CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Contract No. 5297

Lusail Plaza Infrastructure, LRT Station,
Public Car Parks & Landscape

Method Statement for Excavation, Laying of Pipes and Backfilling of

Trenches for Stormwater Network

Note: Resubmission of this document is to secure “Code A” status for Closeout.

Issued for 24-April-

1 RA MO MM MB MA
Approval 2022
Issued for 22-Oct-
0
Approval 2018
Technical Corporate QHSE Technical
HSE Manager QA/QC Manager
Engineer Manager Manager

Rev Description Date Prepared Checked Checked Reviewed Approved

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

TABLE OF AMENDMENTS

Amendment
Description of
Rev. Reason for Amendment Details
Amendment
Page Section
0 Issued for Approval Approved with Comments
To incorporate all of the comments from the previous
1 Issued for Approval revision to this latest document submittal and obtain
“Code A” status for closeout.

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

REPLY TO COMMENTS
S. No. Comments from R.0 QD-SBG Reply

Civil:
The attached method statement has been carefully
reviewed as per DCQ scope of work, found
Noted.
acceptable and recommended for approval with the
following comments:
This comments sheet as well as the attached HSE
comments sheet shall be considered as an essential
01 Noted. QD-SBG shall adhere with the comment.
part of the method statement and can't be separated
for any reason whatsoever.
If during trench excavation some cavities are
02 encountered, provide the method of facing such an Noted.
issue.
The following clauses/ statements shall be added
to the method statement and shall be considered
as an essential elements of it which can't be
ignored or neglected under any circumstances
whatsoever:
 RC pipes are not allowed to be cut at site. Special
lengths of pipe shall be manufactured for
closures as required.
 Trenches shall be backfilled in layers not
exceeding 150 mm compacted thicknesses.
03  No backfill layer shall be covered by the next
Noted and added in Section V.1 – General.
layer until it has been inspected, tested and
passed.
 Stormwater pipelines shall be laid accurately to
the lines, levels and gradients shown on the
approved drawings so that the pipeline is
straight between successive manholes in the
vertical and horizontal planes.
 Using of selected excavated material for trench
backfilling purpose shall conform to the
requirements mentioned in clauses 3.3.2, 3.3.3
& 3.3.5 of section 6 - part 3 of QCS 2010.
 Any temporary storage of the excavated
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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

material alongside the trench excavation shall

be to stable slopes and heights & deposited in
such a manner that no damage and as little
inconvenience as possible is caused.
 Excavation shall be kept free of water, sewage
and other liquids whether affected by tides,
floods, and storms or otherwise so that the pipes
shall be laid IN DRY CONDITIONS.
 The trench sides shall be vertical (Unless the
contractor proposes otherwise and approved by
the Engineer) and shall be supported (Wherever
required and directed by the Engineer) by a
support system necessary to safeguard the
works and the WORKMEN in order to prevent
sliding and settlement of adjacent ground.
 If the trench widths shown in table 2.1 in section
8, part 2 of QCS 2010 for the maximum pipe
trench widths are exceeded, a plain or
reinforced concrete cradles and/or reinforced
concrete arches to the approval of the Engineer
shall be provided.
 Adequate temporary barriers and fencing
shall be provided which shall not be removed
until the trench excavation has been refilled and
reinstated.
 No dewatering system shall be removed until
infiltration testing is completed.
 If during excavation the formation level was
exceeded, the excess depth shall be
compensated/ filled with grade 20 SRC or
with approved suitable material compacted
according to the specifications and as per the
Engineer's instructions.
 Only potable water is allowed to be mixed with
soil/ selected excavated material or any other
approved backfilling material in order to get the
optimum density and moisture content.

In the attached ITP (Inspections and Tests

Plan):
04  Activity # 2.5 is only relevant to laying of GRP Noted. Refer to revised ITP in Appendix C.
pipe and fittings. What about the RC pipe and
the associated items such as blinding concrete,
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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

the concrete cradles… etc. (refer to clause # V.5

for laying & testing of GRP and RC pipes). RC
pipe laying must be added to the ITP.
 Laying of the SW warning/marker tape is
missing from the ITP. Must be added.
 Installing of the geotextile filter membrane is
missing from the ITP. Must be added.
 Construction of cut-off walls is missing from ITP.
Must be added.
 Casting of concrete encasement in the case of
having earth cover to pipeline less than 1200
mm is missing from the ITP. Must be added.
 The type and frequency of soil compaction tests
are missing from the ITP. Must be added
provided that testing for density and moisture
content shall be at the rate of one test per
backfill layer for every 30m of pipeline trench.

HSE:
A number of activities have been noted with
overestimated severity risk scores of 4 which is
01 equivalent to Disaster: Fatality i.e. vibration (hand Refer to revised Risk Assessment in Appendix B.
or muscle pain), minor injury due to flying debris,
etc.
It is imperative that risk management is in line with
applicable health and safety laws standards and
guidelines from internationally recognized health
and safety agencies, organizations and associations.
The Institution of Occupational Safety and Health or
IOSH suggests that “risk can be controlled by
02 reducing the likelihood of hazardous event, OR Noted.
reducing the consequences of the event, OR both."
To reduce the number of injuries that happen in the
workplace, it’s noteworthy to look at and consider
the three (3) Risk Control main options, rather than
just one (1), to effectively control all identified risks.

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

TABLE OF CONTENTS

I. Description of Works........................................................................................................................................................ 9

1. Introduction ......................................................................................................................................................................... 9

2. Definitions............................................................................................................................................................................. 9

3. Reference............................................................................................................................................................................... 9

4. Responsibilities................................................................................................................................................................ 10

5. Interfacing with other Operations ........................................................................................................................... 12

6. Duration, Phasing with the Subcontractors ......................................................................................................... 12

7. List of Subcontractors ................................................................................................................................................... 13

II. Resources ........................................................................................................................................................................... 13

III. Materials ............................................................................................................................................................................. 14

IV. Site Planning ..................................................................................................................................................................... 14

a. Preparation........................................................................................................................................................................ 15

b. Site Clearance ................................................................................................................................................................... 15

c. Traffic Management ....................................................................................................................................................... 15

d. Pre-Construction Safety Meetings ........................................................................................................................... 15

V. Methodology ..................................................................................................................................................................... 16

V.1 General ................................................................................................................................................................................ 16

V.2 Pre-Excavation Works .................................................................................................................................................. 17

V.3 Trench Excavation .......................................................................................................................................................... 17

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

V.4 Placing of Bedding and Surround............................................................................................................................. 19

V.4.1 Bedding and Surround Materials................................................................................................................................. 19

V.4.2 Concrete Protection to Pipes ......................................................................................................................................... 19

V.5 Laying & Testing of GRP & Reinforced Concrete Pipes ................................................................................... 20

V.6 Geotextile Filter Membrane ........................................................................................................................................ 20

V.7 Backfilling of Utility Trenches ................................................................................................................................... 20

VI. Risk Assessment .............................................................................................................................................................. 21

VII. Permit and Licensing Requirements....................................................................................................................... 21

VIII. Drawings, Diagrams, Maps and Survey Data ....................................................................................................... 21

IX. Pre-Start Safety Briefing Arrangements ................................................................................................................ 21

1. Protective and Safety Equipment ............................................................................................................................. 21

2. Information to Personnel ............................................................................................................................................ 21

3. Special Safety Requirements ...................................................................................................................................... 22

4. Emergency Procedures................................................................................................................................................. 23

5. Emergency Contact Numbers ......................................................................................................................................... 24

X. Supervision and Monitoring Arrangements ........................................................................................................ 26

XI. Environment and Quality Issues............................................................................................................................... 27

1. Precautionary Measure ................................................................................................................................................ 27

2. Disposal Requirements................................................................................................................................................. 27

3. Inspection, Test and Sampling................................................................................................................................... 27

4. Quality Assurance Requirements Table ................................................................................................................ 27

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

XII. List of Appendices........................................................................................................................................................... 28

Appendix A: Risk Assessment .................................................................................................................................................. 29

Appendix B: Inspection and Test Plan .................................................................................................................................. 30

Appendix C: Permit to Work ..................................................................................................................................................... 31

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

I. Description of Works
1. Introduction
This Method Statement defines the sequence and describes the control procedures for Excavation, Laying of Pipes
and Backfilling of Trenches for Stormwater Network for CP07B – Lusail Plaza Infrastructure, LRT Station, Public
Car Parks and Landscape.

