Request of Inspection Notice (RIN)

TO BE FILLED - IN BY CONTRACTOR Date of Request: 14 Oct. 2012 Contractor Request No. : KOTC-PP(UG)-0188 Check the box if this is a request for re-inspection Site Name & Location : MECC Work Shop Inspection Category & Application (Check Appropriate Box) : Civil/Architectural Electrical/Instrument Safety Mechanical Piping Others (Specify) 1. Item for Inspection: Weld visual Inspection of (CWS) CHILLED WATER SUPPLY Scope: KOTC-PP(UG)-CWS-0020 Daily Joint Inspection Report 2. Inspection Date : 15 Oct. 2012 3. Inspection Time: 7:00 Am Work is ready for inspection and complies with the Scope of Work and Technical Specifications. Name: Date: Signature: ___________________

TO BE FILLED-IN BY CONSULTANT Received by consultant to conduct inspection of the work covered by this Inspection Notice. Name: Date: Signature: ___________________

INSPECTION RESULTS AND COMMENTS : 1. Inspection Date and Time : 2. Results and Comments : See Below

Approved Approved as noted Resubmit

Sub-contractor PREPARED BY: Name : Date : Signature :

Contractor CHECKED BY: Name : Date : Signature:

Consultant WITNESSED BY: Name : Date : Signature: