Submittal Transmittal: Date: 3/8/2016 Reference Number: 0483

Submittal Transmittal
Detailed, Grouped by Each Number
LC3 (R-15-085-BF-0) Project # RUH-CP-1502

Tel: Fax:
Date: 3/8/2016 Reference Number: 0483
Transmitted To: Hadi Omar Harb Transmitted By: Paul Teague

SSEM AECOM
P.O. Box 6341 P.O. Box 58806
Al Rashid Tower, 5th Floor 4 Floor, Tower 4, Tatweer Tower
Al Ma'athar Street 11515 Riyadh
11442 Riyadh Tel:
Tel: 4625511 Fax:
Fax: 4627804
Qty Submittal Package No Description Due Date Package Action

1 0120 - 013300 - D1 - 1 Method Statement for Formworks, Rebars, Reviewed -
Cast-In-Situ Concrete(Pouring, Embedments, Exceptions Noted
Curing)
Transmitted For Delivered Via Tracking Number

Action Hand
Items Qty Description Notes Item Action

001 1 Method Statement for Reviewed - Exceptions
Formworks, Rebars, Noted
Cast-In-Situ Concrete(Pouring,
Embedments, Curing)
Cc: Company Name Contact Name Copies Notes
Remarks
Reviewed Exceptions Noted, Resubmission Required.
1. Please see attached.
Best Regards,
Signature Signed Date
Prolog Converge Printed on: 3/9/2016 Prolog KKIA Page 1

KINGDOM OF SAUDI ARABIA
GENERAL AUTHORITY OF CIVIL AVIATION
CONSTRUCTION OF LOAD CENTER -3
METHOD STATEMENT FOR FORMWORKS, REBARS,

CAST-IN-SITU CONCRETE (POURING, EMBEDMENTS,
CURING)
First Rev. A B CONTRACT #: R-15-085-BF-0
Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B
METHOD STATEMENT FOR

FORMWORKS, REBARS,
CAST-INSITU CONCRETE
(POURING,
EMBEDMENTS, CURING)
1.The page header shall also include KKIA logo in the following
sequence from left to right - GACA, KKIA, AECOM & SSEM. SSEM may
opt to place their company logo below the first three mentioned logos.
2.All appendices shall also show the correct (current) logos of GACA,
KKIA and AECOM accordingly.

Project Quality Manager: Project Manager:

ENGR. Amr Ibrahim Metwally ENGR. HADI OMAR HARB
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Table of Contents
1.0 Purpose ………………………………………………………………… ………………..03
2.0 Scope …………………………………………………………………………………….. 03
3.0 References and Standards …………………………………………………………… 03
4.0 Abbreviations/Definitions …………………………………………………………….. 04
5.0 Work Program …………………………………………………………………………...04
6.0 Equipment ………………………………………………………………………………..04
7.0 PPE Materials …………………………………………………………………………… 05
8.0 Manpower Schedule …………………………………………………………………… 05
9.0 Responsibilities of Key Personnel ………………………………………………….. 06
10.0 Concreting Methodology ………………………………………………………………07
11.0 Quality Requirements …………………………………………………………………. 12
12.0 Health and Safety ………………………………………………………………………. 13
Appendices
Appendix 1.0- Job Risk Assessment ………………………………………………..15
Appendix 1.1- Carpentry Works ……………………………………………………...15
Appendix 1.2- Formworks …………………………………………………………… 17
Appendix 1.3- Steel Cutting and Bending …………………………………………. 19
Appendix 1.4- Concrete Works ……………………………………………………….21
Appendix 2.0- Related ITP ……………………………………………………………. 23
Appendix 3.0- Checklist ………………………………………………………………. 25
Appendix 4.0- Proforma Work Permit ……………………………………………….27
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1.0 PURPOSE
The purpose of this method statement is to provide description of procedure and method for the
execution of for construction of reinforced concrete structure, the LC-3 Building and related
structures. This include the fabrication/installation of formworks and reinforcing bars, the pouring
of cast in situ concrete, and repair of newly casted concrete. As well as the necessary materials to
ensure health and safety of employees with the requirement stipulated in the Contract
Documents, as well as those in Saudi Construction Specifications (ASTM and SASO-ISO)
2.0 SCOPE
This method statement covers the task related to construction of reinforced concrete building.
This include but is not limited to : raft or strip foundations, retaining walls, columns, girders,
suspended and slab on grade, concrete duct banks, manholes, other equipment supports and
foundation.
3.0 REFERENCES AND STANDARDS
Construction of reinforced concrete building will be in accordance with the following standards:
3.1 Saudi Arabia Construction Specification.
3.2 Employers requirements, Materials Specification
3.3 Approved with Comments (AWC) design and construction drawings.
3.4 ACI-117
3.5 ACI-318
3.6 ACI-347R
3.7 ACI-304R
3.8 ACI-305R
3.9 ASTM-C39
3.10 SASO SSA2
3.11 SASO SA 224
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4.0 ABBREVIATION/DEFINITION
PM Project Manager
PQP Project Quality Plan
QIP Quality Inspection Plan
QA&QC Quality Assurance & Quality control
MS Method Statement
PPE Personal Protective Equipment
HSE Health, Safety & Environment
PPE Personal Protective Equipment
ECO Environmental Control Officer
CR Construction Regulation
EMP Environmental Management Plan
OHSA Occupational Health and Safety Act
SO Safety Officer
EO Environmental Officer
5.0 WORK PROGRAM
Construction of the building comprise of:
5.1 Two level building with floor area approximately 5,500 sq. m.
5.2 Construction of generator room, 1500 sq. m. with individual support for the equipment.
5.3 Control room area with provision for LV and MV- panel controls.
5.4 Construction of duct banks for the associated power, communication, waterlines and
plumbing lines.
6.0 EQUIPMENT
The contractor (SSEM) will provide the following equipment throughout the project, quantities will
be determined by actual site demand. Equipment will be inspected prior to mobilization and shall
hold valid insurance certificates, as well as certified/competent operators.
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Type of Equipment Units (No.)