2. Definitions
 LREDC Developer / Client
 Parsons Project Management
 QD-SBG Main Contractor
 CM Construction Manager
 QC Quality Control
 HSE Health Safety & Environment
 PPE Personal Protective Equipment
 PMV Plants, Machineries & Vehicles
 QCS Qatar Construction Specifications
 QNHD Qatar National Height Datum
 QNGD Qatar National Grid Datum
 GIS Geographical Information System
 LPS Loss Prevention System

3. Reference
 QCS 2010 Section 8
 QCS 2010 Section 12, Part 4 (Utility Trenches)
 BS 1377
 Health and Safety Plan, LUS-CP7B-QDSBG-PLN-HSE-00001
 Construction and Environmental Management Plan, LUS-CP7B-QDSBG-PLN-HSE-00008
 General Lifting Plan, LUS-CP7B-QDSBG-PLN-HSE-00004
 MS- Trial Pits Excavation, LUS-CP7B-QD-SBG-MST-CV-00034
 MS- Protection of Existing Utilities, LUS-CP7B-QD-SBG-MST-CV-00239
 MS- Installation & Testing of GRP Pipes & Fittings for Stormwater Network, LUS-CP7B-QD-SBG-
MST-MC-00203
 MS- Laying & Testing of Reinforced Concrete Pipes for Stormwater Network, LUS-CP7B-QD-SBG-
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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

MST-MC-00055
 Material Approval for Crushed Stone for Bedding & Surround (Dry Condition), LUS-CP7B-QD-SBG-
MAT-CV-00909
 Material Approval for Gabbro Bedding, LUS-CP7B-QD-SBG-MAT-CV-00979

4. Responsibilities

Responsible for accomplishing the stated project objectives which include

1 creating clear and attainable project objectives, building the project
Project Manager
requirements, and managing the constraints of the project management
triangle, which are cost, time, scope, and quality.

Responsible for overall construction activities ensuring that all quality and
2 Construction
safety procedures are implemented and required approved permits are
Manager
obtained.

To support the project delivery teams, to support and lead the management
Temporary Works
3 and delivery of temporary works engineering whilst ensuring programme,
Manager
cost, quality and safety objectives are achieved.

Supervise operations in accordance with the approved Method Statement,

4 Site Engineer shop drawings, specifications, material submittals and schedules to achieve
the acceptance of the project deliverables.

Supervise closely, the activities designated to them and ensure that all
Site Supervisor
5 instructions and safety procedure are followed and strictly adhered to.

6 Site Foreman To liaise with the Site Engineer and Supervisor for the work execution.

Ensure the proper implementation on Quality system and monitor overall

quality of the work is maintained. Conduct inspection and monitor tests.
Determine and report any non-conformance and recommended corrective
7 QA/QC Engineer actions. Ensure that all personnel are aware of the quality requirement.
Training of relevant personnel.

Conduct surveillance and inspection duties at various stages to ensure

compliance to QA/QC Plan.

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Health, safety and environmental (HSE) managers generally plan, coordinate

8 HSE Manager and implement issues and directives within the organization. They ensure safe
environmental working conditions for all employees.

Ensure enforcement of safety procedures in accordance with the approved

HSE Plan.

Will be closely monitoring the site engineer's strict implementation of the MS

and Risk Assessment, the use of proper tools and equipment to maintain
9 HSE Engineer safety, certifications of equipment and their adherence to safety regulations,
reporting of any unsafe work or stopping work that does not comply with
ES&H procedures. Will advise for Health & Safety requirements and monitor
the Hazard controls implemented on site as per the Method Statement/Risk
assessment.

The Safety Engineer shall be full time at site and shall frequently visit all the
HSE ongoing works at site. All safety violations and on-conformance of the HSE
10
Supervisor/Officer Plan shall be registered and immediate action shall be done in coordination
with the Site Engineer.

11 To ensure the equipment use are in good condition and monitor the
PMV Engineer
equipment performance during operation.

Carry out pre-construction survey to fix the locations and corresponding

elevations as per the approved shop drawings.

Ensure the quality and compliance during phases of surveying works and the
regular checking of the surveying equipment or periodic calibration from
third party.
12 Chief Surveyor
Ensure validity and serial number of calibration certificates is available and
posted in the survey equipment.

Ensure proper safety guarding of surveying equipment.

To maintain the records of all surveying equipment handled.

Maintain and use Surveying equipment. Assist Surveyors in taking

13 Survey Aide measurements, record measurements manually or electronically, and peg out
boundaries.

A person trained to identify unsafe hazards or working conditions in the

14 Soils Competent workplace or working conditions with authority to have the hazards
Person(s) eliminated or controlled. The soils competent person must have specific
training in and be knowledgeable about, soil analysis, the use of protective
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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

systems and requirement of the standards. A competent person must be on

every job site when workers are exposed especially on deep excavation
inspecting indications of possible cave-ins, failure of protective systems,
hazardous atmospheres, other hazardous conditions, inspection of materials
or equipment if damaged to determine if usable, monitoring of water removal
equipment and operations, visual and manual tests of soils to determine type
and inspection prior to the start or continuation of work after rainstorms or
after any other hazard-increasing occurrences.

16 Site Foreman Liaise with the Site Engineer and Supervisor for the work execution.

Supervise closely, the activities designated to them and ensure that all
Lifting instructions and safety procedure are followed and strictly adhered to.
17
Manager/Lifting Responsible to all lifting operations on site are carried out in a safe manner.
Supervisor Responsible for preparing, securing and communicating Lifting Permit,
Lifting Plan/Calculation Sheet, Pre-Lift Checklist to all his crew.
18 Equipment The only authorized person to operate any equipment to be used in the
Operator project.

The rigger assist in movement of heavy equipment and loads to be lifted. A

rigger set ups machinery and secures it in place and signal or verbally direct
19 Rigger
workers engaged in hoisting and moving loads, in order to ensure safety of
workers and materials.

The first aider respond promptly when requested, operate with competence,
20 First Aider know how to secure additional help when needed, reports incidents and
actions taken and comply with requirements for certification.

21 The role of a banksman is to provide additional eyes and ears to assist the
Banksman
operator of the equipment to navigate or operate safely.

22 Third Party Performs the required testing and provides test results to certify that the work
Laboratory is in compliance with the project requirements.

5. Interfacing with other Operations

 Existing Utilities

6. Duration, Phasing with the Subcontractors

 The work shall be done by QD-SBG and duration of work shall be indeterminate and will not
critically affect the progress of the project.

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

7. List of Subcontractors
Main Contractor:

 QD-SBG Construction

II. Resources
1. Plant and Equipment

Description No. of Units Application

Excavator w/ Hammer 5 For Excavation

Bucket Excavator 5 For Hauling and Loading
Mobile Crane 1 Lifting Works
Dump Trucks (MAN TGA 35.430) 10 Hauling of Fill Material
Iron Rammers (weighing less than
5 Compaction
5kg)
Vibrating Plate Compactors 5 Compaction
Hand Compactors 3 Compaction
Leica TS 15m Total Station 1 Setting Out for Construction
Leica NA2 Automatic Level 1 Levelling

2. Work Force

Designation No. of Persons

Soils Competent Person 1

Site Engineer 2
Land Surveyor 1
Survey Aide 2

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Foreman 2
Equipment Operator 1 for each Equipment
Banksman 4
Carpenter 10
Helpers/Laborers 15
Safety Engineer 2
First Aider 3
Third Party Laboratory 1 Team

3. Light Tools

Description No. of Units Application

Power Tools (Various) As per Site requirement Construction

Hand Tools (Various) As per Site requirement Construction

III. Materials
 Paints
 Pins and Pegs
 Warning Tapes
 Concrete Barriers
 Approved Bedding and Surround Materials
 Approved Pipes and Fittings

IV. Site Planning

 Duration of work shall be indeterminate but will not critically affect progress of the project.

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

a. Preparation

 Permits from concerned authority shall be obtained prior to start work at site.
 QD-SBG shall ensure that all gate passes, permits, tools, materials for safety precautions, manpower
and equipment are available before commencement of work.
 The Site Team shall make sure that access roads are always clear from any obstruction and site is always
accessible.
 Provision of access and egress such as ladders, steps, ramps or other safe means of egress and be with
reasonable distance.

b. Site Clearance

 Before commencing the work, the area shall be cleared of all debris, materials or other obstructions.

c. Traffic Management

 The Site Team with the assistance of the Safety Officers shall coordinate logistics and materials
movement through site following the direction and road signs displayed on site. The required diversion
routes shall be marked on drawings including the required traffic signs.
 The Work Permits and Operator Certificates shall be compiled for reference of authorized personnel.

d. Pre-Construction Safety Meetings

Meeting shall be scheduled prior to the beginning of the work and before any Sub-contractor starts on the
project.
 General contractual safety, health and environmental requirements.
 Traffic safety will be discussed to emphasize these meetings.
 Roles of the contractor, subcontractors, authority representatives and all project workers.
 Accident reporting requirements.
 Specific details of the work to be performed along with the use of personal protective equipment.
 Emergency procedure.

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

V. Methodology
This document shall be read in conjunction with the following documents:

1. MS- Installation & Testing of GRP Pipes & Fittings for Stormwater Network, LUS-CP7B-QD-SBG-MST-
MC-00203

2. MS- Laying & Testing of Reinforced Concrete Pipes for Stormwater Network, LUS-CP7B-QD-SBG-MST-
MC-00055

V.1 General
This Methodology specifies the requirement for excavation, laying of pipes, and backfilling of trenches for
Stormwater Network in concurrence with the existing specifications and requirements of ASHGHAL and
related Project Specifications.

