Inspection and Test Plan (Itp) : ITP Number: Project Name: Department / Vendor / Contractor: Project Location

INSPECTION AND TEST PLAN (ITP)
DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

ITP number: ITP
Project Name:
Department / Vendor / Contractor:
Project Location:
RESPONSIBLE PARTY RECORD REF

ITEM TASK ACTIVITY TOC (Work proc
NO. A B C D Quality Rec
1
1.1
1.1.1
1.1.1.1
1.1.1.2
1.1.1.3
1.1.1.4
1.1.1.5
1.1.1.6
1.1.1.7
1.1.1.8
1.1.1.9
1.1.1.10
1.1.1.11
1.1.1.12
1.1.1.12
1.1.2
1.1.2.1 D/R H S H S
1.1.2.1 D/R H S H S
1.1.3
1.1.3.1
1.2
1.2.1
1.2.1.1 R/I H S H S
1.2.2 I H S S S
2

ITP number: ITP
Project Name:
Project Location:

2.1 I H W S S
2.2
2.2.1
2.2.1 I H S H S
2.3
2.3.1 R/I H W S w
2.3.2 R/I H W S w
2.3.3 R/I H S S w
2.3.4
2.3.4.1 R/I H S H S
2.3.5 I H S S S
2.3.6 I H S S S

ITP number: ITP
Project Name:
Project Location:

2.3.7
2.3.7.1 R/I H S H S
2.3.7.2 R/I H S W S
2.3.8 I H S S S
2.4
2.4.1 R/I H W S S
2.4.2 R/I H W S S
2.4.3
2.4.3.1 R/I H S H S
2.4.3.2 R/I H S H S
2.4.4
2.4.4.1 I H S S S
2.4.4.2 R/I H S H S
2.4.4.3 R/I H S H S
2.4.5
2.4.5.1 R/I H S H S
2.4.5.2 I H S S S
2.4.5.3 R/I H S H S
2.4.5.4 I H S S S
2.4.5.5 R/I H S H S
2.4.5.6 I H S S S
2.4.5.7 R/I H S H S
2.4.6

ITP number: ITP
Project Name:
Project Location:

2.4.6.1 I H S H S
2.4.6.2 I H S S S
2.4.6.3 I H S W S
2.4.6.4 I H S H S
2.4.7
2.4.7.1 I H S H S
2.4.7.2 I H S S S
2.4.7.3 I H S W S
2.4.7.4 I H S H S
2.4.8
2.4.8.1 I H S H S
2.4.8.2 I H S W S
2.4.9
2.4.9.1 I H S H S
2.4.9.2 I H S W S
2.4.9.3 I H S H S
2.4.10 I H S W S
2.4.10.1 I H S H S
2.4.10.2 I H S S S
2.4.10.3 I H S W S
2.4.10.4 I H S H S
2.4.11 I H S S S
2.5
2.5.1
2.5.1.1 I H S H S

ITP number: ITP
Project Name:
Project Location:

2.5.1.2 I H S S S
2.6
2.6.1 R/I H S H W
2.6.1.1 R/I H S H W
2.6.1.2 R/I H S H W
2.6.2 I H S S S
2.6.3 R H S H H
2.6.3.1 R H S H H
2.6.3.2 R H S H H
Note:
Add more rows to complete the site activity inspection per task activity
Definition of inspection and test plan legends

Hold point: The organization shall be notified of the timing of inspection or test in advance. Inspection or test shall not be carried out the organization's representative in attend
Witness point: The organization shall be notified of the timing of inspection or test in advance. However, the inspection or test shall be performed as scheduled even if the the orga

ITP number: ITP
Project Name:
Project Location:

Surveillance: The organization to monitor work in progress without notice from contractor / implementor
Document review: Documents are to be submitted to the appropriate inspectorate for review. Note that a document is subject to approval and work shall not proceed until it has been
Record: Documents required for record purpose shall be filed and retained for project quality records
Inspection: A point where all evaluation/verification is made before commencing subsequent activity unless rejected. RFI to inform is required. Visual inspection will be accordin
Test: A point where all evaluation/verification is made through lab testing or equipment testing and shall commence subsequent activity unless rejected. RFI may be requ
ITP RAISED BY:

