GR5HRM-CIVIL-ITP-ENGLISH Version

COMPRESSION STATION GR5 HRM
PROJECT NO. GR5HRM
DOCUMENT NUMBER DOCUMENT TITLE Page 1 of 65
GR5HRM-330-QA-TI-0001
INSPECTION AND TEST PLAN FOR Rev 0
GENERAL CIVIL WORK Date 16-NOV-2014
PROJECT : Compression Station GR5 HRM
PROJECT NO : GR5HRM
OWNER : SONATRACH
CONTRACTOR : Dodsal Engineering & Construction FZE
DOCUMENT NO. : GR5HRM-330-QA-TI-0001
DOCUMENT REVISION STATUS : 0
DOCUMENT CLASS : 1
Revision and Authorization Record
Issued for
0 16-NOV-2014 Construction
PV RA BSS
A 5-NOV-2014 Issued for approval PV RA BSS
Date DODSAL SONATRACH

Rev Description Prepared By Checked By
(DD-MMM-YYYY) Approved
PROJECT NO. GR5HRM
REVISION RECORD:
Revision
Reason for Revision Date
No.
A Issued for approval 5-NOV-2014
0 Issued for Construction 16-NOV-2014
Note:
The changes made in this document during the latest revision are marked on the right hand side of the
corresponding pages with black vertical bars.
PROJECT NO. GR5HRM
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REMARKS/REMARQUES:
CLIENT JOB UNIT
SONATRACH 330
PLANT LOCATION
DOC No.:GR5HRM-330-QA-TI-0001
Hassi R’Mel, Algeria
PROJECT TITLE Rev.
Sh. 4 of 65
0
COMPRESSION STATION GR5HRM

UNIT 330
INSPECTION AND TEST PLAN
FOR
GENERAL CIVIL WORK
File name:
CLIENT JOB UNIT
SONATRACH 330
PLANT LOCATION
PROJECT TITLE Rev.
Sh. 5 of 65
0
TABLE OF CONTENTS
1 INSPECTION TEST STANDARDS
1.1 Inspection Test Standards list:

CI- 0001 “Survey instrument and electronic operating measuring devices “
CI- 0002 “Project bench marks“
CI- 0003 “Materials for earthworks“
CI- 0004 “Concrete and materials for concrete and grout “
CI- 0005 “Earthworks (excavation & fill)“
CI- 0006 “Main and minor structural concrete items“
CI- 0008 “Sanitary and rain water sewer system“
CI- 0009 “Cement based and epoxy non-shrink grouts“
CI- 0010 “Concrete basins, sewer pits, inspection manholes and catch basins“
CI- 0011 “Tank foundations in concrete“
CI- 0012 “Protective coating application on concrete surfaces“
1.2 Forms list

GR5HRM-QA-FM-025 “Request for inspection (RFI)“
GR5HRM-QA-FM-026 “General checks report of ……….……….”
GR5HRM-QA-FM-027 “Bench marks inspection report“
GR5HRM-QA-FM-028 “Concrete mix design inspection report“
GR5HRM-QA-FM-029 “Structural concrete finishing inspection report”
GR5HRM-QA-FM-030 “Check of lean concrete and structural concrete before placement“
GR5HRM-QA-FM-031 “Lean and structural concrete daily pouring record“
GR5HRM-QA-FM-032 “Inspection report for……………………“
GR5HRM-QA-FM-033 “Concrete specimens compressive strength test report“
GR5HRM-QA-FM-034 “Watertight test report for basins, sewer pits, manholes and catch
basins“
GR5HRM-QA-FM-035 “Sewer system pipes watertight test report“
GR5HRM-QA-FM-036 “Tank foundation settlement test report “
GR5HRM-QA-FM-037 “Inspection report before application of cementitious fireproofing on

structures & equipment“
GR5HRM-QA-FM-038 “Grout compressive strength test report“
GR5HRM-QA-FM-039 “Inspection report of roads, parking and paving areas before structural
concrete pouring “
GR5HRM-QA-FM-040 “Inspection report before lean concrete pouring“
GR5HRM-QA-FM-041 “Inspection report before structural concrete pouring“
GR5HRM-QA-FM-042 “Inspection report before grouting“
GR5HRM-QA-FM-043 “Inspection report of sewer system after pipe laying“
GR5HRM-QA-FM-044 “Subgrade inspection report before laying fill material“
GR5HRM-QA-FM-045 “Inspection of formation level of binder and wearing courses “
GR5HRM-QA-FM-046 “Inspection report on tank foundations before placement of lining“
GR5HRM-QA-FM-047 “Final inspection report of cementitious concrete fireproofing”
GR5HRM-QA-FM-048 “Final inspection report for sewer system “
GR5HRM-QA-FM-049 “Grouting daily pouring record“
GR5HRM-QA-FM-050 “Final inspection report of tank foundations“
File name:
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PLANT LOCATION
PROJECT TITLE Rev.
Sh. 6 of 65
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GR5HRM-QA-FM-051 “Final inspection report before application of protective coat“

GR5HRM-QA-FM-052 “Inspection report after protective coat application “
GR5HRM-QA-FM-053 “Final inspection report of site excavation/fill works“
GR5HRM-QA-FM-054 “Inspection report of completed fences and gates system“
1.2 ITP Legend

Involvement code
P-Perform Organization to conduct the Inspection and test activities.

S-Surveillance Organization to Monitor the work in progress without notice from Construction
Contractors.
R-Review Organization to review and approve the documents prior to stat the related
work.
W-Witness Organization shall be notified by Construction Contractor of the timing of
inspection and test in advance. However, the inspection and test shall be
performed as scheduled if the Organization representative is not present.
Unless otherwise specified in column “Notes” of the ITP, Organization shall
ensure the continuous presence of its inspectors during inspection and tests.
Some incidents may be tolerated provided that this lack of attendance is
occasional and is not causing negative impact on the quality of the work.
Hold Point Organization shall be notified of the timing of the inspection and test in
advance. Inspection and test shall not be carried out without the Organization
representative in attendance.
Organization codes
CC – Construction Contractor
QC – Construction Contractor QA/QC
DS – Dodsal Supervisors
DQ – Dodsal QA/QC
TP – Laboratories or TPI
CL – COMPANY
CT – Agency of control technical
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COMPRESSION STATION GR5 HRM Sh. 7 of 65 0
N° ITS : CI - 0001 DISCIPLINE

ITEM
Title: SURVEY INSTRUMENT AND ELECTRONIC GENERAL CIVIL WORKS
OPERATING MEASURING DEVICES
Reference Acceptance Quality Record Involvement
QC CODE Description Document Ref. Criteria Form CC QC DS TP DQ CL CT Notes
CI 0001 01 Review certificates validity of surveying Manufacturer Expiring date GR5HRM-QA-FM- P R R R R P

equipment calibration ISO Conformity 026
Calibration
and calibration
certificate certificates
N° ITS : CI - 0002 DISCIPLINE ITEM
ORGANIZATION CODE INVOLVEMENT CODE

