SUPERSEDED BY MD-216-1000-QD-IX-ITP- 1072

Mansourah Massarah Gold Project

INSPECTION AND TEST PLAN

ITP FOR CONSOLE, INSTRUMENT JB, CONTROL BOX, LPBS, LCS AND FIELD PANELS

MD-216-1000-QD-IX-ITP-1078

ISSUED FOR APPROVAL

Ma’aden Document Number:

PROPRIETARY & CONFIDENTIAL This document and the
information contained herein is Ma’aden and Outotec MD-216-1000-QD-IX-ITP-1078 A01
Oyj/Larsen & Toubro proprietary know-how. This document or
any part thereof should not be reproduced, stored in a Outotec Document Number:
A01 09/10/2021 First Issue RA-L&T ESS - L&T PKV-L&T retrieval system or transmitted by any means, electronic or
otherwise, or divulged without prior written permission from
L&T Document Number:
Rev Date Revision Text Prepared By Reviewed By Approved By Client Ma’aden and Outotec Oyj/Larsen & Toubro.
O19045 001 X K 00501 701 R0

PROPRIETARY & CONFIDENTIAL: This document and the information contained herein is Ma’aden and Outotec Oyj/Larsen & Toubro proprietary know-how. This document or any part thereof should not be reproduced,
stored in a retrieval system or transmitted by any means, electronic or otherwise, or divulged without prior written permission from Ma’aden and Outotec Oyj/Larsen & Toubro.

# Sensitivity: LNT Construction Internal Use 1 of 1

 MD-216-1000-QD-IX-ITP-1078-A01 Page 2 of 9

Inspection and Test Plan (ITP) No: Related requirements reference, when applicable
O19045_001_X_K_00501_701_R0 (Manufacturing/installation/specification/design):
 MD-101-SMEM-EG-EL-SPC-0001-C01
 MD-101-SMEM-EG-EL-SPC-0011-C01
 MD-101-SMEM-EG-IN-SPC-0001-C01
 QVD-E0001, E0047, E0048

Project: Mansourah Massarah Gold Project
Sub-contractor Name/Contact Details:
SENDAN INTERNATIONAL COMPANY LTD.
Remarks:
Contract No/ Title: 17-PME MM GP-0002 / DP-190009 Maaden gold
Equipment/ Work Package/ Activity Description:
ITP FOR INSTALLATION OF CONSOLE, INSTRUMENT JB, CONTROL BOX, LPBS, LCS AND FIELD
PANELS
P – Performance, Executing an activity
H – Hold Point, a point beyond which work shall not proceed without
inspection/approval of representative of indicated party
W – Witness Point, representative of indicated party must be notified, if not in
attendance at specified time, inspection may proceed
S – Surveillance, representative of indicated party may carry out surveillance of
work in progress
R – Review, representative of indicated party to review submitted documents,
result of tests etc.

A01 09-10-2021 Issued for Approval

INDEX DATE Reason for Revision LT OT EMP

M/s SENDAN RIZWAN AGHA E.SIVA

Prepared by Reviewed by (L&T) Approved by (L&T) OT Approval, Date Employer Approval, Date

Page: 1
 MD-216-1000-QD-IX-ITP-1078-A01 Page 3 of 9

Sub- Contractor
Frequency of
Inspection /

Contractor

Employer
Acceptance Criteria /
Process Description

Test
S.N Responsible Inspection or Test Method Specification / QC Record Reference
or QC activity
Drawing

1.0 Document Review

IFC Drawings and Project Minutes of Meeting
1.1 Pre-Inspection Meeting (PIM). Document Review ONCE
Specifications P P R
Responsible & List of attendees
Instrument Installation Engineers MD-101-SMEM-EG-EL-SPC-0001-C01
1.2 Document Review Approval MD-101-SMEM-EG-EL-SPC-0011-C01 R P R Approved MOS
Method statement. Approved Method of Statement:
2.0 Material receiving
MRIR
Incoming Instrument Responsible 1- Visual Inspection upon Material Arrival a) Factory Acceptance Test &
2.1 100 %
b) Approved Data sheet --- W R
Material. Engineer 2- Checking of Instrument Panel traceability. IRF COVERSHEET
3.0 Pre –Installation
QA/QC Approved document
3.1 Installation and procedure. Document Review, Detailed MOS, JSA 100 % Document Review R R R
INSPECTOR Transmittal
4.0 Installation
Visual inspection for verification of panel
QVD-E0047
QA/QC identification nameplate, typical installation  MD-101-SMEM-EG-EL-SPC-0001-C01
4.1 Installation for Console Panel. 100 %
Sec 5.5.3, Sec 4.2, Sec 5.4.4, 5.4.5
W W S &
INSPECTOR details, mounting location and clearances
IRF COVERSHEET
between the unit and any equipment.
Visual inspection for verification of panel
QVD-E0047
Installation for Instrument JB QA/QC identification nameplate, typical installation  MD-101-SMEM-EG-EL-SPC-0001-C01
4.2 100 %
Sec 5.5.7, Sec 4.2, Sec 5.4.4, 5.4.5
W W S &
and Field Panel. INSPECTOR details, mounting location and clearances
IRF COVERSHEET
between the unit and any equipment.
Visual inspection for verification of control
box identification nameplate, typical QVD-E0047
QA/QC  MD-101-SMEM-EG-EL-SPC-0001-C01
4.3 Installation for Control Box. installation details, mounting location and 100 %
Sec 5.5.3, Sec 4.2, Sec 5.4.4, 5.4.5
W W S &
INSPECTOR
clearances between the unit and any IRF COVERSHEET
equipment.
 MD-101-SMEM-EG-EL-SPC-0001-C01
Visual inspection for verification of LPBS and Sec 5.5.6, Sec 5.5.7, Sec 5.4.4, 5.4.5 QVD-E0048
QA/QC
4.4 Installation for LPBS and LCS. LCS identification nameplate, typical 100 % Sec 4.2 W W S &
INSPECTOR  MD-101-SMEM-EG-EL-SPC-0011-C01
installation details, mounting location and IRF COVERSHEET
Sec 5.2

