Batch No. 1120212/1120216 as per QAP and found satisfactory. ) Inprocess inspection QAP S: No. 11 jo 16 (randomly witnessed ) 41) Visual inspecton of pipes for color of pipes and found satisfactory, 2) Interal & Extemeal surface of pipes randomly checked for visual appearance and found smooth, Clean and {toe from Cavites, scares and other surface defects. - Hence visual inspection found satisfactory 3). Dimensions inspection of pipes (mean outside diameter, Ovaty, wall thickness, Length) checked as per QAP ‘Requirements and found within acceptabe limit. 4) Marking randomly checked as per requirement and found in order. ©) Final inspection QAP Sr No. 25,27 to 33 witnessed on3 selected col samples) 41) Wnessed Hyaro test (or 165 Hrs, at 80°C) Loading & Unloading for 3 selected samples, Found Satstactory. 2) As per QAP: Witnessed Heat reversion test, Conventional density, Melt Mass fw rate, OIT (Thermal Stal), ‘Volatile content tes, Tensile yield strength test & Elongation at break test as per reference standard and found results meet withthe requirements. Hence listed tests found satisfactory, List of Calibration Instruments: Reviewed calibration oeicaes of insvumens as per elon tbl et caley ; nt Sr.No./ID No. | NABL | Calration Sele | _Tetho pment nes | qemu | oot [1] Vernier Caper (Digital) Oo 150 mm 151101081 i ‘107202 2 erie Cler0 to 300 mm 10206728 “rvnar02t 3. | Micrometer (al End Digital Oo 25 mm 35067000 [iva 4 Pi Tape 28 0 300 mm Da STC-1000081 ‘arozoat 5 PiTape 20 to 300 mm Dia 515A al 190672021 6 Measuring Tape O15 itr Unats ‘evrozt21 T_| Bevel Protector (Angle Protector 1501 “anion0t 6 Microscope Hot Pate TDPPL2006 20007 1 E280 rinonazt | Froese esse Tsing Heine | ppm 008 wren 40 Cold Water Bath ‘DPPL/2010-201 110340 i) 43/70/2021 Fiydslatic Pressure Testing Machine 1 re DPPL2011.20120067510701 ‘ero02t Z Hel Water Bath (40%20»40)" DPPLZ008-20087108, eAOzIeT 3 Hot Water Bath DPPL2016.2017/174028T7 ano021 14 Noich Cuter ‘DPPL2041-201200608, 12062021 18 | ZeroDegree Chamber (Deep Feeze)_| — DPPLZ010-20110345, ‘evtoz021 16 Nor-Ventlated Hot A Oven (DPPL2008-2009/111 an02024 Top Load Digtal Balance with Deny 7 seen 42900251 ‘rorzo2t‘Continuation sheet of IRN :-IND-017039/AHDIVIPLIIMP/20/01 Date: 30.11.2020 ” Testrument Sr. No,/ID No. | NABL | Calibration | eche! een Enemas Model No. | Accredited | Due Date @ ysraule Press 20 Ton ‘DPPL/2008-2010336 “2ri0021 19 Melt Flow Index Tester (DPPL/2006-2009/112 ‘wno7024 29 | Diftenal Thermal Arayzer (OT Dc 4000 Tinawl Tester) 02 8 N2 Gas Cynder 201120508, Tensie Tesing Machine wih Scale, Yes 2a eles erie et 1DPPL2008-2009/115 ‘woreozt Z Dry & Wet Thermometer ‘AMCIOOREA Tnzate ZB ‘Gass Thermometer THOt 15082001 24 Hyerometer 036077 1 9062021 Enclosure Test Reports 2. Raw Mateal Test Cerficates 3. Type test report 4_Insrurent Calibration summary sheet Detall of entiation ee TWSLORADW danse ptdalteenitbepeetete” = © 133 2 Rubber Stamp Die Stam, Inspection Status = Eihccepl Dispatch Recomended Action (1) Vendor shal lake utmost care while handling he produc afer completion of nspecion | Distribution @ Clent Gl Suppler/Sub supplier racing ofice 2 Performing office Inspection Engineer Name sign & stamp Jay M nt Pandya, HardikR, Patel, Pawan Kushwah, Ganshyam