CC – Construction Sub Contractor DQ- QC Dodsal CT – Agency of control technical P – Perform/Submit W – Witness
QC – QC Sub contractor TP – Laboratory / Third Party S – Surveillance H – Hold Point
DS – Dodsal Supervision CL – COMPANY R – Review
CLIENT JOB UNIT
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PROJECT TITLE Rev.
Title: PROJECT BENCH MARKS GENERAL CIVIL WORKS

CI 0002 01 Bench marks inspection Topographic GR5HRM-330-CI- GR5HRM-QA-FM- P H H R R  Check if ITP GR5HRM-
True coordinates and mean sea level survey and/or SP-0001 027 330-CI-TI-0001 is
elevation  grading plans completed and approved
GR5HRM-330-
CI-SP-0001

CLIENT JOB UNIT
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PROJECT TITLE Rev.
Title: MATERIALS FOR EARTHWORKS GENERAL CIVIL WORKS

CI 0003 01 Natural soil laboratory test GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- H R P R R R  Only for sampling
 Soil sampling CI-SP-0009 SP-0009 026
 Review of natural soil properties R
certificates including:
- soil classification
- natural water content
- maximum dry density
- optimum moisture content
- particle size distribution
- liquid limit
- plasticity index
Any other properties as applicable.
CI 0003 02 Fill material laboratory test GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R R  Only for sampling
(site excavated or imported borrow pit CI-SP-0009 SP-0009 026
R
material)
 Soil sampling
 Review of material properties
- liquid limit
- plasticity index

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PROJECT TITLE Rev.

ITEM
CI 0003 03 Laboratory test of base and subbase GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R  Only for sampling
material for roads, parking and paving CI-SP-0009 SP-0009 026
areas R
(site excavated or imported borrow pit
material)
 Soil sampling
- maximum dry density (compaction
tests using standard modified effort)
- liquid limit
- plasticity index
CI 0003 04 Material for final finishing / surfacing GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R  Only for sampling
Review compliance to project specific CI-SP-0003 SP-0003 026 
requirement of site and borrow pit available
R
material to be used for finishing/surfacing

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PROJECT TITLE Rev.

ITEM
CI 0003 05 Laboratory test of soil-cement mix GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R P  Only for sampling
material for foundation of roads, parking CI-SP-0009 SP-0009 026
and paving areas R R
 Material sampling
certificates including
- liquid limit
- plasticity index
CI 0003 06 Soil-cement mix compressive strength GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R P  Only for sampling
laboratory test CI-SP-0009 SP-0009 026
 Material sampling R R
 Review certificates

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: CONCRETE AND MATERIALS FOR CONCRETE AND GENERAL CIVIL WORKS
GROUT
CI 0004 01 Cements for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R P

Review mill certificates for physical and CI-SP-0004 SP-0004 026
chemical properties.
CI 0004 02 Admixtures for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R P  Admixtures to be used
Review admixtures technical sheets CI-SP-0009 SP-0009 026 must be approved before
including: commencement of the
GR5HRM-330- GR5HRM-330-CI-
- field of application works.
CI-SP-0004 SP-0004
- instruction for use and storage
- Laboratory Test Certificate in
accordance with ASTM C260, ASTM
C494
- side effects (positive and negative)
- proportioning of admixture in % (by mass
of cement)
- chloride content
- Instruction for mixing with concrete.
Any other information as applicable.

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PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 03 Mixing water for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R R  Only for sampling
 Material sampling CI-SP-0009 SP-0009 026
R
 Review of Laboratory Test Certificates GR5HRM-330- GR5HRM-330-CI-
in accordance with ASTM D512, ASTM CI-SP-0004 SP-0004
D516, ASTM D513, ASTM D1293
CI 0004 04 Coarse and fine aggregates for concrete GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R R  Only for sampling
work CI-SP-0009 SP-0009 026
 Material sampling R
 Review of Laboratory Test Certificates CI-SP-0004 SP-0004
accordance with ASTM C33
certificates including: i.e. grading and
fineness modulus, amount of material
finer than No. 200 sieve; bulk unit
weight; petrography examination;
abrasion; water soluble chlorides;
reactivity of aggregate, etc.

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PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 05 Mix design documentation for concrete GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H H P P R R  Only for sampling
work CI-SP-0009 SP-0009 028
R H  Mix design
 Material sampling GR5HRM-330- GR5HRM-330-CI- documentation is to be
 Review concrete mix design CI-SP-0004 SP-0004 produced before
documentation: commencement of the
- schedule of preliminary trial tests works.
for the determination of the mixes
- results of concrete preliminary trial
tests which document that the
proposed concrete proportions will
produce an average strength equal
to or greater that the required
average strength
- documentation of proposed
batching plant or source of ready-
mix concrete supply
- procedures for operations
necessary to reach a good
concrete curing.

CLIENT JOB UNIT
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PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 06 Other material for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

Review technical sheets for: CI-SP-0004 SP-0004 026
- Release agent for formwork
- Spacers for concrete cover and
formwork ties
- Hydrocarbon resistant mastic
- Joint material
CI 0004 07 Reinforcement for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R P R R  Only for sampling
 Material sampling CI-SP-0004 SP-0009 026
W
 Review of material properties GR5HRM-330-CI-
certificates including: SP-0004
- reinforcing bar (mill test report with
physical and chemical properties)
- Frequency of the test for concrete
ingredient and steel shall be
conducted by third party and Test
shall be carried as per Project
Specification
- Welded wire fabric (Manufacturer’s
certification meeting requirements
of applicable standards)
- Placing and Fixing of reinforcement

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 08 Embedment materials GR5HRM-QA-FM- P R R R R

Review of materials proprieties certificates 026
of:
- Commercial bolts, Anchor bolts, nuts
and washers
- Plates, flats, sections, bars and bent
bars with anchors having dovetail ends
or otherwise shaped
- Special pipe sections of various diameter
and material shaped
- Expansion bolts
- Chemical bolts
- Installation and survey of Embedded
item, conduits and box outs etc.
CI 0004 09 Material for fireproofing concrete and GR5HRM-QA-FM- P R R R R R R

gunite coating 026
Review of material properties certificates
for:
- cement
- aggregates
- water
- galvanized electric-welded wire fabric
- galvanized tying wire.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 10 Lightweight cementitious fireproofing GR5HRM-QA-FM- P R R R R R R

products 026
Review material documentation:
- Manufacturer material certificates for
commercial products.
- certificates of laboratory tests showing
the thickness to be obtained,
construction details and application
methods.
CI 0004 11 Sealing compound for fireproofing GR5HRM-QA-FM- P R R R R R R

Review Manufacturer’s technical card of the 026
non-flammable, weatherproof and
temperature resistant sealing compound.
CI 0004 12 Personnel qualification for special GR5HRM-QA-FM- P R R R R R

fireproofing application 026
Personnel qualification by Manufacturer or
Supplier.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 13 Sand-cement grout materials GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