All civil aspects of work involve for the construction of Stormwater Network shall be done and inspected as
per this document.

The working area will be barricaded and restricted from entry of unauthorized personnel.

It will be properly illuminated and necessary warning signs to be installed in the proper location.

The relevant permits to be fully complied by construction team prior to commence activity and ensure its
validity.

All workers to be involved in the activity shall receive proper information, instructions, training and adequate
supervision during the activity. All workers shall be briefed as well with the safe system of work and procedure
along with the use of proper PPE’s and emergency procedures.

The following clauses/ statements shall be considered as an essential elements of this document which can't
be ignored or neglected under any circumstances whatsoever:

 RC pipes are not allowed to be cut at site. Special lengths of pipe shall be manufactured for closures as
required.
 Trenches shall be backfilled in layers not exceeding 150 mm compacted thicknesses.
 No backfill layer shall be covered by the next layer until it has been inspected, tested and passed.
 Stormwater pipelines shall be laid accurately to the lines, levels and gradients shown on the approved
drawings so that the pipeline is straight between successive manholes in the vertical and horizontal planes.
 Using of selected excavated material for trench backfilling purpose shall conform to the requirements

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

mentioned in clauses 3.3.2, 3.3.3 & 3.3.5 of section 6 - part 3 of QCS 2010.
 Any temporary storage of the excavated material alongside the trench excavation shall be to stable slopes
and heights & deposited in such a manner that no damage and as little inconvenience as possible is caused.
 Excavation shall be kept free of water, sewage and other liquids whether affected by tides, floods, and
storms or otherwise so that the pipes shall be laid IN DRY CONDITIONS.
 The trench sides shall be vertical (Unless the contractor proposes otherwise and approved by the Engineer)
and shall be supported (Wherever required and directed by the Engineer) by a support system necessary
to safeguard the works and the WORKMEN in order to prevent sliding and settlement of adjacent ground.
 If the trench widths shown in table 2.1 in section 8, part 2 of QCS 2010 for the maximum pipe trench widths
are exceeded, a plain or reinforced concrete cradles and/or reinforced concrete arches to the approval of
the Engineer shall be provided.
 Adequate temporary barriers and fencing shall be provided which shall not be removed until the
trench excavation has been refilled and reinstated.
 No dewatering system shall be removed until infiltration testing is completed.
 If during excavation the formation level was exceeded, the excess depth shall be compensated/ filled with
grade 20 SRC or with approved suitable material compacted according to the specifications and as per
the Engineer's instructions.
Only potable water is allowed to be mixed with soil/ selected excavated material or any other approved
backfilling material in order to get the optimum density and moisture content.

V.2 Pre-Excavation Works

The working area shall be cleared with general rubbish and any obstructions that might hinder the continuous
implementation of the activity.

Notwithstanding with the information given on the As-built Drawings, the contractor shall be responsible for
locating all services crossing or in parallel with the line of trench to be excavated.

Trial holes/pits will be dug by hand in sufficient number to ensure that all services on the route of the pipeline
are uncovered. Trial holes/pits will be of sufficient size and depth to enable clear identification of service type.
This activity shall be done in accordance with the approved Method Statement for Trial Pits Excavation, LUS-
CP7B-QDSBG-MST-CV-00034.

V.3 Trench Excavation

 All trenches related to Stormwater Network are to be excavated to the lines and dimensions indicated in
the specification shown on the approved Shop Drawings.

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

 The depth and width of trench shall be as per approved Shop Drawings and in accordance with QCS 2010,
Section 8 Part 2. Below Table 2.1 is the maximum trench width unless otherwise shown on the approved
Shop Drawings.

 Prior to start trench excavation, the route of the pipeline shall be surveyed and set out accurately in
accordance with approved Shop Drawings.

 The depth and width of trench or the change in gradient shall be established by installing sight rails or
boning rods for checking of bottom profiles at an adequate spacing set up using proper levelling techniques
and to the levels shown on the drawings. (see sample photo below)

 No length of trench shall be excavated until the pipes and fittings to be laid in the length of excavation are
available at site. The Engineer reserves the right to direct the lengths of trench which shall be excavated at
any one time.

 Rock encountered in trench excavations shall be so excavated that the clearance between the pipe, when
laid, and the rock sides and bottom of the trench is kept to the minimum limits necessary to provide for the
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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

specified thickness of bedding.

 All existing services found during trial pit excavation will be adequately protected from damage and fully
supported during excavation works in such a manner as to prevent from any distortion or damage to the
services. This activity shall be done as per approved Method Statement for Protection of Existing Utilities
during Excavation, LUS-CP7B-QDSBG-MST-CV-00239.

 All excavated material must be removed from site immediately to enable working areas to be clean and free
from obstacles for the duration of the works.

 For any possible presence of water at excavated trench, currently water level at site is controlled by ongoing
dewatering system at site. In case presence of water is detected, mobile diesel pumps or submersible
pumps will be used to collect locally the water and ensure dry condition throughout the performance of the
work.

V.4 Placing of Bedding and Surround

V.4.1 Bedding and Surround Materials

 Pipe bedding and surround shall be provided as shown on the approved Shop Drawings.

 Pipe bedding shall be well compacted and shall completely fill the whole width of the trench excavated.

 Granular bedding materials shall conform with the following requirements:

a. Shall be clean gravel or broken stone from an approved source. Gabbro shall be used in water logged
areas as per Material Submittal ref. no.: LUS-CP7B-QDSBG-MAT-CV-00979.

b. The granular material size shall be in accordance with the approved Material Submittal ref. no.: LUS-
CP7B-QDSBG-MAT-CV-00909.

V.4.2 Concrete Protection to Pipes

Concrete protection to the pipelines shall be concrete cradle or concrete surround as detailed in the approved
Shop Drawings and shall be of Grade SRC 20. For Reinforced Concrete Pipes, cradle shall be installed at every
joints of pipes and another one at the centerline of the pipes. Concrete cradle depth, width and length shall be
in accordance with ASHGHAL Standards.

The concrete protection to pipes shall be on top of a 75mm thick blinding concrete with Grade SRC 20 laid over
the full width of the trench.

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

V.5 Laying & Testing of GRP & Reinforced Concrete Pipes

Before the pipes and fittings are laid in the trench, the Consultant will inspect the formation level of the
excavated trench as to its suitability to receive the approved bedding materials, pipes and fittings.

The methodology for laying and testing of Glass Reinforced Pipes for Stormwater Network shall be done as per
approved Method Statements for Installation & Testing of GRP Pipes & Fittings for Stormwater Network, LUS-
CP7B-QD-SBG-MST-MC-00203 and Laying & Testing of Reinforced Concrete Pipes for Stormwater Network
(Large Diameter Pipelines), LUS-CP7B-QD-SBG-MST-MC-00055.

V.6 Geotextile Filter Membrane

Geotextile filter membrane for surround to granular material shall be installed as shown in the approved Shop
Drawings and shall be laid with minimum overlap between sheets of 300mm in any direction.

Geotextile fabric shall surround the granular bedding as follows:

a. The surface to receive the fabric shall be formed to a relatively smooth condition free of obstruction,
depressions, and debris. The geotextile fabric shall be laid loosely.

b. To prevent slippage of the overlapping fabric, the areas of overlap shall be stabilized with pins, anchor
blocks, or piles of aggregates.

c. Fabric damaged or displaced before or during placement of backfill material shall be repaired or placed.

V.7 Backfilling of Utility Trenches

 Trenches are not to be backfilled until all required tests are performed on the utilities and until the Engineer
has verified that the utilities have been installed as per approved Shop Drawings and in accordance with
the Project Specification.

 After the utilities have been laid, the trench refilling is to commence with approved fill in compacted layers
not exceeding 150 mm unconsolidated thickness. Each layer shall be well compacted by hand with iron
rammers weighing not less than 5 kg, until the trench has been filled to a height of 300 mm above the top
of the utility.

 The remainder of the trench is then to be refilled in compacted layers not exceeding 250 mm
unconsolidated thickness. Each layer being well compacted, with power rammers, vibrating plate
compactors or other mechanical means of a type to be approved until the ground is thoroughly
consolidated up to the required level for surface reinstatement. Each layer is to be compacted to 95% of its
maximum dry density as determined by BS 1377.
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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

 Where necessary or as instructed by Engineer, the moisture content of the fill shall be adjusted either by
drying out or adding potable water to assist the compaction of the material. During compaction, the backfill
shall have a uniform moisture content of (± 2%) recorded in the compaction test.

 PVC warning tape shall be laid above the utility pipe whenever shown in the approved Shop Drawings and
shall be approximately 300mm below finished ground level.

VI. Risk Assessment

 Please refer to attached document on Appendix A.

VII. Permit and Licensing Requirements

 Refer to Appendix C for Permit to Work.