Panchal v Page 03 of03‘TSU Sout Asia - Of Sol har Rod Sh Nas And Ea Mu A072 INSPECTION RELEASE NOTE TRN No. [INo-o18075/AHOMPLIMP 2001 Date: 30112020 1.0, 10v SUD CLIENT DATA customer Nave Mis. nian OF Adar Gas Pale Lined, Malappuram Contact No (Cito TOV SUD) | IND-01075 | Project Name 7No. | Ms. Indian Oi-Adani Gas Pate Limited, Malappuram, meal Contact Person of Customer | Mr. Abhishek Chon TWVS0 Coonnatar | Me Senay Singh 20, SUPPLIER! SUBSUPPLIER DETAIL Name [Me Vehaie re am ral tein Bk NOT, Sebspar Red, ik Nation Taka Kal Dt arog Ono. ae LOIN ORGPLANAAROVPE Pes Dane 2-8 2020 7.0. Saa ara OFA Dat fs [iar 1208, 81.2000. So am 30: REFERENCE DOINENT roving] QAP Spetcton No. | __Desepion | Dee. No Revs | Aap Cole] Approved By Tees anste LOIN: TOAGPLAOZTLOTPE | Wis TORGAL to | ). Copy Pipe/ALL/014 Dated: 22-09-2020 A VIP ‘QAP for Polyethylene VOAGPLSHHAO REV a0ar0- 2 | fase SHANI REY = = | wstoxer ‘eset | 7a EUS NSBECTED (OTL em ten Descion POQY | epectd Gly | Accepted Oy Bian OD x SDR PE AD Payee Pes | Teo Neer —| emo Weer Ey for Malappuram (1 Coil = 200 Meter) 12000 Mie {90Coils) _| (90 Coils) Page 01 of 03 For any suggestions/complaint please write 1 “Quality Industryservices@tuv-sud.in* Tv sumo xu. Webern us sown 2 a he Ro ‘Tio na Tov’ ‘Soetn er. ms a 0sSouth Asia ‘Continuation sheet of IRN = IND-O1807S/AHDIVIPLIMPI2OIO1 Date: 30.11.2020 Io nsecion - ‘LOI Line item No Description P.O. Qty. Total Inspected Qty. [gy apmmxrezoxson | OAPURZIAGIFEPERALIOT 1s | WOPEPpe Orta) | gy OHA 2EIA | go apn tite Details of Inspection Activites: Lisl Calbnn numa: Rowlett Tame Shee AASL— Caan Sr.No, Testing Equipment ModelNo. | Accredited | Due Date ‘| Wei lp ii Goma —— er iva 2] "ener Sages 0 rn ica nga 3 ‘Micrometer (Ball End Digital) 0 to 25 mm 65067000. 4102/2021 [tie ohn Da usr 0H ‘pian! [aio soomo ‘sien is0e2tt $—|—essoia Te ds ‘stoatt | se oe og Pe oa ‘aioe! 3 ers at? ORBLE TT voz o_| Paes esa aie | pean ra wore 10 Cold Water Bath DPPL/2010-2011/0340_ 7 43/0/2021 Fw Pesce Tea dine tt cheese eg Tee opp an1037S070 ‘aioe | fata 6 coe. —|— pecans — ‘mina = vow sah See a SUT ‘pia! tt no Sona a ‘poet 15 | es Das Cte Op fea] — Dean OTN ‘ana 16 | NrVewaga einen | — bpRLcomonoT rata Tilo Ogee wn Soay i Dg Bare asec tact 1) Raw Maleal Test Crates, Type test report ae reviewed and found inorder. 1) Raw Material 1) AS petQAP Sr No, 2107 Winessed Conventional dens, Melt Mass ow rate, IT (Therma tai), ‘Volatle content est & Prment dispersion test of Raw mateial of PEEO Grade M3441, Batch No, 1120212120216 as per QAP and found satslactory. 5) Inprocess inspection QAP Sr No. 11 to 16 (andomiywinessed ) 1) Visualinspecion of pipes for color of pipes and ound satisfactory 2) Intemal 8 Extemal surface of pipes radon checked for visual appearance and found smoot, Clean and free from Cavites, scares and oer surace defacts, Hence visual inspection fund satisfactory 3) Dimensions inspection of pipes (ean outside dame, Ovaliy wal tnckness, Length) checked as per QAP Requirements and found win acceptable it. 4) Marking randomly checked as per equiement and found in oder ©) Finalinspection QAP Sr No, 25,27 t 3 winessed on 3 selected col samples) 1) Witnessed Hydro test (or 15 Fs. 80°C) Loading & Unloading for 3 selected