Review of materials properties certificates of: CI-SP-0004 SP-0004 026
- mixing water
- cement
- aggregates.
CI 0004 14 Grout mixes specimen compressive GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P H R P R R  Only for sampling
strength CI-SP-0004 SP-0004 038
GR5HRM-330-CI-
 Review laboratory results of grout SP-0009
compressive strength tests for:
- grouts mix for thickness < 400mm
- grouts mix for thickness ≥ 400mm.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 15 Non-shrink cement base premixed grouts GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

Review materials documentation: CI-SP-0004 SP-0004 026
- non-shrink premixed grouts materials
certificates
- non-shrink premixed concrete materials
certificates
- procedures for preserving, mixing,
laying, and curing the non-shrink cement
grout.
CI 0004 16 Non-shrink epoxy grout GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

Review the Manufacturer documentation: CI-SP-0004 SP-0004 026
- characteristics of the materials
- procedures for preserving, mixing,
laying, and curing the non-shrink epoxy
grout.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
GROUT
CI 0004 17 Sewer and drains materials GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

Review certificate of conformance (including CI-SP-0006 SP-0006 026
tests) of followings materials:
- non-reinforced concrete piping
- reinforced concrete piping
- vitrified clay piping
- cast iron piping
- rigid PVC pipes
- septic tanks
- cast iron covers and gratings
- concrete channels.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: EARTHWORKS (EXCAVATION & FILL) GENERAL CIVIL WORKS
Notes
QC CODE Description Document Ref. Criteria Form CC QC DS TP DQ CL CT
CI 0005 01 Test of in-situ density of compacted GR5HRM-330-CI- GR5HRM-330- GR5HRM-QA-FM-032 P H W P R S/R R Check if QC Code 01 of ITP
GR5HRM-330-CI-TI-0003 is
subgrade SP-0009 CI-SP-0009
completed and approved.
 Only for sampling:
 Determination of subgrade in situ witness min. first 2
density as compared with the maximum occurrences and 1 every 4
laboratory density. occurrences thereafter.
CI 0005 02 Inspection on subgrade / grade AFC DWG GR5HRM-330- GR5HRM-QA-FM-044 H WS R S/R Check if ITP GR5HRM-330-
CI-TI-0002 is completed and
Inspection of subgrade and grade layer CI-SP-0004 
GR5HRM-330-CI- approved.
before laying fill material. SP-0004  Witness first 2
occurrences and perform
surveillance of occurrences
thereafter.
Check if QC Code 02 and
CI 0005 03 Test of in-situ density of fill AFC DWG GR5HRM-330- GR5HRM-QA-FM-032 P H W P R S/R
03 of ITP GR5HRM-330-CI-
(fill, subbase, base, backfill materials) CI-SP-0009
GR5HRM-330-CI- TI-0003 are completed and
SP-0009 approved.
 Determination of each compacted layer  Only for sampling:
in situ density as compared with the witness min. first 2
maximum laboratory density. occurrences and 1 every 4
AFC DWG occurrences thereafter.
CI 0005 04 Final inspection of site excavation/fill AFC DWG GR5HRM-QA-FM-053 P H W R R R Check if the QC Code 04 of
works GR5HRM-330-CI- ITP GR5HRM-330-CI-TI-
GR5HRM-330-
Inspection of finishing/surfacing works: i.e. SP-0003 0003 are completed and
CI-SP-0003 approved.
vertical and horizontal levels, slope,
thickness, dimensions and surfacing status.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.
Title: MAIN AND MINOR STRUCTURAL CONCRETE ITEMS GENERAL CIVIL WORKS
CI 0006 01 Test of in-situ density of compacted AFC DWG GR5HRM-QA-FM- P H W P R R R  Only for sampling
subgrade 032
GR5HRM-330-CI- GR5HRM-330-CI- R  Only for main structural
 Material sampling SP-0003 SP-0003 concrete items and when
 Determination of subgrade in situ
density as compared with the maximum GR5HRM-330-CI- specifically indicated in AFC
laboratory density. SP-0009 Drawings
CI 0006 02 Subgrade field inspection AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R Check if ITP GR5HRM-330-
Inspection of location, elevation, dimensions, SP-0004 040 CI-TI-0002 is completed and
GR5HRM-330-CI- approved.
shape and preparation of surface, before SP-0004
lean concrete delivery and placement.
CI 0006 03 Check of lean concrete before placement AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W P R R Check if the QC code from
030  01 to 06 of ITP GR5HRM-
 Document review of batch ticket GR5HRM-330-CI-
SP-0009
330-CI-TI-0004 are
 Material sampling  R
SP-0004 GR5HRM-330-CI- GR5HRM-QA-FM- completed and approved.
 Document review for compressive SP-0004 033 
strength tests result   Only for sampling
 Lean concrete batch
ticket shall contain as
minimum the information
indicated by the form
GR5HRM-QA-FM-030
 Only when specifically
indicated in AFC Drawings

CLIENT JOB UNIT
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PROJECT TITLE Rev.

ITEM
CI 0006 04 Lean concrete pouring record AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R (): Log book to be
Batch daily recording of total lean concrete SP-0004 031 maintained by CC/QC. QC
GR5HRM-330-CI-
poured and items traceability. to submit weekly the log to
SP-0004 () DODSAL.
CI 0006 05 Inspection before structural concrete AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H H R R Check if the QC codes from
pouring SP-0004 041 01 to 08 of ITP GR5HRM-
GR5HRM-330-CI- W 330-CI-TI-0004 are
Inspection of lean concrete status, SP-0004
positioning, formwork, reinforcement, anchor completed and approved.
bolts, embedment, pockets and holes, joints,
clean.  Only for main structural
concrete items.
CI 0006 06 Check of fresh structural concrete before GR5HRM-330-CI- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R  Structural concrete batch
pouring SP-0004 SP-0004 030 ticket shall contain as
 Document review of batch ticket 
GR5HRM-QA-FM-030

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PROJECT TITLE Rev.