Concrete Transit mixers Depend on conc. volume
Concrete Pumps 1
Portable Concrete Vibrator 2
Boom trucks 1
Water Truck 1
Bar Benders 2
Bar Cutters 2
Circular Saw (Table Type) 2
Portable electric grinders 4
Portable electric jigsaws 4
Misc. hand tools 1 lot
Table I. Equipment Intended for Concrete construction works.
7.0 PPE MATERIALS
Personal Protective Equipment (PPE) should be provided in order to perform all works in
accordance with the safety procedures and taking into consideration the importance of proper
preventive measures to ensure safety in the performance of work.
Type of Equipment
Safety Helmet
Safety Boots/Shoes
Safety Glasses
Safety Masks
Coveralls
High Visibility Vests
Hand Gloves
Fall Arrester
Safety Harness
Table II. Personal Protective Equipment Intended for Concrete Construction Works.
8.0 MANPOWER
The workforce including foremen, operators, and technicians shall be well qualified with third party
certificates wherever applicable/relevant.
Subcontractors for different trades shall be deployed depending on demand, to cover up shortfalls
and to cope up with the construction schedule.
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CONTRACTOR
(SSEM)
Construction Manager
Site Engineer
QC- Engineers
Surveyor
Safety Engineers
Civil Foreman
Carpenters
Steel fixers
Mason
Scaffolders
Equipment Operators
Safety officers
Flagmen
First Aider
Laborers
Table III. Manpower for Concrete Construction Works.
9.0 RESPONSIBILITIES OF KEY PERSONNEL
9.1 Construction Manager
The Construction Manager will plan and expedite for the continuous supply of resources to
cope up with the project demand and schedule. The construction manager will keep record
of the progress of work. He will report to the project manager on matters affecting
completion of project. He will give direct orders to the site engineer for the effective
implementation of work program.
9.2 Site Engineer
The Site Engineer will be in charge for the supervision and implementation of all concrete
construction works as required in the specifications and drawing, especially in giving orders
to Site foremen. Site engineer is also in charge for the preparation of daily, weekly and
monthly reports. He will coordinate with the QC-engineer on matters concerning Inspection
request and attend to final inspection together with SSEM QC-engineer and the owners’
Engineer.
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9.3 Quality Control Engineer
The QC Engineer will be responsible for compliance of work to the reference contract
drawings, specifications and other QA/QC conditions required by The Engineer. He will
monitor daily activities and notify concerned parties when works deviates from the standard.
He will issue proactive notification when needed to prevent non-compliance works.
9.4 Site Foreman
The Site Foreman will be in charge for the supervision and implementation of various stages
of concrete construction works, as instructed by the Site engineer. He will be responsible for
the execution of works in compliance to approved drawing and contract specifications.
Foreman shall also keep record of all work schedules, work production and daily safety
issues.
9.5 Site Surveyor
The Site Surveyor will be in charge for the setting out for building corners, elevation and
make the vertical/horizontal reference at site. He will stake out for lines and elevations of
underground utilities construction and will prepare reports for excavation and backfilling
works.
10.0 CONCRETING METHODOLOGY
10.1 Sequence of Work
The following are the sequence of work in the construction of Cast-in Situ Concrete:
10.1.1 Fabrication and installation of form works.
10.1.2 Fabrication and installation of steel reinforcements.
10.1.3 Installation of anchor bolts, block-outs and other embedment to concrete when
needed.
10.1.4 Form closure and installation of supports
10.1.5 Pouring of ready mix concrete.
10.1.6 Preparation of concrete sample specimen for testing purposes.
10.1.7 Finishing and curing of concrete.
10.1.8 Stripping of formworks.
10.1.9 Repair of minor concrete imperfection.
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10.2 Formworks
10.2.1 Forms shall be substantial and sufficiently tight to prevent leakage of

