CADANGAN TAMBAHAN RUANG KILANG DAN PINDAAN RUANG DALAMAN KEPADA BANGUNAN KILANG DAN

GUDANG 1 TINGKAT SEDIA ADA SERTA PEMBINAAN PENCAWANG ELEKTRIK 33KV 2 TINGKAT DI ATAS LOT 5962,
PERSIARAAN CASSIA SELATAN 1, TAMAN PERINDUSTRIAN BATU KAWAN, MUKIM 13, BATU KAWAN, SEBERANG
PERAI SELATAN, PULAU PINANG.

MATERIAL & SAMPLE APPROVAL FORM

Material Ref. No.: Construction Stage: Material For:
ARC – Architectural Works
LDC/P025/MS/CS/011 (R2) Piling 1st Submission
MEC – Mechanical Works
Sub-Structure
Superstructure 2nd Submission ELE – Electrical Works
Façade
NSC: ___________ 3rd Submission ICT – Information Communication &
Technology Works

CIV – Civil Works

Location of Usage: Approval For: STR – Structural Works

LAN – Landscape Works

CONTRACTOR MATERIAL SUBMMISSION DETAILS

CER3 Material
CER4 SIG - Signages Works

Trades
TNB
:________________________________ Samples
IDW – Interior works
Supplier/Manufacturer LTG – Lighting Works

Others: _______________ FCD – Facade Works

SCT – Security Works

Material Description:
ACT – Acoustic Works

-Item: HSV Stud Anchor M10 x 90 BMS – Building Maintenance Works

Others :__________________

Technical Specification Material Certificate Test Report Warranties Submit by:

Contractor’s Letter – ref. No._______________________________________________ Signature With Company Stamp:
Consultant’s Recommendation – ref. No._____________________________________
Brochure / Manual / Catalogue
Attachments

Sample – no of sample provided____________________________________________

– sample identification tag no. ___________________________________________ Name: Wayne Liew
Others – please specify __________________________________________________
Date: 14 July 2023

Date Required: 17 July 2023

Comments:

• This submission is for record purposes only. The Contractor's Professional Engineer with
Practicing Certificate (PEPC) shall hold full responsibility for the design of the structures,
RECOMMENDATION & APPROVAL BY CONSULTANT

including the implications for the existing structural support, in compliance with the MS EN
Code, Uniform Building By Law, and good engineering practices. The design liability by the
Contractor's PEPC shall be fit for purpose.
• Kindly ensure the Professional engineer endorsed in this submission is person to certified on
Form G4 on post install anchor for issuance of CCC. Please read with post installation note in Type of Material (Category):
general note IFC Drawing. Material as per Contract/
• Please submit the design calculation related to this project instead of copy from other Design Specification
project. Alternative Material
• No additional costs or time impacts shall be incurred in this submission.
Special Material
• All existing CIS RC/Steel structure shall be checked on-site, and the design shall be updated
if any structural modification is needed.
• The Contractor and Contractor's PEPC shall coordinate with other disciplines in the design
before carrying out any work.
• All structural designs shall be read and comply with the Construction Drawing General
Note.
• The structural design load shall refer to the construction drawing Loading Plan, in addition
to loading requirements from the Uniform Building By Law, MS EN 1991, and user
requirements.
• All structural designs shall take into consideration the method of construction and
construction load. The self-weight of the structure, M&E hanging load, and design loading
from other interconnected structures, if any, shall be included in the structural analysis and
design.
• All structural member size, location, and level that affect other disciplines shall be reviewed
by M&E AE, Architect, Building Owner, and End Users.
• All dimensions in the method statement and shop drawing shall be coordinated and read
with structural construction drawing, architect drawing, and M&E drawing, structural general
note, typical detail drawing, and technical specification.
• This review is for general conformance with design drawings and specifications only. The
Contractor shall be responsible for the method of construction and shall be liable for the
relevance and accuracy of the content of this method statement, compliance to meet technical
specification, drawing, quality, and confirming and correlating dimensions at job sites for
tolerances, clearances, quantities, fabrication, and installation/application processes and
techniques of construction, coordination of their work with other trades, and full compliance
with the contract documents.
• Contractor’s PEPC to provide design calculation and drawing certified by PEPC for
submission to local authority. Contractor’s PEPC shall sign on Form G4 for issuance of CCC.
• To verify with pull out test as per original contract.
• Kindly ensure the expansion of anchor bolt will not cause damage to existing RC structure.

Checklists:
APPROVAL STATUS:
Yes/No
Material origin:___________________________________________________ A -Approved
Compliance with technical specifications
Compliance with performance specifications B - Reviewed with Comments
Compliance with Malaysian Standard
Compliance with Foreign Standard. Specify_____________________________ C-Rejected and Resubmission Require
SIRIM Certification
Bomba Certification
Other Please Specify:______________________________________________
Reviewed & Checked By: Approved By:
Signature : Signature With Company Stamp:

Name:__Tan KH__________________________________ Name:_______________________________________________

Date :__20/07/2023________________________________ Date :_______________________________________________