ITEM
CI 0006 07 Structural concrete pouring record AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R (): Log book to be
SP-0004 031 maintained by CC/QC. QC
Batch daily recording of total structural GR5HRM-330-CI-
to submit weekly the log to
concrete poured and items traceability. SP-0004 () DODSAL.
CI 0006 08 Concrete specimens compressive AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H HW P R W/S R  Only for sampling: Hold
strength test SP-0004 033  point for the first 3
 Material sampling GR5HRM-330-CI- occurrences and witness
SP-0004 GR5HRM-330-CI- R
 Document review for compressive SP-0009
thereafter.
strength tests result of Cubes samples.
CI 0006 09 Structural concrete finishing inspection AFC DWG GR5HRM-QA-FM- P H W R S Check if the ITP GR5HRM-
Structural concrete finishing inspection prior 029 330-CI-TI-0012 is
GR5HRM-330-CI- GR5HRM-330-CI-
to proceed with backfilling activities. completed and approved. (if
SP-0004 SP-0004 GR5HRM-QA-FM- applicable).
054
 Form to be used for
erected fence and gates
system only.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: SANITARY AND RAIN WATER SEWER SYSTEM GENERAL CIVIL WORKS
CI 0008 01 Inspection of sewer system after pipe AFC Drwgs GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R Check if ITP. GR5HRM-
laying SP-0006 043 330-CI-TI-0002 and QC
Inspection of pipe size and quality, GR5HRM-330- Code 17 of ITP. GR5HRM-
alignments, elevations, gradients, CI-SP-0006 330-CI-TI-0004 are
connections, thrust blocks, no debris in completed and approved.
pipelines, bedding type
CI 0008 02 Sewer system watertight test AFC Drwgs GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R Check if QC Code 09 of
Test of the sanitary and rain water sewer SP-0006 035 ITP. GR5HRM-330-CI-TI-
system watertight fulfilment GR5HRM-330- 0010 is completed and
CI-SP-0006 approved.
CI 0008 03 Sanitary and rain water sewer system AFC Drwgs GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R
final inspection SP-0006 048
Inspection of pits, manholes and catch GR5HRM-330-
CI-SP-0006
basins, steps, frames, cover slab, grating,
hermetic cover and internal cleaning

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.
Title: CEMENT BASED AND EPOXY NON-SHRINK GROUTS GENERAL CIVIL WORKS
CI 0009 01 Inspection before grout placement AFC DWG AFC DWG GR5HRM-QA-FM- P H H R W Check if the QC codes from
Inspection of top foundation surface 042  13 to 16 of ITP. GR5HRM-
GR5HRM-330- GR5HRM-330-CI- 330-CI-TI-0004 are
preparation (chipping, soaking and cleaning), CI-SP-0004 SP-0004 W
formworks (positions/shapes, levels, joints, completed and approved.
chamfers, clearance between base plate and Manufacturer’s Manufacturer’s  Only for machinery
foundation)  technical data technical data foundations
sheet of grout sheet of grout
 Only for main structural
concrete items
CI 0009 02 Grout specimens compressive strength AFC DWG AFC DWG GR5HRM-QA-FM- P H H P R R  Only for sampling
test 048   Only for main structural
Manufacturer’s Manufacturer’s
 Material sampling technical data technical data R concrete items.
 Document review for compressive sheet of grout sheet of grout
strength test results
CI-SP-0004 SP-0004
CI 0009 03 Grout pouring record AFC DWG AFC DWG GR5HRM-QA-FM- P R R R R (): Log book to be
Batch daily recording of total grout poured 049 maintained by CC/QC. QC
GR5HRM-330- GR5HRM-330-CI- to submit weekly the log to
and items traceability. CI-SP-0004 SP-0004 ()
DODSAL.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: CONCRETE BASINS, SEWER PITS, INSPECTION GENERAL CIVIL WORKS
MANHOLES AND CATCH BASINS
Quality Record Involvement
Reference Acceptance
QC CODE Description CC QC DS TP DQ CL CT Notes
Document Ref. Criteria Form
CI 0010 01 Test of compacted subgrade for main AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W P R R  Only for sampling
structural concrete items  SP-0004 032
 Material sampling GR5HRM-330- R  Only for main structural
CI-SP-0004 GR5HRM-330-CI- concrete items and when
 Tests result document review for sub- SP-0009 specifically indicated in AFC
grade compaction before lean concrete
delivery and placement. Drawings
CI 0010 02 Subgrade field inspection AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R Check if ITP. GR5HRM-
Inspection of location, elevation, dimensions, GR5HRM-330- SP-0004 040 330-CI-TI-0002 is
shape and preparation of surface, before lean CI-SP-0004 completed and approved.
concrete delivery and placement.
CI 0010 03 Check of lean concrete before placement AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W P R R Check if the QC code from
01 to 06 of ITP GR5HRM-
 Document review of batch ticket SP-0004 030
330-CI-TI-0004 are
GR5HRM-330- R
 Material sampling  GR5HRM-330-CI-  completed and approved.
 Document review for compressive CI-SP-0004
SP-0009  Only for sampling
strength tests result  GR5HRM-QA-FM-
033  Only for main structural
concrete items.

GR5HRM-QA-FM-030

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
CI 0010 04 Lean concrete pouring record AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P R R (): Log book to be
R R
Batch daily recording of total lean concrete GR5HRM-330- SP-0004 031 () maintained by CC/QC. QC
poured and items traceability. CI-SP-0004 to submit weekly the log to
DODSAL.
CI 0010 05 Inspection before structural concrete AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H H R R Check if the QC code from
pouring GR5HRM-330- SP-0004 041 01 to 08 of ITP. GR5HRM-
Inspection of: lean concrete status, positioning, CI-SP-0004 W 330-CI-TI-0004 are
formwork, reinforcement, anchor bolts, completed and approved.
embedment, pockets and holes, joints, clean.
 Only for main structural
concrete items.
CI 0010 06 Check of fresh structural concrete before AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P R R  Structural concrete batch
pouring GR5HRM-330- SP-0004 030 R R ticket shall contain as
Document review of batch ticket CI-SP-0004 minimum the information
 indicated by the GR5HRM-
QA-FM-030

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
CI 0010 07 Structural concrete pouring record AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P R R (): Log book to be
Batch daily recording of total structural GR5HRM-330- SP-0004 031 () R R maintained by CC/QC. QC
concrete poured and items traceability. CI-SP-0004 to submit weekly the log to
DODSAL.
CI 0010 08 Concrete specimens compressive strength AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H HW P R R R  Only for sampling: Hold
test GR5HRM-330- SP-0004 033  point for the first 3
 Material sampling CI-SP-0004 GR5HRM-330-CI-
occurrences and witness
 Document review for compressive R thereafter.
SP-0009
strength tests result.
CI 0010 09 Watertight test AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R

GR5HRM-330- SP-0004 034
Test water tightness of basins, sewer pits, CI-SP-0004
inspection manholes and catch basins.
CI 0010 10 Structural concrete finishing inspection AFC DWG GR5HRM-330-CI- GR5HRM-QA-FM- P H W R R Check if the ITP. GR5HRM-
Structural concrete finishing inspection prior to SP-0004 029 330-CI-TI-0012 is
proceed with backfilling activities. GR5HRM-330- completed and approved (if
CI-SP-0004 applicable).

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: TANK FOUNDATIONS IN CONCRETE GENERAL CIVIL WORKS
Involvement
Reference Acceptance Quality Record Notes
CI 0011 01 Test of in-situ density of compacted GR5HRM-330-CI- GR5HRM-330- GR5HRM-QA-FM- P H W P R R Check if Code 01 of ITP.
subgrade SP-0004 CI-SP-0004 032  GR5HRM-330-CI-TI-0003 is
 Material sampling completed and approved.
 Determination of subgrade in situ R
density as compared with the maximum  Only for sampling:
witness min. first 2
laboratory density.
occurrences and 1 every 4
occurrences thereafter.
CI 0011 02 Subgrade field inspection AFC DWG AFC DWG GR5HRM-QA-FM- P H W R R Check if ITP. GR5HRM-
Inspection of location, elevation, dimensions, 040 330-CI-TI-0002 is
GR5HRM-330-CI- GR5HRM-330- completed and approved
shape and preparation of surface before SP-0004 CI-SP-0004
lean concrete delivery and placement.
CI 0011 03 Check of lean concrete before placement AFC DWG AFC DWG GR5HRM-QA-FM- P H W P R R Check if the QC code from
 Document review of batch ticket 030   01 to 06 of ITP GR5HRM-
GR5HRM-330-CI- GR5HRM-330-
 Material sampling  SP-0004 CI-SP-0004 GR5HRM-QA-FM- R
330-CI-TI-0004 are
 Document review for compressive 033 
completed and approved
strength tests result 
 Only for sampling


CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
GR5HRM-QA-FM-030
 Only when specifically
indicated in AFC Drawings
CI 0011 04 Lean concrete pouring record AFC DWG AFC DWG GR5HRM-QA-FM- P R R R R (): Log book to be
031 () maintained by CC/QC. QC
Batch daily recording of total lean concrete GR5HRM-330-CI- GR5HRM-330- to submit weekly the log to
poured and items related traceability. SP-0004 CI-SP-0004
DODSAL.
CI 0011 05 Inspection before structural concrete AFC DWG AFC DWG GR5HRM-QA-FM- P H H R R Check if, the QC codes from
pouring 041 01 to 08 of ITP. GR5HRM-
GR5HRM-330-CI- GR5HRM-330- W 330-CI-TI-0004 are
Inspection of lean concrete status, SP-0004 CI-SP-0004
positioning, formwork, reinforcement, anchor completed and approved.
bolts, embedment, pockets and holes, joints,
clean.  Only for main structural
concrete items.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
CI 0011 06 Check of fresh structural concrete before AFC DWG AFC DWG GR5HRM-QA-FM- P R R R R  Structural concrete batch
pouring 030  ticket shall contain as
Document review of batch ticket minimum the information
SP-0004 CI-SP-0004 indicated by the GR5HRM-
QA-FM-030
CI 0011 07 Structural concrete pouring record AFC DWG AFC DWG GR5HRM-QA-FM- P R R R R (): Log book to be
031 () maintained by CC/QC. QC
Batch daily recording of total structural GR5HRM-330-CI- GR5HRM-330-
concrete poured and items related SP-0004 CI-SP-0004 DODSAL.
traceability.
CI 0011 08 Concrete specimens compressive AFC DWG AFC DWG GR5HRM-QA-FM- P H HW P R R R  Only for sampling: Hold
strength test 033 point for the first 3
GR5HRM-330-CI- GR5HRM-330- 
 Material sampling SP-0004 CI-SP-0004
occurrences and Witness
 Document review for compressive thereafter.
R
strength tests result.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
CI 0011 09 Structural concrete finishing inspection AFC DWG AFC DWG GR5HRM-QA-FM- P H W R R Check ITP. GR5HRM-330-
Structural concrete finishing inspection prior 029 CI-TI-0012 is completed and
to proceed with backfilling activities. approved.
SP-0004 CI-SP-0004
CI 0011 10 Inspection on subgrade / grade AFC DWG AFC DWG GR5HRM-QA-FM- H W R R  Witness first 2
044 S occurrences and perform
Inspection of subgrade and grade layer GR5HRM-330-CI- GR5HRM-330-  surveillance of occurrences
before laying fill material. SP-0004 CI-SP-0004
thereafter.
CI 0011 11 Test of in-situ density of fill AFC DWG AFC DWG GR5HRM-QA-FM- P H W P R R Check if QC Code 02 of
(tank pad, ring) 032  ITP. GR5HRM-330-CI-TI-
GR5HRM-330-CI- GR5HRM-330- 0003 is completed and
SP-0004 CI-SP-0004 R
 Material sampling approved.
 Determination of each compacted layer  Only for sampling:
in situ density as compared with the Witness min. first 2
maximum laboratory density. occurrences and 1 every 4
occurrences thereafter.

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
CI 0011 12 Inspection of formation level AFC DWG AFC DWG GR5HRM-QA-FM- P H W R R  Min. Witness the first 2
Inspection of vertical and horizontal levels, 053  occurrences and 1 every 4
slope, thickness, dimensions and inspection occurrences thereafter.
SP-0004 CI-SP-0004 GR5HRM-QA-FM-
of finished surface before asphalt concrete
application. 046   GR5HRM-QA-FM-046 in
place of GR5HRM-QA-FM-
053 for inspection before
final coat application
CI 0011 13 Check of bituminous prime coat and AFC DWG AFC DWG GR5HRM-QA-FM- P H W P R R  Only for sampling
asphalt concrete before spreading 032 
 Document review of batch ticket SP-0004 CI-SP-0004
 Tests result document review :
- Particle size distribution check of
aggregates (twice a week)
- mixture composition (twice a week)
- Marshall stability and specimens
density as average values of two
tests (once every working day)

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
CI 0011 14 Asphalt concrete pouring record AFC DWG AFC DWG () P R R R R (): Log book to be
maintained by CC/QC. QC
Batch daily recording of total asphalt GR5HRM-330-CI- GR5HRM-330-
concrete material poured and items SP-0004 CI-SP-0004 DODSAL.
traceability.
CI 0011 15 Core samples tests 24 hours after AFC DWG AFC DWG P H W P R R  Only for sampling
spreading of bituminous mixture 
 Material sampling SP-0004 CI-SP-0004 R
 Tests result document review :
- in-situ density
- % of voids
- layer thickness
CI 0011 16 Final inspection report of tank foundation AFC DWG AFC DWG GR5HRM-QA-FM- P H W R R
050
Inspection of vertical and horizontal levels, GR5HRM-330-CI- GR5HRM-330-
slope, dimensions, surface texture prior to SP-0004 CI-SP-0004
proceed with mechanical tank erection

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Involvement
CI 0011 17 Test of tank earth foundation settlement AFC DWG AFC DWG GR5HRM-QA-FM- P H H R R
Check foundation settlement during tank 036
water filling test SP-0004 CI-SP-0004

CLIENT JOB UNIT
SONATRACH 330
PROJECT TITLE Rev.