VIII. Drawings, Diagrams, Maps and Survey Data

 Refer to approved Shop Drawings.

IX. Pre-Start Safety Briefing Arrangements

 Refer to Risk Assessment on Appendix A.

1. Protective and Safety Equipment

All workers Involved shall be equipped with adequate PPE as stated below:
a. Safety Helmet with Company Logo
b. Safety Boots
c. High Visibility Vest
d. Safety Goggles
e. Hand Gloves
f. Coveralls

2. Information to Personnel

a. Safety Induction
b. Job training
c. Superintendents Notices/Memos
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Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

d. Toolbox talks
e. START Card

3. Special Safety Requirements

a. All necessary personal/protective equipment (PPE) as well as harness be provided.

b. Banksman, wearing distinctive vests, shall be assigned to help operators maneuver their equipment.
c. The equipment operators shall possess the required licenses and certificates.
d. Generated dust shall be controlled by periodic water spraying.
e. The project safety officer is responsible along with the project zone site engineer for ensuring that all
operations are carried out with due regard to the safety of all project personnel & property.
f. All working activity shall comply with Client Safety Procedure.
g. First Aid Material.
h. General management of protection/operation hazards are to be observed.
i. In case of working at night, please refer to Method Statement for Night Works (Reference no.: LUS-
CP7B-QDSBG-MST-HSE-00001).

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Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

4. Emergency Procedures

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

5. Emergency Contact Numbers

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CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

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 CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

X. Supervision and Monitoring Arrangements

 Construction Manager
He is in charge of all construction activities. Schedule the project in logical steps and budget time required
to meet deadlines. Inspect and review projects to monitor compliance with building and safety codes, and
other regulations.
 Temporary Works Manager
He is in charge for the inspection of ongoing backfilling operation and ensure that works are carried out in
a safest manner.
 Site Engineer
The Site Engineer shall evaluate the quantity of materials consumed by each trade to be compared against
planned quantity.
 Site Foreman
A construction foreman is responsible for supervising the workers and also doing actual construction work.
The foreman monitors employees to ensure that the work is done efficiently and within quality standards.
 Chief Surveyor
A Chief Surveyor ensures that surveying data are collected and recorded accurately and that all company
procedures are followed by crew members.
 QA/QC Engineer
The QA/QC Engineer shall monitor whether the installation works is conforming to the required quality
otherwise he shall notify the Site Engineer should he found non-conformance to the ongoing activities. The
Site Engineer shall immediately rectify the work to avoid receipt of NCR from the QA/QC Engineer.
 HSE Engineer
The Safety Engineer shall be full time at site and shall frequently visit all the ongoing works at site. All safety
violations and on-conformance of the HSE Plan shall be registered and immediate action shall be done in
coordination with the Site Engineer.
 Lifting Manager/Lifting Supervisor
Supervise closely, the activities designated to them and ensure that all instructions and safety procedure are
followed and strictly adhered to.
 Soils Competent Person(s)
A person trained to identify unsafe hazards or working conditions in the workplace or working conditions
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Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

with authority to have the hazards eliminated or controlled.

A competent person must be on every job site when workers are exposed especially on deep excavation
inspecting indications of possible cave-ins, failure of protective systems, hazardous atmospheres, other
hazardous conditions, inspection of materials or equipment if damaged to determine if usable, monitoring
of water removal equipment and operations, visual and manual tests of soils to determine type and
inspection prior to the start or continuation of work after rainstorms or after any other hazard-increasing
occurrences.
 PMV Engineer
The PMV Engineer shall monitor the proper utilization of all equipment, machineries, vehicles and plant in
the site. Keep records of all equipment, machineries, vehicles and plant as per Daily Checklist and prepares
the preventive maintenance schedule as well.
 Third Party Laboratory
Performs the required testing and ensures the accurateness of all test results.
Note: Site Engineers / HSE Staff shall have access on site to each MS/RA. PIL will monitor activities on site based
against the MS/RA.

XI. Environment and Quality Issues

1. Precautionary Measure

All precautionary measures shall be briefed to all workers prior to commence activity

2. Disposal Requirements

All waste shall be disposed as per Construction and Environmental Management Plan, LUS-CP7B-QDSBG-
PLN-HSE-00008 and as per Government approved disposal areas.

3. Inspection, Test and Sampling

Request for Inspection and Testing will be submitted prior and after execution of works.

4. Quality Assurance Requirements Table

Refer to Project Quality Plan

a. Lusail Particular Specifications
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Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

b. QCS 2010

XII. List of Appendices

Appendix A: Risk Assessment
Appendix B: Inspection and Test Plan (ITP)
Appendix C: Permit to Work

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Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Appendix A: Risk Assessment

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Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. S.T.A.R.R.T will be conducted prior to commence the work and ensure all the necessary control
measures has been communicated to all levels.
2. Mandatory PPE must be wear as per activities required.
3. Ensure adequate control supervision must be in place.
4. Ensure the evacuation procedure has been briefed to all level and in case of emergency, QD-SBG
evacuation procedure must be followed.
Slips, trips and fall Supervisor, Site Foreman,
1 General 3 4 12 5. Ensure all the plant and equipment entering in the site must be inspected, have a valid 3rd Party 1 4 4
Injuries due to Accident Workers
Certificate and vehicle registration.
6. Adequate lighting must be provided.
7. Ensure valid permit prior to any excavation.
8. Excavation area cleared off from any materials and superficial rubbles and boulders.
9. Area to be barricaded and safety signage provided for work isolation
10. Road/access affected should be re-routed and provided with directional arraows.

1. Traffic control will be planned in liaison with Lusail Regulations.

2. Designated / Access segregation for pedestrians and provision of Flagmen for controling vehicles
movement in work areas and reversing vehicles complying with logistics and Lusail requirements..
3. One way traffic and provision of roundabout whichever is fessible.
Vehicle collision
4. Provision of dedicated flagman based on actual site condition & requirement .
Overturning of vehicles/ Equipment
5. Mandatory basic PPE to all & parking of vehicles at designated place only.
Toppling of equipment
6. Traffic control signs, lighting and safety zones will be set out complying with road and traffic safety
Men Machinery interface Workforce,
rules including stoppers for tipper trucks dumping materials.
2 Traffic Management Noise Vehicles/Equipments, Site 3 4 12 1 4 4
7. All Plant, Equipment and Vehicle complying with Lusail & QD-SBG requirements having valid Qatari
Dust Offices & Materials
Driving License and certification.
Slips, Trips & Fall
8. Provision of sufficient illumination for night work.
Injury
9. Provision of regular monitoring of traffic and no use of curtains in cabs.
Property damage
10. No use of Mobile Phones or other means of distraction while driving or operating.
11. Access control by means of security checks, etc.
12. No crossing of vehicles either loaded or empty over identified services.
13. No parking of vehicles and Equipment beside excavation edge.

1. Restrict working area with barricades only authorized personnel to be allowed.

2. Ensure working area is clear of trip hazards and clear of all debris.
3. Compliance with standard mentioned in NOC and provison of engineered and agreed tie. No use of
Breakage of services
steel binding wires or sythentic ropes.
Flooding
4. Provision of Engineering/ construction inspection, clearance and regular monitoring.
Electrocution
3 Protection of Identified Utility Services Workforce 3 5 15 4. Provision of steel beams and supports to attach/ tie identified services on appropriate distance with 1 5 5
Slip trip fall
warning signs.
Injury
5. Provision of Emergency contact number for utility service owners and LREDC and QD-SBG for
desired/ required assistance.
6. Use of adequate work platform and suitable PPE for supporting utility services.
7. No utility service support during Night hours or on Holidays.
Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. Restriction of work areas.

2. Ensure adequate control supervision must be in place.
3. Excavated soil shall be stacked away at a distance at least half the depth of trench.
Site Foreman
Collapse of sides 4 5 20 4. No under cutting shall be allowed. 1 5 5
Workers
5. No machinery or vehicle shall be allowed to work near the excavation.
6. Daily monitoring/inspection of excavation, to check for stability of trench sides to be done by
geotechnical specialist.

1. Crossover shall be provided at required locations.

2. Barriers sign boards and caution lamps shall be adequately provided.
3. Walking over the edges of excavation shall be prohibited.
Site Foreman
Falling of Personnel 4 4 16 4. Ladders shall be used for access to the excavation pit/trench. 1 4 4
Workers
5. Signages must be posted.
6. Do not walk inside the excavation/trench using it as an access. Instead climb up to the ground level
using the nearest access to reach the location from ground level.

1. Identify the location of electric cables with the help of cable locator and other underground utilities
shall be identified with the help of drawings.
2. Trial pits shall be done to locate the identified services. The depth of the trial pit shall be at least
0.5m more than the depth of actual excavation.
3. Only hand tools shall be used for excavation and for removing hard top layers, power tools may be
4 Excavation & Trenching
used.
Site Foreman
Damage to underground utilities 3 3 9 4. Sharp edged tools like crow bars shall not use after identifying the existence of underground 1 3 3
Workers
services.
5. Necessary PTW system shall be followed (if applicable). Utility services identified inside the
excavation area shall be protected from damages.
6. Ensure continuous supervision for removal of top soil in locations, wherever underground services
have been identified and located. Sharp edged hand tools shall keep away from such locations to avoid
their usage.