mortar from the concrete. Contractor shall use sufficient nailing,
bolting, welding, shoring, whalers, form clamps and forming of
adequate strength to contain the fluid concrete without noticeable
deflection, leaning or bulging
10.2.2 Forms shall be properly braced or tied together to maintain position

and shape. Forms shall be built to resist the pressures to which they
will be subjected and to limit deflections to a practicable minimum
within the specified tolerance.
10.2.3 Formwork shall be anchored to the shores below so that movement of

any part of the formwork system will be prevented during concreting
10.2.4 Block outs, inserts, sleeves, anchors, water stops and other embedded
items shall be properly identified, positioned and secured in the forms
to resist all forces while concrete is being placed and hardens.
10.2.5 Old forms shall be thoroughly cleaned of all dirt, mortar and foreign matter and
coated with a release agent before each use.
10.2.6 A polyethylene sheet shall be placed beneath and around the sides of concrete
that is placed against soil where bitumen or coal tar epoxy cannot be applied.
10.2.7 A polyethylene sheet, minimum 0.15mm thick, shall be placed beneath slabs on
grade and other concrete structure when shown in the drawing.
10.2.8 Water stops shall be provided in joints where watertight construction is required.
Location and type of water stops shall be as shown on construction drawing.
10.2.9 Expansion joint filler strips shall be made from fiber board securely bound together
by a suitable asphaltic binder.
10.2.10 Well trained manpower shall be deployed as the height of formworks increases.
10.2.11 Erecting formwork frames should be erected in a progressive manner to ensure

both the installers safety and the stability of the overall structure.
10.2.12 Braces should be attached to the frames as soon as practical. As erecting the
frames continues, designated access ways should be indicated by using bunting or
by other means.
10.2.13 Provide the side bracing or other edge protection is installed progressively and as
soon as enough material has been raised up.
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10.2.14 Framing is carried out in accordance with on-site design documentation and
manufacturers’ instructions.
10.3 Steel Reinforcements
10.3.1 Forms shall be inspected and checked before the reinforcing steel is placed to the
dimensions and locations on the structural plans.
10.3.2 The minimum concrete cover shall be measured from the outer most rebar (tie
bar), that shall be provided for reinforcement of cast-in-place concrete structures
as indicated in the drawings.
10.3.3 Reinforcing steel rebar shall be correct in size, quantity, layout, spacing, position
as per the contract drawing
10.3.4 Reinforcing Steel lap splice lengths for each bar size shall be as detailed for each
size as shown on the Contract Drawings.
10.3.5 Welding of reinforcement shall not be allowed unless authorized by The Engineer
or called for specifically on the Contract Drawings.
10.3.6 Provide necessary and safe scaffolding / platform as the height increases for steel
reinforcement installation.
10.3.7 Dowel bars and anchorage shall be as per approved drawing and specifications
and be maintained whenever necessary.
10.3.8 All reinforcement must be cleared to ensure that it is free from oil, dust and
deleterious materials.
10.4 Anchor bolts and Embedded Items
10.4.1 Anchor bolts and embedded items shall be set accurately, using templates.
10.4.2 Anchor bolt projection above the top of concrete is computed as follows:
Single Nuts:
Thickness of grout + thickness of base plate (or height of anchor bolt chair above
the top of grout) + 1.5 x diameter of anchor bolt.
Double Nuts:
Thickness of grout + thickness of base plate (or height of anchor bolt chair above
the top of grout) + 2.5 x diameter of anchor bolt.
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10.5 Form Closure Inspection
10.5.1 Reference markers shall be installed on the formwork shores to detect formwork
movements during concreting
10.5.2 Wedges used for final alignment before concrete placement shall be secured
before placing concrete.
10.5.3 Formwork shall be anchored to shoring to prevent any movement of any part of the
formwork during concreting.
10.5.4 Closure of form joints, settlement of blinding slabs, shrinkage of lumber, elastic
shortening and deflections of form members shall all be countered prior to concrete
placement.
10.6 Concrete Pouring
10.6.1 Concrete pouring shall be done after pre-placement inspection and authorization to
proceed by The Engineer.
10.6.2 Temperature, slump of ready mix concrete shall be checked upon arrival at site.
10.6.3 Experienced form watchers shall be provided during concrete placement to detect
form displacement or the beginning of failure.
10.6.4 Re-tempering of concrete after initial setting is prohibited.
10.6.5 Concrete that has partially hardened or been contaminated by foreign materials
shall not be deposited in the structure.
10.6.6 Concrete shall not be dropped freely where reinforcing will cause segregation nor
where it would fall freely from a height not allowed by the specifications.
10.6.7 Concrete shall be discharged as near as possible to its final position to avoid
segregation due to re-handling or flowing.
10.6.8 Placed concrete shall be consolidated by mechanical vibration equipment