ITEM
Title: PROTECTIVE COATING APPLICATION ON GENERAL CIVIL WORKS
CONCRETE SURFACES
Reference Acceptance Involvement
QC CODE Description Quality Record Form CC QC DS TP DQ CL CT Notes
Document Ref. Criteria
CI 0012 01 Inspection before protective coating AFC DWG AFC DWG GR5HRM-QA-FM-051 P W W R R  Witness first two
application  occurrences of coating
GR5HRM-330- GR5HRM-330-CI- application and once every
Inspection of concrete surface status before CI-SP-0004 SP-0004 three occurrences thereafter
protective coating application: i.e. cleaning
and texture of the surface, joints (if any),
chamfer (if any)
CI 0012 02 Inspection after concrete protective AFC DWG AFC DWG GR5HRM-QA-FM-052 P W W R R  Witness first two
coating application  occurrences of coating
application and once every
CI-SP-0004 SP-0004 three occurrences thereafter

Sh. 38 of 65
CLIENT JOB UNIT

SONATRACH
PLANT LOCATION REPORT No.
Hassi R’Mel, Algeria QC CODE PROGRESS. No.
PROJECT TITLE
COMPRESSION STATION GR5 HRM ITP REF.GR5HRM-330-QA-TI-0001
ST
1 INSPECTION REQUEST FOR INSPECTION (RFI)
MONTH DAY HOUR MIN
JAN FEB MAR APR 1 2 3 4 5 6 7 8 9 10 11 00 01 02 03 04 05 06 07 08 00 10
MAY JUN JUL AGO 12 13 14 15 16 17 18 19 20 21 22 09 10 11 12 13 14 15 16 17 20 30
SEP OCT NOV DEC 23 24 25 26 27 28 29 30 31 18 19 20 21 22 23 40 50
REFERENCE DRAWING FOR RESULT
No. ITEM TAG No. ITEM DESCRIPTION
LOCATION Conformance Non Conformance
1 □ □
2 □ □
3 □ □
4 □ □
5 □ □
Note:
QC Inspector Name: Signature: Date
nd
2 INSPECTION REQUEST FOR INSPECTION ON DATE
MONTH DAY HOUR MIN
JAN FEB MAR APR 1 2 3 4 5 6 7 8 9 10 11 00 01 02 03 04 05 06 07 08 00 10
MAY JUN JUL AGO 12 13 14 15 16 17 18 19 20 21 22 09 10 11 12 13 14 15 16 17 20 30
SEP OCT NOV DEC 23 24 25 26 27 28 29 30 31 18 19 20 21 22 23 40 50
REFERENCE DRAWING FOR RESULT
No. ITEM TAG No. ITEM DESCRIPTION
LOCATION Conformance Non Conformance
1 □ □
2 □ □
3 □ □
4 □ □
5 □ □
Note:
QC Inspector Name: Signature: Date
QC CONSTRUCTION DODSAL CONSTRUCTION QC DODSAL COMPANY

NAME NAME NAME NAME
SIGNATURE SIGNATURE SIGNATURE SIGNATURE
Date Date Date Date
No. Inspection and test report issued ? YES NO Form Code Report number
1 □ □
2 □ □
3 □ □
4 □ □
5 □ □
Form code: GR5HRM-QA-FM-025 sh.01 / Rev. 0
Sh. 39 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
GENERAL CHECKS REPORT OF …………….………….…
ENGINEERING DOCUMENT No. SUPPLIER DOCUMENT No. CODE/SPECIFICATION
IDENTIFICATION OF MONITORING AND MEASURING DEVICES PAGE OF
DATE: …………………………….
MATERIAL/MEASURING DEVICES: ………………………………………………..……………………………..…………………………………
See attached certificate / report No.: …………………………………….……………………………………………………………………..
RESULT: Conformance □ Non Conformance □

NOTES
INSPECTION NOTIFICATION REFERENCE
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 40 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
BENCH MARKS INSPECTION REPORT

IDENTIFICATION OF MONITORING AND MEASURING DEVICES: PAGE OF

COORDINATES ELEVATIONS RESULT
MONUMENT
BENCH MARK No. FROM MEAN SEA REMARKS Non
NORTH EAST RATING Conformance
LEVEL Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
NOTES INSPECTION NOTIFICATION REFERENCE
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 41 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
CONCRETE MIX DESIGN INSPECTION REPORT

Concrete class: Date:

______________________________________________________
Cement source and type: ………………………………………………
Fine
Aggregate source ………………………………………………………………………………..
Coarse Aggregate max. size
Fine aggregate Coarse aggregate Fine aggregate Coarse aggregate
Specific Absorption
F.A. (1) F.A. (2) C.A. (1) C.A. (2) C.A. (3) F.A. (1) F.A. (2) C.A. (1) C.A. (2) C.A. (3)
gravity %
Unit Fine aggregate Coarse aggregate Fine aggregate

Fineness
weight F.A. (1) F.A. (2) C.A. (1) C.A. (2) C.A. (3) F.A. (1) F.A. (2)
modulus
kg/m3
Admixtures
MIX PROPORTION per m3

Water Fine aggregate Coarse aggregate Air Concrete
MIX W/C Cement Slump Specimen
admixtures F.A. (1) F.A. (2) C.A. (1) C.A. (2) C.A. (3) Content temperature
No. Ratio kg mm Marks
l l/kg kg kg kg kg kg % °C
COMPRESSIVE STRENGTH TEST ON SPECIMENS

Result
Specimen 7 days 28 days
Average Average Remarks Non
Mark N/mm2 N/mm2 Conformance
Conformance
□ □
□ □
Reference Certificate:

RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 42 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
STRUCTURAL CONCRETE FINISHING INSPECTION REPORT

REPAIRING OF CONCRETE
REFERENCE DWG. FINISHED RESULT
Tag - Item / DAMAGED COATING
CONCRETE CLEANLINESS
Element CONCRETE STATUS Non
No. Rev. SURFACE STATUS Conformance
(if any) (if any) Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY

NAME NAME NAME NAME
Date Date Date Date

Sh. 43 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
CHECK OF LEAN CONCRETE AND STRUCTURAL CONCRETE BEFORE PLACEMENT
PAGE OF
Batching …………………………….…………… 3
Concrete volume: ______________________m
Plant : ……………………………………….…
Truck No.: …………………………….……………

Offloading Time at Site: _____________________
……………………………………….…
…………………………….…………… Slump at Site: ___________________________cm

Loading
Batch Time : ……………………………………….… Satisfactory: Yes □ Not □
Concrete
…………………………….…………… Air temperature :_________________________°C
Mix Type
and Strength
Class No.
……………………………………….… Within limits: Yes □ Not □
Water Added at Batching __________________Litres Taken specimens Code No.:___________________
CONFORMANCE □
NON CONFORMANCE □
Concrete temperature at Site ________________°C RISULTATO:
Tag - Item/Element:
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 44 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
LEAN AND STRUCTURAL CONCRETE DAILY POURING RECORD

TICKET Loading Off- CONCRETE TEMPERATURE °C TAKEN
Q.ty SLUMP mm
Tag - Item / Element No. Batch loading SPECIMENS
m3 Class Mix No. (at site) Air Concrete
time time CODE No.
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 45 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT FOR ………………………………………………..
DWG. / SPEC. REF. INSPECTION/ RESULTS

Tag - Item / Element CHECK / TEST Non
No. Rev. No. Conformance
FOR Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
See enclosed certificate / report No.:……………………………………………………………………………………….
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 46 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
ITP REF.GR5HRM-330-QA-TI-0001
CONCRETE SPECIMENS COMPRESSIVE STRENGTH TEST REPORT

STRENGTH TEST No. (n) TAG - ITEM/ELEMENT:
TAKEN SPECIMENS CODE NO

Crushing test
Laboratory report id. 1
Mix No. 2
Sampling date 3
Age of specimen
days 4
Maximum load
kN 5
Dimensions 6
h (mm)
dia (mm)
base (mm)
Cross section area
mm2 7
Type of fracture
(usual cone, other to 8
specify)
Defects 9
Specif. compres. strength
2
f’c [N/mm ]
10
Ref.compres. strength [1]
N/mm2 11
Specimen compr. strength
N/mm2 12
Average strength [2]
N/mm2 13
Result of strength test
(Pass / Fall) 14
n n+1 n+2 n-1 n n+1 n-2 n-1 n
Values of three
consecutive strength tests 15 This test Code.. Code.. Code.. This test Code.. Code.. Code.. This test
2
N/mm
Average of three
consecutive
2
strength tests 16
N/mm
Evaluation of compres.
Tests [3] 17
(Pass / Fall)
NOTES: INSPECTION NOTIFICATION REFERENCE

[1] In accordance with ACI 318 the reference compressive strength is computed as f’c-35 N/mm2 when f’c<= 350 N/mm2
RFI No.
or 0.9 f’c when f’c>350 N/mm2.
[2] In accordance with ACI 318 the average is calculated on two specimens strength results.
ISSUE DATE:
[3] In accordance with ACI 318 the results are acceptable if the average of 3 consecutive strength test is >= f’c.
[4] If the information relevant to point 3 to 9 is available on laboratory report, filling in may be omitted.
NAME NAME NAME NAME
Date Date Date Date

Sh. 47 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
WATERTIGHT TEST REPORT FOR BASINS, SEWER PITS, MANHOLES AND CATCH BASINS
RESULTS
STARTING ENDING
Tag - Item / Element Non
TIME TIME Conformance
Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 48 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
SEWER SYSTEM PIPES WATERTIGHT TEST REPORT

Tag - Item / Element PIPE FROM TO STARTING ENDING RESULTS
TIME TIME
DIA. PIT/MANHOLE/ PIT/MANHOLE/ Non
Conformance
CATCH BASIN CATCH BASIN Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 49 of 65
CLIENT JOB UNIT
SONATRACH
PROJECT TITLE
TANK FOUNDATION SETTLEMENT TEST REPORT
TAG/ITEM ENGINEERING DOCUMENT No. SUPPLIER DOCUMENT No. CODE/SPECIFICATION

% WATER
C Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
LEVEL
0 ELEVATION
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
ELEVATION
SETTLEMENT
Q1
CENTER "C" DESIGN ELEVATION ___________
Q8 Q2 TOP RING "Q" DESIGN ELEVATION ___________
Q7 C Q3
RESULT:
Q4
CONFORMANCE □
□
Q6
Q5 NON CONFORMANCE
NOTES
INSPECTION NOTIFICATION REFERENCE
RFI No.
PREPARED BY:
ISSUE DATE:
NAME NAME NAME NAME
Date Date Date Date

Sh. 50 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
GROUT COMPRESSIVE STRENGTH TEST REPORT
COMPRESSIVE STRENGTH
DRAW./SPEC. REF. SPECIMEN RESULT
TEST
TAG – ITEM/ELEMENT
MARK Non
No. Rev 3 Days 7 Days 28 Days Conformance
Conformance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
See attached certificate/report no.
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 51 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT OF ROADS/PARKING/PAVING AREAS

BEFORE STRUCTURAL CONCRETE POURING
ROADS □ PARKING AREAS □ PAVING AREAS □
FORMATION GRADE STATUS
RESULT
REFERENCE VERTICAL AND
REINFORCEMENT
POLY-ETHYLENE
DRAWING HORIZONTAL LEVELS
FORMWORK
SLOPE
SHEET
Tag - Item / Element
Conformance
Conformance
Non
No. Rev. LOCATION ELEVATION
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 52 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT BEFORE LEAN CONCRETE POURING

FOUNDATIONS □ BASINS □ TANKS □
SEWER PITS □ MANHOLES □ CATCH BASINS □
VERTICAL AND
REFERENCE DWG. RESULT
Tag - Item / HORIZONTAL LEVELS SUBGRADE
SHAPE DIMENSIONS
Element STATUS Non
No. Rev. LOCATION ELEVATION Conformance
Conformance
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 53 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT BEFORE STRUCTURAL CONCRETE POURING

TAG – ITEM/ELEMENT
DATE:
REF. DRAWING No
Rev.
LEAN CONCRETE
Status
VERTICAL/HORIZON. LEVELS
Location
Elevation
FORMWORK
Position
Dimension
REINFORCEMENT
Concrete cover
Position
Diameter
ANCHOR BOLTS
Position and level
Diameter
Quantity
EMBEDMENT
POCKETS AND HOLES
JOINTS
CLEAN
Non Non Non Non
Conformance Conformance Conformance Conformance
RESULT Conformance Conformance Conformance Conformance
□ □ □ □ □ □ □ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 54 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT BEFORE GROUTING
ENGINEERING DOCUMENT SUPPLIER DOCUMENT

CODE/SPECIFICATION
No. No.
TAG – ITEM / ELEMENT

DATE:
Ref. Drawing
No
Rev.
Grouting type
Release date
for installed structures/
equipment / machineries
(by mech. Dpt.)
FOUNDATION SURFACE PREPARATION
Chipping
Soaking
Cleaning
FORMWORKS
Positions/shapes
Levels
Joints (if any)
Chamfers
Clearance between base
plate and foundation
RESULT:
Conformance □ Conformance □ Conformance □ Conformance □
Non Conformance □ Non Conformance □ Non Conformance □ Non Conformance □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 55 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT OF SEWER SYSTEM AFTER PIPE LAYING
ENGINEERING DOCUMENT
TAG/ITEM SUPPLIER DOCUMENT No. CODE/SPECIFICATION
No.
SANITARY SEWER □ RAIN WATER SEWER □

REFERENCE LAID PIPES RESULTS
PIT/MANHOLE/
PIT/MANHOLE/
CATCH BASIN
CATCH BASIN
CONNECTIONS
ALIGNMENTS /
AND QUALITY
IN PIPELINES
Conformance
Conformance
ELEVATIONS
GRADIENTS
NO DEBRIS
FROM
PIPE SIZE
BEDDING
BLOCKS
THRUST
TO
Tag - Item / Element
TYPE
Non
DRAWING No. Rev.
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
□ □ □ □ □ □ □ □ □ □ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 56 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
SUBGRADE/GRADE INSPECTION REPORT BEFORE LAYING FILL MATERIAL
GENERAL Fill AREA □ ROADS AREA □ PARKING AREA □ PAVING AREA □ TANK AREA □
VERTICAL AND SUBGRADE /
HORIZONTAL LEVELS GRADE STATUS
Tag - Item /
SHAPE DIMENSIONS Non
Element Conforma
No. Rev. LOCATION ELEVATION Conforma
nce
nce
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 57 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION OF FORMATION LEVEL OF BINDER AND WEARING COURSES
ASPHALT ROADS □ ASPHALT PARKING AREA □