samples, Found Saisactory 2) As per GAP: Witnessed Heat everson es, Conventional densi, Melt Mass fow rat, OT (Thermal Stab), Volatile content test, Tensile yl tength est &Elongaton at beak test s per reference standard and found resus mee withthe requirements Herc sted test found salstactony.Continuation sheet of IRN = IND-OT6OTSIARONIPLOMPYZUOY Date: 90.7 2000 - it Sr.No, No, iL Se, Testing Eevee Ne | aecmeted | Duet 18_| yale Press 20 Ton BPL2008-2010396 ratooei 9 Met Flow inex Tester (DBPL2008.2000/112 nono Difrenal Themal Analyzer (OFT Sc 4000 a Tester) 02 & NZ Gas Cylinder 5201120503 jie Tensile Tsing Machine wit Sale, Yes | 2 ne eee an DPPLeo0E2ONH 5 ‘rore021 az Diy & Wet Thermometer ICHAT TmzaHe1 2. ‘Gass Thermometer ot 18067021 2 Hydrometer 38077 1 1306202 | Enclosure: 1. Test Reports 2. Raw Material Test Certificates 3. Type test report 4._Instrument Calibration summary sheet Detail of dentification ‘TUV SUD Rubber stamp sticker pasted atthe end ofthe pipes coll as * Rubber Stamp Die Stamp Inspection Status = Accept Ti Dispatch ‘Recomended Action (1) Vendor sal lake utmost care while handing the product air completion of Mspecion Distribution: @ Clent Cl Suppler/Sub supplier jofice © Performing of con Engine ae sign & stamp day Paes Pandya, Harh Pall Pawan Kista Gussyon Feet Page 03 of 05ieee {1 St0 oA -OF Srna Ae El 02 INSPECTION RELEASE NOTE RN Ne. TWO-019095/HOMIPLMPr001 [pater s0-a020 1.0. TOV SUD CLIENT DATA Customer Name. ‘Mis. Indian Oi-Adani Gas Private Limited, Kozhikode. | Contacto. (Cento TOV SUB) | NO-78095 f Projet Name [No Ws ndan Oi da Gas Prat nied Rocio. Cent Person of Customer | Mr, Abhishek Chowin TOV SUD Coordinator | Mr. Sanjay Singh 2.0, SUPPLIER SUBSUPPLIER DETAIL ane fs. Vshatha gaton PAL Locaton Block No.2 Sabespur Rod, Vik Motthoyan, Taluk Kal st Gardinegar PONo. 8 Dae LOIN. JOAGPL2021ROFPE PipeALLOY4 Dated 2-002020 0. Sats pan O Ful Date of vis 1.1.20 o 131-202, 1941202010 23.1200, 90.1200 30, REFERENCE DOCUMENT (raving! GAP/ Speciation No. | Description | Doc. No, Rev. App. Code | Approved By 1! P.O.c LOI No.: IOAGPL20-21/LO-PE ‘Wis IOAGPL to mid Pipe/ALL014 Dated: 22-09-2020 VIPL Cid OAGPLIVISHKHA01/REV-00/2020- | 2. | Pesos pers = | istoae. ou sae 20217309202) £0: TTEMS INSPECTED Eo een em Description Poay | Inspected ty | Accepted ay Bem OD SDR FEB) Postion Pes «| too eer —| Teo Weer tl for Kozhikode (1 Coil = 200 Meter) s1t000 Eee (55 Coils) (65Coils) 133 For any suggestions/complaint please write to "Qual Industryservices@tuv-sud in” agen omen Capote es: Ena gi edin Testo soatesPa ue TSM sme neehe Lt wamipeadin TW sibrewe tan OF i tse er ea, Tino ana Tov’ Son eet at Pom ines Ts a‘Continuation sheet of RN IND-01609S/AHDIVIPLIIMPI20/07 Date: 30.17.2020 Detail of Inspect olin He Ne.| Basen FO. Tal napected se | 2mmxreanxson ss | OGPURZILOIFEFDSALLOTE son ya HOPE pe @ Ll) cain 209.2120 |_| ecole 20 Me Details of inspection Activities : “.) Raw Materal Test Cerifcates, Type test repr are reviewed and found in order. 2) Raw Material 1) As per QAP Sr. No, 2 to 7: Witnessed Conventional density, Melt Mass flow rate, OIT (Thermal Stability), Volatie content test & Pigment dispersion test of Raw material of PEO Grade M3441, Bach No, 1120212/1120216 as per QAP and found sastacoy. 