supplemented by hand spading, rodding or tamping.
10.6.9 After completing placing and finishing operations, efforts must continue to protect
concrete from high temperatures, direct sunlight, low humidity, and drying winds.
10.6.10 Concrete paving shall have control joints or construction joints located shown in
the contract drawing.
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10.6.11 Paving or slab construction joints not specified on the Contract Drawings, shall be
located at column centerlines and at intermediate intervals approved by The
Engineer.
10.6.12 Paving or slab construction joints not specified on the drawings, shall meet all
requirements for architectural concrete matching the grade and type of finish
present in the adjacent concrete.
10.6.13 Contraction or isolation joints shall be provided to divide structurally plain concrete
members into flexural discontinuous elements. (ACI 318M, Sec. 2.2.3.1).
10.7 Concrete Finishing and Curing Inspection
10.7.1 Initial floating shall be completed after concrete placement.
10.7.2 The second floating operation shall take place after initial set but before final set
has occurred (usually performed using a power trowel with float shoes or a pan
attached).
10.7.3 The use of any floating or troweling machine that has a water attachment for
wetting the concrete surface during finishing shall be prohibited.
10.7.4 Maximum total dissolved solids in water used for moist curing shall not exceed
1000 parts per million.
10.7.5 Water curing shall be continuous until the compressive strength has reached 70%
of the specified strength, but not less than 7 days after placement.
10.7.6 Continuous water cure can be provided by covering with wet burlap and plastic; the
saturated burlap shall be covered with a polyethylene sheet vapor barrier,
minimum 0.15 mm (150 microns) in thickness.
10.7.7 Where appearance is important, concrete curing by 0.15 mm polyethylene film

shall be avoided; film over damp burlap may be used (ACI 308, Sec. 2.4.2.1)
10.8 Stripping of Formworks
10.8.1 Unless otherwise specified in the project specifications, formwork and shoring shall
be left in place to support the mass of concrete in beams, slabs and in-place
structural members until the specified concrete strength f'c is attained. (ACI 301,
Sec. 2.3.2.5) Note: The preferred method of determining stripping time is by testing
test cylinders that are cured on-site or testing concrete strength in the field.
10.8.2 When finishing is required, remove forms as soon as removal operations will not
damage concrete. (ACI 301, Sec. 2.3.2.1)
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10.8.3 Repairs and treatment on minor concrete damage shall be started immediately.
(ACI 301, Sec. 2.3.2.5).
10.8.4 Forms removal (stripping) shall be based on concrete's achieving minimum

strength requirements as set forth by the design engineer as verified by sample
cylinders compressive strength results.
10.9 Cast-In-Place Concrete Final Acceptance
10.9.1 All concrete surfaces in direct contact with earth shall be coated with two coats of
coal tar or bitumen coating consisting of two coats coal tar epoxy coating system
for Immersion Service or Bituminous Paint for Moderate Temperatures in Buried or
Immersion Service. Overall dry coating thickness shall be from 325μm to 605μm.
10.9.2 All surface defects such as cracks or honey-combing shall be filled with mortar
consisting of 1 part Portland Cement of the type specified for the job and 2.5 parts
fine sand and ground in smooth with a trowel or carborundum grind stone float.
(ACI 515.1R, Sec. 3.2.1) Note: Proprietary compounds may be used in lieu of
mortar in accordance with the manufacturer's recommendations and with prior
approval of The Engineer.
10.9.3 Finns, protrusions or similar irregularities projecting from the concrete shall be
removed back to the surface by chipping, brush hammering, needle gunning or
wire brushing. (ACI 515.1R, Sec. 3.2.4)
10.9.4 Sharp offsets in the concrete caused by formwork misalignment, shall be

mechanically abraded to provide gradual and smooth transitions between offset
surfaces. (ACI 515.1R, Sec. 3.4.2)
10.9.5 After finishing and curing operations all exposed construction joints, control joints,
expansion-contraction joints or other types shall blend into and match with the
existing adjacent concrete finishes (ACI 301, Sec. 5.3.3)
11.0 QUALITY REQUIREMENTS
To ensure the quality control of reinforced concrete construction works, a third party laboratory
technician will be at site to check the following:
11.1 Temperature of ready mix concrete upon arrival at site.
11.2 Concrete workability by checking concrete slump.
11.3 Preparation and proper curing/preservation of concrete sample specimen.
11.4 Check proper mixing proportion and procedure for application of proprietary compounds
for concrete repairs and surfacing.
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11.5 Check for surface preparation and thickness of coating application.
12.0 HEALTH AND SAFETY
During the progress of works, the necessary welfare facilities shall be provided at the project site.
The workers shall be provided with safe drinking water, toilets, place to eat their food and place to
store their clothes.
Tower lights will be used during night time works and is essential for the safety of workers, the
equipment and the proper execution of work. Barriers around construction area shall be installed.
12.1 ISSUES
12.1.1 The HSE engineer has the responsibility for providing help advice to the
supervisor who is responsible for the work safety.
12.1.2 No one shall be allowed to enter the construction site without wearing the proper
PPE’s.
12.1.3 Ensure that there is sufficient scaffolding/platforms and safety harness/fall