VERTICAL AND
HORIZONTAL LEVELS
Tag - Item / GRADE
SLOPE DIMENSIONS Non
Element STATUS Confor
No. Rev. LOCATION ELEVATION Confor
mance
mance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 58 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT ON TANK FOUNDATIONS BEFORE PLACEMENT OF LINING
EARTH FOUNDATION □ CONCRETE FOUNDATION □

VERTICAL AND HORIZONTAL
LEVELS TRIMMED
Tag - Item /
SHAPE DIMENSIONS SLOPE Non
Element Conform
No. Rev. LOCATION ELEVATION STATUS Conform
ance
ance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 59 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
FINAL INSPECTION REPORT OF SEWER SYSTEM

SANITARY SEWER □ RAIN WATER SEWER □

PITS, MANHOLES AND CATCH BASINS,
PITS, MANHOLES AND CATCH BASINS
REFERENCE DWG. STEPS, FRAMES, COVER SLAB, GRATING
Tag - Item / Element INTERNAL CLEANING
& HERMETIC COVER
No. Rev. Conformance Non Conformance Conformance Non Conformance
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
□ □ □ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 60 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
GROUTING DAILY POURING RECORD

TICKET Off- TEMPERATURE °C TAKEN
Loading Q.ty GROUT TYPE
Tag - Item / Element No. loading SPECIMENS
Batch time dm3 Air Grout
time CODE No.
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 61 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
FINAL INSPECTION REPORT OF TANK FOUNDATIONS

EARTH FOUNDATION  CONCRETE FOUNDATION 
VERTICAL AND HORIZONTAL
Tag - Item / LEVELS SURFACE
SLOPE DIMENSIONS Non
Element TEXTURE Confor
No. Rev. LOCATION ELEVATION Confor
mance
mance
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 62 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
FINAL INSPECTION REPORT BEFORE APPLICATION OF PROTECTIVE COAT
DATE
TAG-ITEM/ELEMENT
REF. DRAWING No.
REF. DRAWING Rev.
COATING TYPE
PREPARED CONCRETE
SURFACE STATUS
JOINTS (If any)
CHAMFER STATUS (If any)

RESULT: Non Conformance □ Non Conformance □ Non Conformance □ Non Conformance □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 63 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT AFTER PROTECTIVE COAT APPLICATION
DATE
TAG-ITEM/ELEMENT
REF. DRAWING No.
REF. DRAWING Rev.
COATING TYPE
CONCRETE COATED SURFACE

STATUS
RESULT:
Non Conformance □ Non Conformance □ Non Conformance □ Non Conformance □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date
CLIENT JOB UNIT

SONATRACH
Sh. 64 of 65

PROJECT TITLE
FINAL INSPECTION REPORT OF SITE EXCAVATION/FILL WORKS

VERTICAL AND
REFERENCE DWG. DIMENSIONS SURFACING STATUS
HORIZONTAL LEVELS
RESULT
(IF ANY)
SLOPE
ELEVATION
Tag - Item /
GRAVEL
LENGTH
GRASS
WIDT H
SOIL
Element
Conformance
Conformance
No. Rev. LOCATION
Non
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

Sh. 65 of 65
CLIENT JOB UNIT

SONATRACH
PROJECT TITLE
INSPECTION REPORT OF COMPLETED FENCES AND GATES SYSTEM
SUPPLIER DOCUMENT
ENGINEERING DOCUMENT No. CODE/SPECIFICATION
No.

VERTICAL AND
COATING STATUS
REFERENCE DWG. GATE DIMENSIONS RESULT
HORIZONTAL LEVELS
PROTECTIVE
Conformance
Conformance
Tag - Item /
VERTICALITY
Element
Non
No. Rev. LOCATION ELEVATION WIDTH HIGHT
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
□ □
RFI No.
ISSUE DATE:
PREPARED BY:
NAME NAME NAME NAME
Date Date Date Date

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COMPRESSION STATION GR5 HRM

PROJECT NO. GR5HRM

DOCUMENT NUMBER DOCUMENT TITLE Page 1 of 65

PROJECT : Compression Station GR5 HRM

CONTRACTOR : Dodsal Engineering & Construction FZE

DOCUMENT NO. : GR5HRM-330-QA-TI-0001

DOCUMENT REVISION STATUS : 0

Revision and Authorization Record

A 5-NOV-2014 Issued for approval PV RA BSS

Date DODSAL SONATRACH

PROJECT NO. GR5HRM

DOCUMENT NUMBER DOCUMENT TITLE Page 2 of 65

PROJECT NO. GR5HRM

DOCUMENT NUMBER DOCUMENT TITLE Page 3 of 65

Page Index/Grille de Révision :

COMPRESSION STATION GR5HRM

INSPECTION AND TEST PLAN

GENERAL CIVIL WORK

1.1 Inspection Test Standards list:

1.2 Forms list

GR5HRM-QA-FM-037 “Inspection report before application of cementitious fireproofing on

GR5HRM-QA-FM-051 “Final inspection report before application of protective coat“

1.2 ITP Legend

P-Perform Organization to conduct the Inspection and test activities.

N° ITS : CI - 0001 DISCIPLINE

CI 0001 01 Review certificates validity of surveying Manufacturer Expiring date GR5HRM-QA-FM- P R R R R P

N° ITS : CI - 0002 DISCIPLINE ITEM

ORGANIZATION CODE INVOLVEMENT CODE

Title: PROJECT BENCH MARKS GENERAL CIVIL WORKS

Reference Acceptance Quality Record Involvement

N° ITS : CI - 0003 DISCIPLINE ITEM

ORGANIZATION CODE INVOLVEMENT CODE

Title: MATERIALS FOR EARTHWORKS GENERAL CIVIL WORKS

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0003 DISCIPLINE

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0003 DISCIPLINE

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 01 Cements for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R P

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 06 Other material for concrete work GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 08 Embedment materials GR5HRM-QA-FM- P R R R R

CI 0004 09 Material for fireproofing concrete and GR5HRM-QA-FM- P R R R R R R

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 10 Lightweight cementitious fireproofing GR5HRM-QA-FM- P R R R R R R

CI 0004 11 Sealing compound for fireproofing GR5HRM-QA-FM- P R R R R R R

CI 0004 12 Personnel qualification for special GR5HRM-QA-FM- P R R R R R

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 13 Sand-cement grout materials GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R

ORGANIZATION CODE INVOLVEMENT CODE

N° ITS : CI - 0004 DISCIPLINE

CI 0004 15 Non-shrink cement base premixed grouts GR5HRM-330- GR5HRM-330-CI- GR5HRM-QA-FM- P R R R R R