1. Do not store spoil or other materials close to the sides of excavations. The spoil may fall into the
excavation and the extra loading will make the sides more prone to collapse. Spoil heaps should not be
Site Foreman less than 1m from the edge of the excavation or 1.5m when the excavation depth exceeds 1.5m
Materials falling into excavations 3 3 9 1 3 3
Workers 2. Make sure the edges of the excavation are protected against falling materials. Provide toe boards
where necessary.
3. Keep working areas above and alongside trenches or excavations clear of objects or loose materials.

1. Safe access should be provided.

Site Foreman 2. Do not jump into or attempt to scale the sides of any excavation.
Access & Egress 3 3 9 1 3 3
Workers. 3. Keep the access clear ofexcvated materials and obstructions.
4. Do not jump across excavations and never stand on struts.

1. Excavation Permit must be secured and approved prior to excavation.

Workforce, Underground 2 .Underground scanning to take in place if necessary.
Damage to underground utilities 3 3 9 1 3 3
Facilities 3. If underground utilities were found, perform manual digging to expose underground utilities
4. Protect and secure identified utilities.
Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. Restrict the working area with barricades.

2. Trained Banksman shall direct vehicles/equipment in the work area.
Struck by vehicles/equipments Workforce 4 4 16 3. Vehicles/Equipments will be fitted reversing alarms. 1 4 4
4. Pedestrian route must be properly defined and protected with hard barriers.
5. Signages must be posted.

1. Ensure the ground is properly compacted and level.

2.During travel, banksman should assist the operator/excavator.
Overturned Excavator, Workforce 3 4 12 3. Proper supervision. 1 4 4
4. Ensure that operator is well experience and fully aware in site area.
5 Excavation (Use of Excavator) 5. Provide safe access.

1. Competent soil expert must inspected and checked the excavation.

2. Proper excavation protection must be implemented, i.e. sloping / benching / shoring.
3. Excavator shall be positioned at least 3meters away from the edge of excavation.
4. Workforce should be limited inside the excavation.
Cave-in / Collapse of excavation Workforce, Excavator 4 5 20 1 5 5
5. Safe access & egress should be provided.
6. Excavated soil shall be stacked at least 3meters away from the edge of excavation.
7. Loose materials must be removed on the edge of excavation.
8. No other machinery or equipments are allowed to work near the excavation.

1. Restrict working area with barricades.

2. Ensure working area is clear of trip hazards and clear of all debris.
Slip, Trips and Fall (Body,hand,foot
Workforce 3 4 12 3. Safe access & egress should be provided working area. 1 4 4
injury)
4. Ensure all materials were stacked properly.
5. Hard barriers should be installed at least 1.2meters away from the edge of excavation.

1. Only scaffold with green tag must be utilized at site.

2. Fall protection, e.g. full body harness must be worn when working at heights.
Fall at Heights Workforce 4 4 16 3. While working in the scaffolding, overreaching is not permitted. 1 4 4
4. Proper edge protection system to all open sides and ends of platform.
5. All crews must be brief by Scaffolding Supervisor in safe use of Scaffolding.

1. Scaffold must be away from any power lines.

2. Extension cables must be double insulated and properly hanged.
Electrical Hazards Workforce 4 4 16 1 4 4
3. Electrical cables should not be directly attached to any structures of scaffolding.
4. Lightings should be properly earthed and properly installed by electricians.

6 Scaffolding Works / Working at Heights

1. All ladders must be founded on a level base. All ladders must be secured.
2. All ladders must be in good condition and must be free from defects. All ladders must be positioned
in correct angle and secured.
Access & Egress Workforce 3 4 12 3. All ladders must extend a minimum of 1.0 meter above the working platform. 1 4 4
4. All personnel climbing the ladder must face the ladder and use both hands. At no time should
equipment be carried up the ladder.
5. During busy periods, personnel must wait until the ladder is clear before ascending and descending.
Health, Safety and Environmental Risk Assessment
Title
6 Scaffolding Works / Working at Heights Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. All scaffold access / platfrom must be free from any debris or any obstruction.
Slip,Trip & Fall on the same level Workforce 3 4 12 2. Adequate ladder must be utilize at site. It must be fixed. 1 4 4
3. Scaffolds should be adequately illuminated at all time either day or night.

1. Banksman will be provided to guide the operator.

2. Banksman should stand where the machine operator can clearly see and can be clearly directed.
Collapse of adjacent structures, injury
3. Ensure no other persons working close to the machine and not work on the blind side of the
from falling equipment and materials,
machine.
entrapment, personal injury to oneself or Site Foreman
7 Backfilling & Compaction of Trenches 3 3 9 4. Compact the backfilling materials in even layers. If shuttering is used, backfill up to level of wallings 1 3 3
others. Failure to check and ensure safe Workers
and props before removing them, at the compaction level only.
use of equipment. Overturning of
5. Shuttering is to be removed in the opposite sequence used.
vehicles/plant etc.
6. Ensure that the correct warning tape, identifying the relevant underground services is provided.
7. Never stand in a trench whilst it is being backfilled or work too close to the machine bucket.

1. Ensure entry/exit points from site allow for adjoining road conditions and use; signs; traffic control.
2. Establish pedestrian & vehicle routes and where practicable demarcate with fencing if adjacent.
3. Establish a 1 way system if practicable.
4. Locate storage to remove or minimise reversing & handling.
Vehicle collision on site. Vehicle collision
Site Foreman 5. Vehicles fitted with reversing alarms.
8 Vehicle Movements on entry and exit to site 4 4 16 1 4 4
Workers 6. Adequate compound lighting.
Pedestrian
7. Unstable ground; route away or culverts or ducts; weak surfaces lay hardcore or other temporary
surfacing.
8. All plant and equipment shall be inspected and tag before allowed to be used at site. Ensure that a
valid Third Party Certificates to be available upon request at site.

1. Plan The Route Before You Lift.

Back injuries, other body injuries, Site Foreman
9 Manual Lifting 3 4 12 2. Trained workers on proper lifting and handling. 1 4 4
Tripping. Workers
3. Use mechanical lifting when possible.

1. The work area should be barricaded and posted with signages.

2. Ensure work area is clear of other workers.
Minor injury due to flying debris Operator, Workforce 3 3 9 3. Prior to use of power tools and periodic inspection and tagging with records. 1 3 3
4. User shall wear hard hat, face protection, dust mask, heavy duty gloves and ear
protection.

1. Work intervals for operators.

2. Provide proper platform for the operatives.
3. Operator to use drilling equipment must wear hard gloves or anti-vibration gloves if necessary.
Vibration (Hand or Muscle Pain) Operator, Workforce 3 3 9 1 3 3
4. Daily inspection by users prior to use and Periodic inspection and maintenance by competent
10 Use of Hand Held Power Tools Electricians.
5. Immediate tagging and removal of Damaged power tools to store.

1. Ensure that the equipment is properly inspected and tagged by a competent Electrical staff.
Electrocution Operator, Workforce 3 3 9 2. Eletrical cables and tools should be free from any damages and double insulated. 1 3 3
3. Power source should be properly grounded/earth linked.

1. Operator must be provided with ear defender where needed.

Noise Operator, Workforce 3 3 9 2. Always keep adequate distance from operating equipments. 1 3 3
3. Only limited/ required worker in work areas and use of tools for right purpose.
Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. Compliance to QCS 2014 Section 10.5.4 Existing utilities, 10.5.5 Excavation, Section 1.4.3 Lifting
operations equipment & accessories, 1.4.6 Plant & work equipment, 1.5.4 working in and around
excavation and adequate supervision for each lifting activity.
2. STARRT Talks with appropriate lift plan permit.
3. Cranes/Lifting Equipment manufacturer's operating instructions specify the maximum wind speed
for safe operation depending on the load to be lifted, all cranes should have Third Party inspection
certificates for all lifting gears and equipment.
Falling materials 4. Provision of trained, lisenced and competent Crane Operator and Riggers.
Failure of Machinery 5. Lifting equipment, accessories and certification documents shall be inspected prior to commencing
Site Foreman
Faulty lifting of works.
11 Lifting Operations Workers 4 5 20 1 5 5
Poor communications 6. Daily Inspection Checklist will be filled by the Crane Operator.
Operator/Rigger
Improper loads 7. Ensure the lifting areas are properly cordoned and barricaded and free from working people.
Crane collapse 8. Cranes/Lifting Equipment Operators shall follow Riggers direction and Riggers shall be aware of the
load being lifted.
9. Ensure proper and clear communications are available between the Cranes/Lifting Equipment
Operator and the Rigger.
10. Ensure all lifting is performed in accordance with the approved lifting plan.
11. The wind velocity should be monitored on a daily basis through checklist by Operator or Rigger.
12. Lifting operations should be stopped in adverse weather conditions (e.g. strong winds, heavy rains,
etc.) complying with LREDC guidelines.