protection when working in heights.
12.1.4 Beware of slipping when using ladders in wet conditions.
12.1.5 Provide protective barriers, shield systems complying with applicable standards.
12.2 RESPONSIBILITIES
12.2.1 Safety Engineer
12.2.1.1 Conduct the safety induction course to all personnel involved in the
work.
12.2.1.2 Monitor and supervise the risk assessment.
12.2.1.3 Ensure that necessary Permit to Work is available.
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FORMWORKS, REBARS, CAST-IN-SITU CONCRETE

(POURING, EMBEDMENTS, CURING)
12.2.1.4 Ensure that the project’s method statement and risk assessment are
understood, complied and applied in the worksite.
12.2.1.5 Ensure that all workers are provided with sufficient information regarding
workplace hazards and planned control measures.
12.2.1.6 Ensure that necessary equipment (e.g. PPE, tools) is provided prior to start
of works.
12.2.1.7 Ensure that all tools, equipment are certified and serviceable in accordance
with the standard industry practice prior to use.
12.2.1.8 Ensure that adequate level of welfare arrangements are available in the
worksite.
12.2.1.9 Daily inspection of health, safety and environmental compliance is carried
out.
12.2.2 Safety Officer
12.2.2.1 Supervision of equipment handling, transportation and disposal of

construction debris.
12.2.2.2 Ensure that relevant work permit is secured prior to start of work.
12.2.2.3 Ensure that equipment is operational and certified.
12.2.2.4 Ensure that all drivers/operators are qualified to operate the
machines/equipment.
12.2.2.5 Regular inspection and maintenance of the equipment.
12.2.2.6 Perform other duties as instructed by the safety engineer.
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APPENDICES
Appendix 1.0 Job Risk Assessment
Appendix 1.1 Carpentry Works
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Page 16 of 27

Appendix 1.2 Formworks
Page 17 of 27

Issue Date: 17.01.16 18.2.2016 DOCUMENT NUMBER: LC3.KKIA-UN-MSM-GEN-CV-0021-B
Page 18 of 27

Appendix 1.3- Steel Cutting and Bending
Page 19 of 27

Page 20 of 27

Appendix 1.4 Concrete Works
Page 21 of 27

Page 22 of 27
Appendix 2.0- Related ITP
CONSTRUCTION OF LOAD CENTER 3 (LC-3) AT KING KHALED INTERNATIONAL AIRPORT (KKIA)

INSPECTION TEST PLAN FOR CIVIL WORKS
CONTRACTOR: SAUDI SERVICES ELECTRO MECHANICAL WORKS. CO. (SSEM) (Close Joint Stock Company) ITP Ref. No.: ISSUANCE: 01
CONTRACT NO.: R-15-085-BF-0 Sec No.: REVISION: 00
TITLE: CIVIL WORKS Sec Title.: Date: October 2015
Method of
Activity Inspection / Test Requirements Reference Documentation Demonstrated Evidence
Activity Description Verification
No. Report/Checklist
Test or Inspection Performed Stage / Frequency Test Required Code/Spec/Etc. Acceptance Criteria SSEM AECOM
STRUCTURAL CEMENT CONCRETE
7
CONSTRUCTION
7.1 FORMWORK
Check dimension of formwork for conformity to Check Visual/Survey Inspection After installation of Technical Specification Approved Construction
7.1.1 SSEM CHECK RR W Checklist Form IC-C-007
the drawings formworks Civil Works Drawings
After installation of Technical Specification Approved Construction
7.1.2 Check elevation and level Check survey design date SSEM CHECK RR W Checklist Form IC-C-007
formworks Civil Works Drawings
Check stability of bracing , trying, shoring, false After installation of Technical Specification
7.1.3 Visual Inspection SSEM CHECK Project Specification RR S Checklist Form IC-C-007
work and supports formworks Civil Works
Check of cleanliness, surface smoothness and After installation of Technical Specification
7.1.4 Visual Inspection SSEM CHECK Project Specification H S Checklist Form IC-C-007
form oil coating formworks Civil Works
After installation of Technical Specification
7.1.5 Corner chamfering as per drawing requirements Visual Inspection SSEM CHECK Project Specification H S Checklist Form IC-C-007
formworks Civil Works
After installation of Technical Specification Approved Construction
7.1.6 Check stability and position of control joints Visual Inspection SSEM CHECK H S Checklist Form IC-C-007
formworks Civil Works Drawings
7.2 LAYING OF REBAR AND EMBEDDED ITEMS
Check Rebar Chemical
Factory Project
Composition, Tensile and Every 300tons/per size Technical Specification
7.2.1 Re-bar Quality Test/Third Party Specification/Approved RR RR Mill Certificate/Test report
Bending Compliance w/ (ASTM dia. Civil Works
Test Material Submittal
A 615)
Check size and spacing of re-bar and concrete Approved Construction
After assembly of Re- Technical Specification
7.2.2 cover as applicable and also ensure that air Visual inspection SSEM CHECK Drawings/Bar bending H W Checklist Form IC-C-007
bar Civil Works
blowing is made to ensure clean surface Schedule
After assembly of Re- Technical Specification
7.2.3 Check embedded item for and free from damage Visual inspection SSEM CHECK Project Specification H W Checklist Form IC-C-007
bar Civil Works
Check installation of embedded items and proper After assembly of Re- Technical Specification Approved Construction
7.2.4 Visual inspection SSEM CHECK H W Checklist Form IC-C-007
support bar Civil Works Drawings
7.3 CONCRETE PLACEMENT
Check Approved Concrete Mix Prior to actual Technical Specification
7.3.1 Concrete mix design Third Party Test Project Specification RR RR Materials Submittal Report
Design production get started Civil Works
Check Coarse/Fine Aggregate Technical Specification
7.3.2 Concrete material quality daily Third Party Test Project Specification S S Checklist Form IC-C-007
comply w/ (ASTM C 33) Civil Works
Check Concrete delivery for correct mix as per Check Approved Concrete Mix Technical Specification
7.3.3 Every Batch Ticket Third Party Test Project Specification S S Checklist Form IC-C-007
specification Design Civil Works
Witness checking of Slump Technical Specification Test Result Compliance w/
7.3.4 Concrete slump Test Every Truck Mixer Third Party Test W W Checklist Form IC-C-007
(ASTM C 143) Civil Works Project Specification
Witness checking of Yield, Air Control Mix Twice Technical Specification Test Result Compliance w/
7.3.5 Concrete Yield, Air Content Third Party Test W W Checklist Form IC-C-007
Content (ASTM C 138) Weekly Civil Works Project Specification
Six test cylinder each
day used for 28 days
Witness checking of sample test additional test THIRD PARTY Technical Specification Test Result Compliance w/
7.3.6 Concrete making specimen in the field W W Checklist Form IC-C-007
cylinder (ASTM C31 cylinder may be TEST Civil Works Project Specification
prepared for 7 days test
(per 200cu.m.)
During Concrete Technical Specification
7.3.7 Check movement and free dropping of concrete Visual Inspection SSEM CHECK Project Specification S S Checklist Form IC-C-007
Placement Civil Works
During Concrete Technical Specification
7.3.8 Check for proper vibration while placing concrete Visual Inspection SSEM CHECK Project Specification S S Checklist Form IC-C-007
Placement Civil Works
Check result compressive Six test cylinder each THIRD PARTY Technical Specification Test Result of 6 tests
7.3.9 Compressive Strength Test RR/W RR Material Test Report
strength (ASTM C39) day used for 28 days TEST Civil Works cylinder at 28 days shall be
N/A – NOT
ABBREVIATIONS: W- WITNESS PONT S– SURVEILLANCE AECOM- Consultant
APPLICABLE
SSEM-
Note: H– HOLD POINT RR – REVIEW OF REPORT
Page 23 of 27
Contractor
Page 1 of 2
Appendix 2.0- Related ITP
CONSTRUCTION OF LOAD CENTER 3 (LC-3) AT KING KHALED INTERNATIONAL AIRPORT (KKIA)

