Method Statement Submittal Form

Our Record Reference: AS/PJC/AA/na/282199/02/S1174 Date: 30/01/2012JV Record Reference: No-CSJVARC-L3-MS-000013 Date: 17/01/2012 Project Details: Musanada’s Project Number:Project Name: The Development of South Shamkha LOT 3Client: Musanada PMC: PILEngineer: Mott MacDonald Contractor: CSCEC-JV-ARCIR No: Rev No : 0

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Material Detail List of EnclosureItem Description    Method statement for HDPE pie playing

Specs. / BOQ / Drwg. Reference  

Material Specified

Material Proposed  For Potable Water Network 

Manufacturer / Local Supplier

 Reason for Alternative  

 Remarks    

Contractor Signature:

Discipline Engineer:

QA/ QC HSE MEP Construction Manager:

Received By Date

The Engineer: A- Approved B- Approved with Comments C- Revise and Resubmit D- Rejected

Comments: 1. Manufacturer’s recommendation for fusion butt welding of HDPE pipe & fittings shall be enclosed2. Fusion butt welding personnel shall be certified.3. General

a- In the proposed method statement for laying HDPE piping, contractor has specified method statement for hydro testing and flushing and disinfection. Contractor to submit method statement for hydro testing, flushing and disinfection inclusive but not limited the following.Hydro testing.

Total length of pipe to be tested. Quantification of water requirement. Safety officer/competent personnel shall be approved M/S ADDC. Valid calibration certificate for pressure gauge to be enclosed. Water drainage location shall be approved by Abu Dhabi Municipality. Acceptance criteria.

Flushing &disinfection MBS TMT 208 - CS-41 – Material Submittal Form Ver.-04 01 July 2010 P a g e | 1

Computation of water and chlorine requirements. Temporary connection filling point details inclusive of schematic sketch to prevent

backflow of water. Approval from Abu Dhabi municipality for drainage of flush water. Safety officer/competent personnel shall be approved M/s ADDC. Flow meter to quantifying the water consumed ,inclusive of factory accuracy calibration

certificate. Layout plan including sampling, injection and drain points.

4- HSE plan shall comply with ADDC requirements as detailed in ADDC’s form FM-HSQ-022( refer enclosed form for completed details ) shall be submitted.

Reviewed By & Signature: (The Engineer) Checked By & Signature: (The Engineer)

Received By (The Contractor) Date

Distribution: Musanada PMC Engineer Contractor

MBS TMT 208 - CS-41 – Material Submittal Form Ver.-04 01 July 2010 P a g e | 2