1») Inprocess inspection QAP Sr No. 11 to 16 (andomiywiessed ) 4) Visualispecton of pipes for color af ppes and fund satisfactory 2) Intemal& Extomalsurlaceof pipes randomly checked for visual appearance and found smooth, Clean and ‘re tom Cavities, scares and che sure delet. Henoe visual inspection found safety. 3) Dimensons inspecton of pipes (ean outside diameter, vali, wal ickness, Length) checked 3s per QAP Requirements ad found within acceptable iit. 4) Marking randomly checked as per requrerment an fourdin ore. ©) Final inspection QAP S No. 25,2710 33 witnessed on 3 selected col samples) 4) Witnessed Hydro test (or 165 Fs. 60°C) Loading & Unloading for selected samples, Found Satsacoy. 2) As per GAP: Witnessed Heat reversion ts, Conventional densi, Mat Mass fow rate, OIT(Themal Stab), Volatile content tet, Tense yield stength test & Elongation at break est as per reference standard and found resus moot wih the requiemens. Hence ited tet ound slstectry. sto Calibration Instruments: Reviewed caltraton cericates of instruments a per below abe lisa ee Instrument Sr. No./ID No. | NABL | Calibration Ne Kee] : Model No. | Accredited | Due Date 1 | Veter Caliper (igta 0 150 mm 15110108 ‘torc2t z emi Caliper 00 300 mm 40206728 ‘voze02t 3 | Mirometr (Bl End Digital) Oo 25 mm 35067000 ‘voze02t 4 Pi Tape 281 300 mm Da MSTC-1000081 aon 5 PiTape 201 300mm Dia 1515A #5082021 6 Measuring Tape Oto 18 Mir Ur444s ‘eytoz021 | Bevel Protector (Ange Protector) 1501 ‘2ri0n021 8 Microscope Hot Plate DPPLIZO08- 2000714 TE02B0 10021 9 _| Hrsestats Prssine Tesing Machine” ppzooe. 200/08 ‘aor20z1 (9 Statons 3 outlet) ves 0 Cold Water Bath DPLZOI0-201 0340 iaioaiei Hydrostatic Pressure Testng Machine " aseea tiene DDppLi2011-20120097510701 seize @ Hot Water Bath 40%20=40) DBPL2006- 20007108 aii 8 Hot Water Bath (DPPL2016.2017/174310287 savo202t 4 Notch Cuter (PPL 1-201200696 1208/2021 48 "Zero Degree Chamber (Deep feeze) | OPPL/20T0-20r10346 | [rsmtorozt 16 Non Ventiated HotAir Oven DDPPLZ008-2009/111 ‘vtozt2t Top Load Digital Balance wih Densiy "7 aad, 452900251 ‘swore Page 02 of 03South Asia ‘Continuation sheet of IRN = IND-O1809S/AHDVVIPLIIMPIZOIO1 Date: 30.11.2020 Instrument Sr. No./IDNo./ | NABL | Calibration SNe. \Leeees Eee Mode! No. Accredited | Due Date 8 Fyraulc Press 20 Ton PPL 2008-20103 y2rtor02t 18 ‘Melt Flow index Testor (DPPL2008-2000/112 1t072021 Diferental Thermal Analyzer (O1T ‘OSC 4000 a Tester) 02 & N2 Gas Cyinder 52041120508 eee Tensile Testing Machine with Scale, c Yes a Neneh Carel ‘DPPLi2008-20091115, ‘1irov2021 ze Dry & Wet Thermometer ACROSS Tozer [3 Giass Thermometer THO 15/067021 24 Hydrometer 038077 1308/2021 Enclosure: 4. Test Reports 2. Raw Matra Test Certificates 3. Type test eport 4._Instument Calibration summary sheet Detail of dentfication: TUV SUD Rubber stamp stcker pasted at the end of the pipe's coll as * Rubber Stamp = Die stamp Inspection Status = Eaaccepl Cl Dispaich Recomended Action (1) Vendor shal lake utmost care whl handling the preduct afer completion af lnepecton, Distribution: & Clent ©) SupplerSub suppl oniractng offce 1 Performing oe 4 Inspection Engineer Name sign & stamp Jay Wl fasant Pandya, Hardik R. Patel, Pawan Kushwah, Ganshyam Panchal Page 03 of 03