Page: 2
 MD-216-1000-QD-IX-ITP-1078-A01 Page 4 of 9

Sub- Contractor
Frequency of
Inspection /

Contractor

Employer
Acceptance Criteria /
Process Description

Test
S.N Responsible Inspection or Test Method Specification / QC Record Reference
or QC activity
Drawing

clearances between the unit and any

equipment.

5.0 Final Inspection / Acceptance

QVD-E0001
Final Inspection / Final QA/QC Final inspection of complete installation /
5.1 100% Closed IRF's and Punch lists H W W &
Acceptance INSPECTOR closing of IRF punch list.
IRF COVERSHEET

INDEX OF INSPECTION CHECLIST AND RECORD

L&T-MMGP-IRF-001 MATERIAL RECEIVING INSPECTION REQUEST FORM / WORK INSPECTION REQUEST FORM

QVD-E0047 CALIBRATION OF INSTRUMENT DIFFERENTIAL FLOW TRANSMITTER TEST RECORD

QVD-E0048 LPBS / LCS INSTALLATION INSPECTION CHECKLIST

QVD-E0001 FINAL INSPECTION / FINAL ACCEPTANCE

Page: 3
 MD-216-1000-QD-IX-ITP-1078-A01 Page 5 of 9

MANSOURAH MASSARAH GOLD PROJECT

INSPECTION REQUEST FORM

(L&T-MMGP-IRF-001, REV.-01)

INSPECTION REQUEST No.: REV No: 00 DATE:

CONTRACT No: NAME: MANUFACTURER / SUPPLIER
IR REFERENCE NUMBER (By L&T ):
AREA: DATE & TIME OF INSPECTION:

REFERENCE DOCUMENT
DRAWING No. :

SPECIFICATION No. :

ITP No. : ACTIVITY No. :

TYPE OF INSPECTION
ITEM TO BE INSPECTED LOCATION ELEVATION
(check mark as Applicable)

Witness Hold

REQUESTOR (Print Name & Sign): DATE:

RECEIVED BY L&T(Print Name & Sign): DATE:

NOTES:
1. This document shall not be used to specify acceptance of the aspects of test; this can only be achieved by sign off of appropriate
inspection report which shall be attached hereto.
2. L&T inspection shall occur only after the inspection report is signed off by Contractor Representative conforming acceptance of the work.

ADDITIONAL INFORMATION/COMMENTS:

STORE REPRESENTATIVE (Print Name & Sign) DATE:

L&T QA/QC REPRESENTATIVE (Print Name & Sign) DATE:

EMPLOYER REPRESENTATIVE (Print Name & Sign) DATE:

 MD-216-1000-QD-IX-ITP-1078-A01 Page 6 of 9

QVD NO SEN-QVD-E0001
FINAL INSPECTION AND ACCEPTANCE
ITP NO MD-216-1000-QD-IX-ITP-1078_A01

IRF NO: Date:

Area/Unit: Drawing No.:

Panel Tag number: Subsystem:

Acceptable Criteria
Item Description of Check
YES NO N/A
01 All installation activities completed.

02 All test activities are completed and test reports submitted.

03 Punchlist are closed completely.

04 All as-built drawing submitted and approved.

Review and Approval Status:  Comments:
Approved      
Approved with Comments 
Disapproved

SUBCONTRACTOR QA/QC LARSEN & TOUBRO QA/QC MA’ADEN / PMC

Name

Sign

Date

1|Page SENDAN – L&T/2055004244

 MD-216-1000-QD-IX-ITP-1078-A01 Page 7 of 9

QVD NO QVD-E0047
INSTRUMENT PANELS INSTALLATION INSPECTION
CHECKLIST ITP NO MD-216-1000-QD-IX-ITP-1078_A01

IRF NO: Date:

Area/Unit: Drawing No.:

Panel Tag number: Subsystem:

Acceptable Criteria
Item Description of Check
YES NO N/A
Check all drawings and documents used for the installation are in 
1
the final edition. 
Check  panel  typical  installation  details  in  accordance  with 
2
approved design drawings. 
Nameplate  securely  attached,  readable  not  obscured  and 
3 nameplate  data  conforms  to  the  information  given  on  the  data 
sheet. 
Check  mounting  location  and  clearances  between  the  unit  and 
4
any equipment. 
Check  orientation  and  alignment  of  installed  panel  in  reference 
5
to approved IFC drawings. 
Ensure that instrument panel installation is mounted on brackets 
6 fixed to steel work or on a suitable stand that are not subject to 
movement. 
Ensure  Panels  have  been  properly  secured  to  protect  against 
7
operational damage. 
Check  for  damage  /  defects  occurred  during  transportation, 
8 storage,  handling  and  installation.  Ensure  no  damage  to  the 
protective coating after installation 
Ensure  the  Installed  panel  are  neat  and  installed  with  a  good 
9
workmanship. 
Check Panel does not obstruct maintenance access and
walkways
Review and Approval Status:  Comments:
Approved      
Approved with Comments 
Disapproved

SUBCONTRACTOR QA/QC LARSEN & TOUBRO QA/QC MA’ADEN / PMC

Name

Sign

Date

1|Page
 MD-216-1000-QD-IX-ITP-1078-A01 Page 8 of 9

LPBS / LCS INSTALLATION INSPECTION QVD NO QVD-E0048

CHECKLIST ITP NO MD-216-1000-QD-IX-ITP-1078_A01

IRF NO: Date:

Area/Unit: Drawing No.:

LPBS / LCS Tag number: Subsystem:

Acceptable Criteria 
Item  Description of Check  
YES  NO  N/A 

1  The construction drawings and documents are the final edition. 

All equipment and materials supplied shall be new, free of flaws, and of 
2 
the highest quality. 
The location and mounting height shall be selected so that the LPBS / 
3 
LCS is readily accessible for switching. 
Check  LPBS  /  LCS  installation  in  accordance  with  approved  design 
4 
drawings. 
LPBS  /  LCS  Mounting  plates,  and  brackets  are  free  of  burrs  and  sharp 
5  edges and have adequate space to attach equipment identification and 
descriptor labels. 
6  LPBS / LCS are Installed in a neat and workmanlike manner. 

LPBS  /  LCS  location  is  readily  accessible  and  exposed  to  damage  from 
7 
maintenance activities or passing traffic. 
LPBS / LCS are located adjacent to, or within a prescribed distance from 
8  the motor being controlled and in a position that provides a clear view 
of the motor. 
LPBS / LCS are located such that an Operator is not exposed to acidic, 
9 
corrosive or other spray from operating hazards. 
LPBS  /  LCS  are  installed  on  solid  foundations  that  are  not  subject  to 
10 
movement. 

11  LPBS / LCS are rated at IP65 minimum for all outdoor installations 
LPBS  /  LCS  are  visually  inspected  for  damage  /  defects  occurred  after 
12  installation.  Check  no  damage  to  the  protective  coating  after 
installation.  Check Panel does not obstruct maintenance access and
Review and approval status: walkways Comments: 
Approved  
Approved with comments 
Disapproved

SUBCONTRACTOR QA/QC LARSEN & TOUBRO QA/QC MA’ADEN / PMC

Name

Signature

Date

1|Page
 MD-216-1000-QD-IX-ITP-1078-A01 Page 9 of 9

MANSOURAH MASSARAH GOLD

PROJECT(MMGP)

INSPECTION REQUEST FORM

(L&T-MMGP-IRF-001, Rev.-01)
INSPECTION REQUEST NO: REV No: DATE:

CONTRACT NO: CONTRACTOR NAME:

AREA: DATE & TIME OF INSPECTION:

REFERENCE DOCUMENTS

DRAWING NO.

SPECIFICATION NO.

ITP NO. Activity No.

TYPE OF INSPECTION
ACTIVITY TO BE INSPECTED LOCATION
(Tick as Applicable)

Witness Hold

Name / Signature Date Name / Signature Date

Requester- subcontractor Checked by
Site Engr. QA/QC-
subcontractor
Reviewed and verified by Received By
L&T Site Engineer QA/QC-L&T

EMPLOYER
(Print Name & Sign): Date:
NOTE:
1. This document shall not be used to specify acceptance of the aspects of test; this can only be achieved by sign off of appropriate inspection report
which shall be attached hereto.
2. L&T inspection shall occur only after the inspection report is signed off by Contractor Representative conforming acceptance of the work.
ADDITIONAL INFORMATION: COMMENTS:

STATUS: ⃝ APPROVED ⃝ APPROVED WITH COMMENTS ⃝ NOT APPROVED

CLOSED BY L&T EXECUTION (Print Name & Sign) DATE:

DATE:
REVIEWED BY L&T QC (Print Name & Sign)

DATE:
EMPLOYER REPRESENTATIVE (Print Name & Sign)