1. Ensure adequate dust suppression has been carried out.

2. Guards must be installed in front of all window areas exposed to flying or intruding hazards.
3. Appropriate hearing protection must be provided.
Flying objects, noise, dust & etc. 4. Shall ensure the soil remove in the area has been dumped in the designated area.
Site Foreman
12 Rock Breaking / Soil Removals Falling from Dump Box while 3 3 9 5. Ensure that trucks are properly parked and idle during tarping/detarping. 1 3 3
Workers
tarping/detarping of trucks. 6. Care must be exercise when climbing trucks and ensure that the steps or side ladder are not
deteriorating to avoid slips, trips and fall.
7. Secure the tarpaulin tightly to prevent from loosening and blown away that might cause accident for
other motorists.
Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department HSES Date: 24-04-2022
Location: Lusail Project Applicable to use : LUS-CP7B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
General Risk Assessment
Ref. Risk Score Residual Risk
Activities Associated Hazards/Risks Hazard Effects Control Measures in Place
No: P S RS P S RRS

1. Temperature to be monitored frequently.

2. Do not work under direct sunlight during the peak hours in summer months. (Between 1130hrs to
1500hrs and too hot and humid condition).
3. Wear suitable clothing’s to cover body parts as much as possible for minimize the exposure.
(Coverall)
4. Apply sunscreen lotion on exposed body parts to minimize the risk of heat rashes, sun burn.
Working under direct sunlight / High
5. Provide a safe work place.
Temperature / Hot air
6. Provide adequate ventilation and fan at the work place.
High Humidity
7. Provide plenty of fluids (Juice/Water/Electrolyte drinks) to workers to drink.
Body becoming weak and Bad Fitness due
8. Avoid working in the hot environment for long time.
to sickness
9. Provide shaded rest area with adequate ventilation.
Consuming alcohol, Caffeinated drinks,
10. Close supervision at all time.
Narcotic drugs
11. Provide sufficient cool drinking water and oral dehydration fluids.
Fasting or not drinking sufficientfluid,
12. Avoid working in humid environment for long time.
salt, electrolyte drinks (eg: Prolyte)
13. Provide short breaks while working in humid environment.
Working In Summer Months (Hot Excess physical work
13 Workers 4 5 20 14. Close supervision at all time. 1 5 5
Whether) Tight, thick and unclean cloths
15. Do not allow any sick person to carry out any job on site.
Exhaustion
16. Eat balanced food..
Heat Cramps
17. Avoid caffeinated carbonated diet drinks and alcohol..
Heat Rash
18. Mechanical aids to be provided and used to minimize excessive physical work.
Sun Burn
19. Provide short breaks while working in hot and humid environment.
Weakness, Fatigue and drowsiness
20. Take proper rest during break hours.
Lack of concentration,
21. Avoid consumption of Alcohol, Caffeinated drinks and Narcotic drugs in summer months.
Heat Stroke
22. Reduce working hours to minimize the exposure / heat related illness. 23. If fasting work only
Fatality
limited hours and avoid working under direct sunlight, high hot and humid condition if possible.
Inflammation / Dermatitis
24. Avoid excessive physical activities in hot and high humid environment.
25. Wear clean, slightly loose and light cotton cloths.
26. Clothes to be washed on a daily basis.
27. Loose the buckles and buttons while taking rest.
28. Heat stress management plan in place
29. Follow the main contractor site duty timing.

1. Adequate illumination on all access road, pedestrian and working area.

2. Warning flashlights with clear signages will be posted.
3. Traffic management wil be implemented.
Collision with pedestrian/other Workforce, Equipments,
4 5 20 4. Banksmen will assist any moving equipments with the use of baton lights and whistle. 1 5 5
vehicles/equipments Vehicles
5. All equipments must be fitted with reverse alarm, strobe light and head lights swiched on.
6. Reflective signs to mark designated access routes and parking areas.
7. All lights shall be checked prior to start work.

1. Restrict the working area with barricades.

2. Trained Banksman shall direct vehicles/equipment in the work area.
3. Vehicles/Equipments will be fitted reversing alarms.
Struck by moving vehicle and equipments Workforce 4 5 20 1 5 5
14 Night Works 4. Pedestrian route must be properly defined and protected with hard barriers.
5. Signages must be posted.
6. Sufficient lighting must be provided in working area.

Change of sleep cycle / over fatigue Workforce 3 3 9 1. Rotation of shift must be implemented. 1 3 3
2. Breaks will be allowed on regular intervals.
Health, Safety and Environmental Risk Assessment
Title Excavation Risk Assessment No.
Company QD-SBG Department
I HSES Date: 2 4-04-2022
Location: Lusail Project Applicable to use: LUS-CP?B-QDSBG-MST-UT-00248
Description of Activity/Tasks: Exacavation & Backfilling of Trenches (Stormwater Network)
Gener al Risk Assessment
Ref. Risi{ Score Residual Risk
Activities Associated Ha zards/ Risks Hazard Effects Control Measures in Place
No: p 5 RS p 5 RRS
1. Restrict working area with barr icades.
2. Ensure w orking area is clear of trip hazards and clear of all deb ris.
Slip, Trips and Fall (Body,hand,foot
Workforce 3 4 12 3. Safe access & egress should be provided working area. 1 4 4
injury)
4. Ensure all materials were stacked properly.
5. Access ways sho uld be siutably defined/lighted.

1. Only fully vaccinated operatives and staff sho uld be allowed to site
2. Check the body temperature before enter ing site
3. Seek medical attention if having, fever cough and experienced difficulty in breathing. Call in
advanced
4. Follow the directions oflocal health authority.
5. Keep checking body temperatu re
6. Cover nose and mouth with bent elbow when coughing/ sneezing
7. Avoid touching eyes, nose and mo uth
8. Washing of han ds frequently and sanitizing
9. Maintain social distancing when communicating to people
10. Maintain good personal hygiene.
11. Wear nose mask and gloves
12. Stop all non-essential visitors.
Severe illness, death/ fatality 13. Introdu ce staggered start and finish times to reduce congestion and contact at all times.
15 Covid-19 Workers 5 5 20
14. Monitor site access points to enable social distancing- you may need to change the 2 s 10
number of access points, either increase treduce congestion or decrease to enable monitoring.
15. Remove or disable entry systems that require skin contact e.g. fingerprint scanners.
16. Require all workers to wash or clean their hands before entering or leaving the site.
17. Allow plenty of space (two meters) between people waiting to enter site.
18. Regularly clean common contact surfaces in reception, office, access control and delivery areas e.g.
scanners, turnstiles, screens, telephon e handsets, desks, particularly during peak flo w times.
19. Reduce the number of people in attendance at site inductions and consider holding them outdoors
wherever possible.
20. Drivers s hould rema in in their vehicles if the load will allow it and must wash or clean their hands
before unloading goods and materials.
21. Always wear required PPE at all times.
22. Upon entering at site, avoid necessary groupings. Social distancing must be applied both in the
workplace and outside ofit.

Additional Comments or Informa tion

./I . / '
Risk Assessm ent Team
Name
Athanasios Kougkoulos
Muid een Oyedele
Designation
Project Director
HSE Manager
Department
Management
HSE
Signature~.....~~.... - -
U .J l'JH I LULL
-
·~
I
CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Appendix B: Inspection and Test Plan

P a g e 30 | 31
 Lusail - CP07B ITP # : Issue Date
CP07-B Lusail Plaza Infrastructure, LRT Station, Public
INSPECTIONS and TESTS PLAN 0 1 2
Car Parks and Landscape
Rev. 24-04-2022
Excavation, Laying of Pipes and Backfilling of Trenches for Stormwater ×
Contract No: 5297 Reference Procedure / Method Statement / Specs: Please refer to Controller Document Column Discipline: Utilities

INSPECTION
Activity
Activity Description Controlling Document Frequency Acceptance Criteria/ Test Verifying Documents
No. S/C QD-SBG Parsons Authority

1.0 SUBMITTALS
Project Specifications / QCS
1.01 Shop Drawing As Required Approved from the Consultant Approved Shop Drawings H H R -
2010, Sec. 1, Part 7
Project Specifications / QCS
1.02 Material Submittals As Required Approved from the Consultant Approved Material Submittall H H R -
2010, Sec. 1, Part 7
QCS 2010, Sec. 1, Part 8
1.03 Method Statement As Required Approved from the Consultant Approved MST H H R -
clause 8.2.4
inspection and as per ITP for Trial Pits No.LUS-CP7B-QDSBG-MST-CV-
1.04 Trial Pits QCS 2010, Sec. 3, Part 3 As Required Approved MST H S R -
00034