INSPECTION TEST PLAN FOR CIVIL WORKS
CONTRACTOR: SAUDI SERVICES ELECTRO MECHANICAL WORKS. CO. (SSEM) (Close Joint Stock Company) ITP Ref. No.: ISSUANCE: 01
CONTRACT NO.: R-15-085-BF-0 Sec No.: REVISION: 00
TITLE: CIVIL WORKS Sec Title.: Date: October 2015
Method of
Activity Inspection / Test Requirements Reference Documentation Demonstrated Evidence
Activity Description Verification
No. Report/Checklist
Test or Inspection Performed Stage / Frequency Test Required Code/Spec/Etc. Acceptance Criteria SSEM AECOM
test additional test at least 25.0 N/mm2
cylinder may be (Average of 6 Cylinder
prepared for 7 days test
7.4 FINISHING AND CURING
Approved Materials
Check for Curing as per specification Check Approved Materials for After placement of Technical Specification
7.4.1 SSEM CHECK compliance w/Project S S Checklist Form IC-C-007
requirements curing Concrete Civil Works
Specification
After Dismantling of Technical Specification
7.4.2 Check formed surfaces for finish Visual Inspection SSEM CHECK Project Specification S S Checklist Form IC-C-007
Concrete Forms Civil Works
Approved Materials
Repair surface defects as per approved As per Approved Material After Dismantling of Technical Specification compliance Method
7.4.3 SSEM CHECK H W Checklist Form IC-C-007
procedure supplier procedure for Repair Concrete Forms Civil Works Statement /Project
Specification
After Dismantling of Technical Specification
7.4.4 Check joints and application of filler and sealant Visual Inspection SSEM CHECK Project Specification H S Checklist Form IC-C-007
Concrete Forms Civil Works
N/A – NOT
ABBREVIATIONS: W- WITNESS PONT S– SURVEILLANCE AECOM- Consultant
APPLICABLE
SSEM-
Note: H– HOLD POINT RR – REVIEW OF REPORT
Page 24 of 27
Contractor
Page 2 of 2
Appendix 3.0- Checklist
 


CONSTRUCTION OF NEW LOAD CENTER-3 AT KING KHALED INTERNATIONAL

AIRPORT
STRUCTURAL CEMENT CONCRETE CONSTRUCTION
Project: Construction of New Load Center-3 IC Checklist No.: 085-IC-C-007

Contract No.: R-15-085-BF-O ITP Ref. No.: 085-ITP-C-8.0
Facility Name: Sec:
Drwg. No. / Line No.: Area/Location:
Work / item for Inspection:
Item Activity SSEM SSEM GACA/AECOM Corr.

Remarks
Engr. QC Representative Sign
A R N/A Off
1 Formworks dimensions and
elevation conforming to the
drawing
2 Check stability of bracing ,
trying, shoring, false work and
supports
3 Check of cleanliness, surface
smoothness and form oil
coating
4 Corner chamfering as per
drawing requirements
5 Check Compaction density of
CTB
6 Check stability and position of
control joints
7 Check Re-bar Quality
8 Check size and spacing of re-
bar and concrete cover as
applicable and also ensure that
air blowing is made to ensure
clean surface
9 Check quality and installation of
embedded materials
10 Check Concrete delivery for
correct mix as per specification
11 Visual inspection of finished
CTB
12 Concrete slump Test
13 Concrete making specimen in
the field
14 Check movement and free
Page 25 of 27
Appendix 3.0- Checklist
 


CONSTRUCTION OF NEW LOAD CENTER-3 AT KING KHALED INTERNATIONAL

AIRPORT
dropping of concrete
15Check for proper vibration of
concrete
16 Check for compressive strength
of concrete
17 Check for proper curing of
concrete
18 Repair of surface defects as
per approved procedure
19 Check joints and application of
filler and sealant
GACA/AECOM Representative Remarks: Legend: A=Acceptable; R=Rejected; N/A=Not
Applicable
SSEM QC Representative GACA / AECOM Representative

Sign: Sign:
Name: Name:
Date: Date:
Page 26 of 27
Appendix 4.0- Proforma Work Permit
SSEM-HSE/PERMIT/002/M07-11, Rev0.1, July2011

FORMWORKS, REBARS & CAST-IN-SITU CONCRETE WORK PERMIT
DATE: ______________________PERIOD: __________________TO:__________________PERMIT NO.:_______________
EQUIPMENTS: _______________________________________________________WORK AREA: ______________________
DESCRIPTION OF WORK:_________________________________________________________________________________
NAME OF THE ORIGINATOR:

COMPANY: DEPARTMENT: SIGNATURE:
PERFORMING AUTHORITY COMPLEMENTARY PERMITS YES NO N/A

DRIVING IN UNAUTHORISED AREAS
NAME: CLEARANCE FROM YERP AUTHORITY
SIGNATURE & DATE: CLEARANCE FROM ROYAL COMMISSION
CONTACT NO: CLEARANCE FROM OTHER DEPARTMENTS
RISK ASSESSMENT SAFETY PRECAUTUONS

