Appendix K: Site Restoration Certificate

_ Petroleum Development Oman

SITE RESTORATION CERTIFICATE
Contract Title
Contractor Contract No.
Sub-Contractors
Site Restoration Activity Date Completed Exceptions
Demobilization Date Approved

Requirement for Isolation of Facilities

(telecoms, electricity, water) notified to
PDO
Residential Camp Inspection Completed

Office Inspection Completed

Industrial Area Inspection Completed

Work-site Inspection Completed

All PDO Assets handed over to PDO

All actions as per SP-1012 completed

All Outstanding materials handed over to

PDO
Summary file of Contract Waste Log
handed over to PDO
Notes:
On behalf of the Contractor I confirm that the activities stated above have been carried out and
we have restored the site(s) according to the Contract Requirements
Name Date Responsibility Signature
Contract Manager
We hereby agree that the HSE status of this Contract allows the Contractor to Demobilize subject
to the exceptions listed above.
Name Date Ref. Ind. Responsibility Signature
Contract Holder
Representative *
Name Date Ref.Ind. Responsibility Signature
HSE TA2

* At Contract Holder's discretion