1.05 All Necessary Permits QCS 2010, Sec. 11, part2 As Required Valid Excavation permit Valid Permit H H R -

2.0 TESTING PROCEDURE / IMPLEMENTATION

Approved Shop Drawing /

Survey Reports/
2.01 Setting out for Manhole / Trenches Project; QGEWC As Required Comply with approved shop drawing, approved by Consultant. H H H -
INR/Checklist
Specification

2.02 Excavation for Trench and Manholes QCS 2010, Sec. 3, Part 3 As Required Comply with approved shop drawing, approved by Consultant. Checklists H H S -

Survey Reports/
2.03 Preparation of Trench Formation Level Approved Shop Drawing As Required Comply with approved shop drawing, approved by Consultant. H H H -
INR/Checklist

2.04 Installation of Geotextile Membrane As per approved Material As Required Comply with approved shop drawing, approved by Consultant. MEP INR/Checklist H H H -

Laying, Spreading and Compaction of

2.05 As per approved Material As Required Comply with approved shop drawing, approved by Consultant. MEP INR/Checklist H H H -
Bedding Material
Survey Reports/
2.06 Laying of GRP Pipes and Fittings Approved Shop Drawing As Required Comply with approved shop drawings and MEP Method Statement H H H -
INR/Checklist

Laying of RC Pipes (Blinding Works,

Survey Reports/
2.07 Geotextile Membrane Installation, Concrete Approved Shop Drawing As Required Comply with approved shop drawings, approved by Consultant H H H -
INR/Checklist
Cradle and Fibre Board Installation)

Survey Reports/
2.09 Laying of the Surround Materials As per approved Material As Required Comply with approved shop drawing, approved by Consultant. H H H -
INR/Checklist
Comply with approved shop drawings, and MEP Method Statement
2.10 Pipe Testing Approved Method Statement As Required Test Report/Checklist H H H -
Reference No. LUS-CP7B-QDSBG-MST-MC-00051 Rev. 01
 00-SBG ~
~
-----
C o n s t r u c t i o n
.p .p .j UUqlAo.U ~ r.n-! lJ.UI - q
w.t.t.
.J q.6
? PARSONS
Lu sail

Lusail - CP07B ITP #: Issue Date

CP07-B Lusail Plaza Infrastructure, LRT Station, Public INSPECTIONS and TESTS PLAN 0 1 2
Car Parks and Landscape
Excavation, Laying of Pipes and Backfilling of Trenches for Stormwater
Rev. 24-04-2022
x

Contract No: 5297 Refer e nce Procedure/ Method Statement / Specs: Please refer to Controller Document Column Discipline : Civil

INSPECTION
Activity
Activity Description Controlling Document Frequency Acceptance Criteria/ Test Verifying Documents
No. QD-SBG
S/ C Parsons Authority

Casting of Concrete Protection Slab (In case

Survey Reports/
2.11 Earth cover to pipeline is less t han 1200 Approved Shop Drawing As Required SRC 20 concrete m ix approved by Consultant. H H H
INR/Checklist
mm]
Survey Reports/
2.12 Construction of Cut-Off Wall Approved Shop Drawing As Required Comply with approved shop drawing, approved by Consultant. H H H
INR/Checklist

2.13 Laying of Warning/Marker Tape Approved Shop Drawing As Required Comply with and shop drawing approved by Consultant. INR / Checklist H H H

150mm thick; by man ually compacted using Skgs weight rammer visually;
QCS 2010; Section 3; Part 3;
2.14 Backfillin g in Layers
Method Statement
As Required and not more than 250mm thick in layers tested for a 95% Field Density FDT Reports/ INR/Checklist s w w
Test in accrodance to BS 1377; Approved by the Consultant.
QCS 2010 ,Sec.12 ,Part 3
2.15 Compaction
clause 3.5
Per Section or Area ~ 95% of Maximum Dry Density Checklist H H w
One (1) tes t per
1. Nuclear gauge operator wit h a pproval from th e Ministry of
BS 1377-9; QCS 2010, Sec. 6, backfill layer for INR / Laboratory Test
2.16 Field Density Testing by Nuclear Met hod Environment; Compliance to BS and CML Method of Test ing. H H H
Par t 3 clause 3.10.2 every 30m pipeline Reports
2. Per layer of lSOmm thickness at ~ 95% Maximum Dry Density.
t rench

INSPECTION POINTS:
H / HOLD POINT: The contractor shall raise INR for a reasonable time of 24 hours before inspection (and CSC to close the Workfiow in Aconex within 48 hours), forthe operation/ item that must be visually examined, tested or measured by the Consultant to verify conformance to quality
requirement The contractor shall not proceed with the work beyond such hold points, except by written agreement from the Consultant
W / WITNESS POINT: The contractor shall raise INR for a reasonable time of 24 hours before inspection (and CSC to close the Workflow in Aconex within 48 hours), for the operation/item that must be visually examined, tested or measured by the Consultant to verify conformance to quality
requirement The contractor may proceed with the work beyond such witness points in case the Consultant's inspector cannot turn up for the inspection at the specified time.
S /SURVEILLANCE POINT: In process monitoring of Contractor's activities to the degree necessary that confidence is gained that the work process /Methods are in compliance with criteria.
R / REVIEW: Reviews of the inspection and Testing records recorded by the contractor and by the Consultant for correctness and completeness.

Prepared By: Reviewed and Endor~..ror-coiisultant Approval ~

-. Approved By:

A~------·---
I C--.i-- ~

If'- \ ____>=:=
Rally Aragon ...., Mohamed Bhekit Athanasios Kougkoulos
Technical Engineer QA/QC Manager Project Director Consultant
 CP07‐B Lusail Plaza Infrastructure, LRT Station, Public Car Parks and Landscape, Lusail, Qatar

Checklist for Utilities Trench Excavation Contract No.: 5297

Location of Work : Ref. No.

Station : From _____________________ To______________________ Date:

Ambient Temperature:

Disposition Dorsch
Description of Works Initials
Accept Reject

1 Shop drawing approved.

2 Ensure that the method statement is approved.

3 Excavation Permit Obtained.

4 Equipment, calibration certificates, Driver/operator license.
5
Barrication, lighting in place for Night shift operation

6 Setting out as per approved shop Drawing

7 Excavation monitoring as per approved MS

8 Dust control

9 Storage of Excavated Materials

10 Level verification of part 1 & setting out of part2(Manhole/pipe)

11 Final formation level verification/slopes

12 Haul Route & Disposal of Excavated Material

Remarks:

Checked by: Inspected by: Approved by:

Subcontractor Representative: QDSBG Q.C. Inspector Consultant Representative
Name and Signature Name and Signature Name and Signature

Date: Date: Date:

CP07B‐F411‐Rev.0‐Mar‐18 Page 1 of 1
CP07‐B Lusail Plaza Infrastructure, LRT Station, Public Car Contract No. Location:
Parks and Landscape 5297 Lusail, Qatar

Backfilling Checklist
Location of Work: Reference No:

Date :
QD‐SBG Dorsch
SR. Description of Works Remark
Accepted Rejected Accepted Rejected
1 Method Statement available and approved
2 Check if Backfill materials is suitable and approved
Removed any debris and organic matters in excavated
3 surface
4 Confirmed method of compaction
5 FDT for previous compacted layer done and passed
6 Field Density testing done and passed
Survey report (level) confirm with Layer thickness
7 requirement.
Survey report (Coordinates and level) confirm with design
8 requiremnt
Comments :

Approved Approved with comment Revise and Resubmit

Checked By: Inspected By: Witnessed By:
QD‐SBG Execution Engineer QD‐SBG QA/QC Engineer Dorsch QC Engineer/Inspector
Name: Name: Name:

CP07b‐F75‐Rev.1‐May‐16 Page 1 of 1
CP07-B Lusail Plaza Infrastructure, LRT Station, Car Park and Landscape; Lusail, Qatar

Contract #: 5297 Document No.: LUS-CP7B-QDSBG-MST-UT-00248 Rev. No.