YES NO N/A YES NO N/A
PERSONAL PROTECTIVE EQUIPMENT (P.P.E)
ELECTRICAL ISOLATION
BARRICADES AND WARNING SIGNS
METHOD STATEMENT / JSA AREA IS SUITABLE FOR CONCRETE REPAIR WORK
ENOUGH ACCESS/EGRESS ADDITIONAL ILLUMINATION
SUFFICIENT PROPER ACCESS
SCAFFOLDING/PLATFORMS ACCESS/EGRESS CLEAR FROM OBSTACLES
AREA CLEAR FROM COMBUSTIBLE FIRE EXTINGUISER / FIRE WATCHMAN
SUBSTANCES LIFE LINES/ SAFETY HARNESS
ANY OTHER WORKS ADJACENT BREATHING EQUIPMENT
EMERGENCY RESCUE TEAM AVAILABLE.
ISOLATION FROM OTHER WORKS SLOPING OR SHIELDLING PROVIDED
AREA CLEAR FROM TOXIC GASES NO MATERIAL KEPT NEAR THE EXCAVATION
EXISTING TEMPORARY OR GAS CYLINDERS KEPT OUT FROM THIS AREA
PERMANENT UTILITIES WORKERS AWARE OF HAZARDS AND PRECAUTUONS
SUITABLE EQUIPMENT AND TOOLS TO BE TAKEN
AVAILABLE
OTHER REQUIREMENTS (IF NECESSARY)
DECLARATION (to be filled by Performing Authority) And Competent Person

I, UNDERSIGNED HAVE CHECKED THE AREA AND COMPLIED TO ALL SAFETY PRECAUTIONS AND RISK ASSESSMENT AND WILL CARRY OUT ACTIVITY WITH
APPROVED METHOD STATEMENT
NAME: SIGN: NAME: SIGN:
PERMIT VALIDITY (to be filled by Site Manager/Engineer)

THE ABOVE WORK HAS BEEN APPROVED AND SHALL BE CARRIED OUT SAFELY. IT HAS TO BE ENSURED THAT THE EMPLOYEE EXECUTING THE JOB HAS A COPY
OF THE PERMIT AT ALL TIMES DURING THE WORK.
NAME: SIGNATURE: DATE:
PERMIT CLEARANCE (to be filled by HSE/Safety Representative)

I DECLARE THAT ALL WORK UNDER MY CONTROL HAS NOW BEEN COMPLETED AND THE AREA HAS BEEN CLEARED AND THAT ALL TOOLS AND OTHER
EQUIPMENT HAVE BEEN REMOVED
PERMIT CLOSED (to be filled by Performing Authority)
THE ABOVE WORK WAS COMPLETED SAFELY AND THE WORK PERMIT SHALL BE CANCELLED
NAME: SIGNATURE : DATE:
SAFETY DEPARTMENT:
Yellow- Site Blue - HSE office White - Client Office
Page 27 of 27

Submittal Transmittal: Date: 3/8/2016 Reference Number: 0483

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Submittal Transmittal

Detailed, Grouped by Each Number

LC3 (R-15-085-BF-0) Project # RUH-CP-1502

Date: 3/8/2016 Reference Number: 0483

Transmitted To: Hadi Omar Harb Transmitted By: Paul Teague

Qty Submittal Package No Description Due Date Package Action

Transmitted For Delivered Via Tracking Number

Items Qty Description Notes Item Action

Cc: Company Name Contact Name Copies Notes

1. Please see attached.

Signature Signed Date

Prolog Converge Printed on: 3/9/2016 Prolog KKIA Page 1

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

METHOD STATEMENT FOR

Project Quality Manager: Project Manager:

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

3.0 REFERENCES AND STANDARDS

3.1 Saudi Arabia Construction Specification.

3.2 Employers requirements, Materials Specification

3.3 Approved with Comments (AWC) design and construction drawings.

3.10 SASO SSA2

3.11 SASO SA 224

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

5.0 WORK PROGRAM

Construction of the building comprise of:

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

Type of Equipment Units (No.)

Table I. Equipment Intended for Concrete construction works.

7.0 PPE MATERIALS

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

9.0 RESPONSIBILITIES OF KEY PERSONNEL

9.1 Construction Manager

9.2 Site Engineer

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

9.3 Quality Control Engineer

9.4 Site Foreman

9.5 Site Surveyor

10.0 CONCRETING METHODOLOGY

10.1 Sequence of Work

10.1.1 Fabrication and installation of form works.

10.1.2 Fabrication and installation of steel reinforcements.

10.1.4 Form closure and installation of supports

10.1.5 Pouring of ready mix concrete.

10.1.6 Preparation of concrete sample specimen for testing purposes.

10.1.7 Finishing and curing of concrete.

10.1.8 Stripping of formworks.

10.1.9 Repair of minor concrete imperfection.

METHOD STATEMENT FOR FORMWORKS, REBARS,

Issue Date: 17.01.16 18.02.16 DOCUMENT NUMBER: LC3.KKIA‐UN‐MSM‐GEN‐CV‐0021‐B

10.2.1 Forms shall be substantial and sufficiently tight to prevent leakage of

10.2.2 Forms shall be properly braced or tied together to maintain position

10.2.3 Formwork shall be anchored to the shores below so that movement of

10.2.11 Erecting formwork frames should be erected in a progressive manner to ensure

METHOD STATEMENT FOR FORMWORKS, REBARS,