Title: Method Statement for Excavation, Laying of Pipes and Backfilling of Trenches for 0 1 2 3
Stormwater Network x

Appendix C: Permit to Work

P a g e 31 | 31
 CP7B – LUSAIL PLAZA, INFRASTRUCTURE, LRT STATION, PUBLIC CAR Doc. Name: CP7B HSES FRM‐011
PARKS & LANDSCAPE Date Issued: 11/2019
Rev. No. : 1
HSES DEPARTMENT
GENERAL WORK PERMIT
Instructions:
1. This permit must be filled/requested by a competent personnel who shall be supervising work,
2. This permit Issued by a person who shall be over-all responsibility within a designed construction area.
3.This permit verified by HSE representative
4. A Register/Log of issued permits must be maintained in permit office
5. This permit must be returned to the Permit office on completion or suspension of the work.
Permit Number :
Requester Name: Designation: Company : Work Area:
Equipment/Tool to be Used: New Work : Continuation :
Location of work Unit, Facility Building, Equipment or Area
Sub Permits Hot Work Isolation Permit Excavation Permit Other: 1 _____________________________
Confined Space Entry Electrical Work Permit Working at Hieght Other: 1 _____________________________
Description of Works to be done:

Permit Validity: From ___/___/20____. _________AM/PM To ___/___/20__. _________AM/PM Revalidation: From ___/___ /20____. _________AM/PM To ___/___/20__. _________AM/PM
Note: This permit is valid only so long as work conditions existing at the same time of its issuance continue, and expires upon occurrence of any hazard such as gas leak, liquid spill, drastic operating
change in adjacent equipment or change in wind direction blowing vapours into the work area. Any worker will have the right to stop the job if he has reasonable grounds to believe that the job is, or
likely to become unsafe. Work shall not resume until a new permit is issued.
Procedures Satisfied Satisfied Satisfied
Discription Yes No N/A Yes No N/A Yes No N/A
Job site inspected Fire Fighting Equipment Head Protection
Method satements/Risk Assessment reviewed Gas Detector Protective clothing
Utility/Power lines identified Air movers/ventilators Face shield/goggles
Job discussed with supervisor/personnel Area roped off and warning signs up Safety Goggles/ Safety Glasses
STARRT Meeting Conducted Electrical equipment grounded type Welding Mask/Goggles
Emergency procedures established Explosion proof electrical cords Guntlet/Gloves
Fire & Rescue , First Aid Team established Scaffolding Ear protection
Mechanical Isolation/Electrical Isolation Done Ladders Work Vest
Standby man/continuous gas monitoring Personnel Basket Fireman Suit
Explosive/toxic gas test Conducted Power Tools SCBA
Oxygen deficiency test cundected Electrical Tools Air Purifiers
Vessels/lines purged Hot Stick Safety harness and lifeline
Drains covered/sumps covered and sealed warning tape, Safety Warning Signs Fall arrestor
Underground line, located and identified Hand Held Air Horn (warning) Chemical Suit
Overhead lines, clearance established Welding BlanketCrane Chemical Apron
Equipment cooled/ventilated/isolated Electrical Rescue Equipment Chemical Gloves
Electrical equipment/valve locked and tagged EX Radios Electrical Gloves
Bonding/Grounding required Spill Containment Equipment Leather Apron
Combustible material removed Other: Life Jacket
Shoring/cut back required Work Vest
Blinds installed/bleeds open Other:
Safe egress from work areas identified
Other:
Special precautions ,Instructions and Equipment required

Permit Requester (Competent Foreman/Subcontractor Engineer) Issuer (Construction Manager or Enginner)

I have checked and confirmed that Health safety and environment measures have I am satisfied that reasonably practicable measures have been implemented
been taken to ensure safety and health of person at work and fully understand the and enforced trough proper evaluation of risks and hazardous. The working
nature of work and legal compliances. I will continuously monitor the activity and personnel are informed health and safety hazards and environmental impacts
undertake to stop /suspend the operation if there any unsafe condition or and protection counter measures to be taken. If incompatible works reported
potentially hazardous situation arose during the work. I undertake to report the works will be revoked.
immediately if there is any incompatible work found in and around the vicinity.

Name :
Name :
Designation :
Designation :
Signature :
Signature :
Permit Verified(HSES Representative)
I inspected and assessed the vicinity of the above area and verifying that all reasonable practicable steps have been taken to safeguard the health and
safety of the person at work, preservation of environment and prevention of any property damage.

Name : Designation : Signature : Date :

Permit Suspension:

This permit is suspended due to (reason)_____________________________________________________________________________________

Name : Designation : Signature : Date :

Work completion :Requester Construction Manager or His Appointed Person HSES Representative
I am confirm that work completed and area safe I am satisfied that work completed and area safe and all I verify that work completed and area safe and
and all safety measures are in place. safety measures are in place. all safety measures are in place.

Name : Name : Name :

Designation : Designation : Designation :
Signature : Signature : Signature :

General Work Permit CP7B HSES FRM‐011R1

 CP7B – LUSAIL PLAZA, INFRASTRUCTURE, LRT STATION, Doc. Name: CP7B HSES FRM-002
PUBLIC CAR PARKS & LANDSCAPE Issued Date: 03/2017
HSES DEPARTMENT Rev. : 1

Excavation Work Permit

Instructions:
1. This permit must be filled/requested by a competent personnel who shall be supervising Excavation work,
2. This permit Issued by a person who shall be over-all responsibility within a designed construction area.
3.This permit verified by HSE representative
4. A Register/Log of issued permits must be maintained in permit office
5. This permit must be returned to the Permit office on completion or suspension of the work.
Issue date: Permit #:
Requester name Company:
Designation Location of work:
Weather conditions: Equipment to be used:
DIMENSIONS DEPTH(S) = Yes No HAZARDOUS CONDITIONS
Width = Top BOTTOM
Saturated soil / standing or seeping water?
Length= Evidence of fracturing or fissuring?
SOIL APPEARANCE TESTED Bulging wall(s) Floor heaving?
Solid rock Average soil Yes No Frozen soil? Depth more than 1.5 meters?
Backfilled Soil Loose sand Sur-charge loading within 10 meters?
A B C Solid Rock Vibration source(s) within 10 meters?
PROTECTIVE SYSTEM(S) PLANNED UTILITY LOCATIONS SURVEY
Timber Shoring Screw Jacks Hydraulic Shoring As built drawings available and reviewed?
Pneumatic Shoring Trench Shield/ Box Has a subsurface utility survey been performed?
Sloping/ Benching to ____ H:_____V test pits / hand dig done to locate known utilities?
other: Has utility owner been notified of work planned?
PRECAUTIONS/ COMMENTS: YES No N/A
Ground condition is evaluated and monitored for contamination and water levels
Access located in protected area? Access within 7.5 meters of workers?
Excavation area clear from Overhead Power Lines /scaffolding/Existing Building
Rescue team(in case of emergency) ready and Stretcher available
Warning lights ,Barriers and signages in place and Excavation edge protected
Area illuminated or proper lightings available?
Certified Banks man is available and briefed for the work
Are equipment inspected and third party certified
Certified First Aiders & First Aid kit available
Complete PPE including Dust Mask in place
Gas Test Required? If Yes provide gas test record
Safe access and egress in and around the excavation provided
Operator competent and certificate available
Underground utilities identified and exact location marked?
Loose materials/rock removed / material not stacked edge of excavation
Dust control/Others( )
Additional precautions /comments:

PERMIT VALIDITY:
This permit is valid from: AM/PM on / / Until: AM/PM on / /
Requester (Competent Foreman/Subcontractor Engineer) Issuer (Construction Manager /Engineer)
I understand the work that is to be carried out and the safety I declare that the above has been known to the competent
precautions that are necessary to complete the work safely as person in charge of the work and consider the above mentioned
outlined in the appropriate method of statements and risk area to be safe for the competent person to commence work.
assessments. If conditions are such that MS and RA become
invalid. It is my responsibility to stop work and notify the
person who authorized this permit to work.
Name & Signature: Name & Signature:
Date Time: Date Time:

HSE Comments VERIFIED BY( HSES REPRESENTATIVE):

Name: & Signature:
Position:

COMPLETION OF WORKS/ CLOSING OF PERMIT

Time of work completed/ suspended: AM/PM
Reason of suspension:
Work area confirmed safe for return : AM/PM
REQUESTER(Person in charge) ISSUER (CM/ENGINEER) Verifier(HSE Representative)
Name: & Signature: Name: & Signature: Name: & Signature:

Excavation Work Permit CP7B HSES FRM-002R1

 Doc. Name: CP7B HSES FRM‐
CP7B – LUSAIL PLAZA, INFRASTRUCTURE, LRT STATION, 014
PUBLIC CAR PARKS & LANDSCAPE Issued Date: 11/2019
Rev. No.: 1
HSES DEPARTMENT

GENERAL LIFTING PERMIT Permit No: _________________

Date & Time of Lifting Operation:

_____/___/20____ ._______ AM/PM TO _____/_____/20____ .________ AM/PM
Location:
Crane Details:
Load to be Lifted:

Lifting Supervisor’s Name:

Signalman’s Name:

Rigger’s Name:
Acceptable
Item Description Comments
Yes No
General Lifting
1. Crane operator’s checks complete
2. Lifting supervisor’s checks complete
3. Crane set up on firm ground
4. Crane safe distance from excavations
5. Check for overhead dangers
6. Crane, Lifting accessories Documents available and valid
7. Operator and riggers certifications available and valid
8. Weather is good and favorable for lifting operation
9. All lifting accessories inspected and color coded
Lifting from a Public Road
10. Warning signs and cones positioned
11 Traffic signalman in position
Permit Requested by: SIGNATURE
(Competent Foreman/Subcontractor Engineer)

Designation:

Date & Time:

Permit Issued by: (Lifting AP/Supervisor) SIGNATURE

Designation:

Date & Time:

Permit Verified by :( HSES Representative) SIGNATURE

Designation
Date & Time:
C.C.:

Doc. Name: CP7B HSES FRM‐014R1 GENERAL LIFTING PERMIT