Discipline Name Signature
Contact No(s):
Note:
Only the shaded blank space will be filled by the issuer of the ITP prior in submitting the document
YPE SEQUENTIAL NO REVISION
TP
RECORD REFERENCES
(Work procedures, ACCEPTANCE CRITERIA
Quality Records, etc)
TP
RECORD REFERENCES
TP
RECORD REFERENCES
TP
RECORD REFERENCES
TP
RECORD REFERENCES
esentative in attendance.
even if the the organization's representative is not present

TP
RECORD REFERENCES
ed until it has been approved by the top management.
tion will be according to its responsibility points
ed. RFI may be required as per agreement
Date
DEPARTMENT PROJECT NUMBER DISCIPLINE

ITP number:
Project Name:
Project Location:
ASSESSMENT / RESULT:
o Notice of No-Objection subject to comments that must

o Notice of No-Objection(s) be addressed prior to implement
Comments (if any):

RELEASE SIGNATURES:
Construction Leader
Technical
Safety
Quality
PHILIPPINE ASSOCIATED SMELTING AND PRE-PRI-FM-050
REFINING CORP Rev.0, 26 Aug. 2017
ISABEL, LEYTE
TYPE SEQUENTIAL NO REVISION

ITP
T:
omments that must o Notice of Objection, please re-submit ITP

ement
S:
Signature Date
PHILIPPINE ASSOCIA
INSPECTION AND TEST PLAN (ITP) REFININ
ISABEL

ITP number: PMG ITP
Project Name:
Project Location:
RESPONSIBLE PARTY RECORD REFER

ITEM TASK ACTIVITY TOC (Work proced
NO. A B C D Quality Record
"TITLE OF TASK ACTIVITY"
MATERIAL ACTIVITY INSPECTION

1.1 Material delivery, handling and storage D/I
1.2 Material sampling and testing (if necessary) T/R
SITE ACTIVITY INSPECTION

2.1 Task Launch/Tool Box Meeting D/R
2.2 "Activity 2.2"
2.3 "Activity 2.3"
Note:

Hold point: QAQC organization shall be notified of the timing of inspection or test in advance. Inspection or test shall not be carried out the QAQC representative in attendance.
Witness point: QAQC organization shall be notified of the timing of inspection or test in advance. However, the inspection or test shall be performed as scheduled if the QAQC represen
Surveillance: QAQC organization to monitor work in progress without notice from contractor / implementor
Document review: Documents are to be submitted to the appropriate inspectorate for review. Note that a document is subject to approval and work shall not proceed until it has been app
Inspection: A point where all evaluation/verification is made before commencing subsequent activity unless rejected. RFI to inform is required. Visual inspection will be according to
Test: A point where all evaluation/verification is made through lab testing or equipment testing and shall commence subsequent activity unless rejected
ITP RAISED BY:

Contact No(s):
Note:
PHILIPPINE ASSOCIA
ISABEL

ITP number: PMG ITP
Project Name:
Project Location:

o Notice of No-Objection(s) o Notice o
be addressed prior to implement
Comments (if any):
RELEASE SIGNATURES:
Project in-charge
Safety in-charge
QAQC Manager
Projects Team Manager
ASSOCIATED SMELTING AND PRE-PRI-FM-050
ISABEL, LEYTE
SEQUENTIAL NO REVISION
RD REFERENCES
k procedures, ACCEPTANCE CRITERIA
y Records, etc)
ndance.
QC representative is not present
as been approved by the QAQC organization.
according to its responsibility points
Date
ASSOCIATED SMELTING AND PRE-PRI-FM-050
ISABEL, LEYTE
Notice of Objection, please re-submit ITP
Date
PHILIPPINE ASSOCIA
ISABEL

ITP number: PMG 190041 A ITP
Project Name: Construction of new building facility
Department / Vendor / Contractor: PASAR - Projects
Project Location: Bunker area
RESPONSIBLE PARTY RECORD REFER

ITEM TASK ACTIVITY TOC (Work proced
NO. A B C D Quality Record
WALL PLASTERING
PMG-A-MSDS-
1.1 Material delivery, handling and storage D/I H W W S PMG-A-MST-0
1.2 Material sampling and testing (if necessary) T/R W - H S PMG-A-TES-0
SITE ACTIVITY INSPECTION

EHSI-SAF-PR
2.1 Task Launch/Tool Box Meeting D/R H H S - PASAR-FM-00-P
EHSI-SAFT-PR
2.2 Scaffolding / platform (if more than 2m high) I H H S H PASAR-FM-02-HRASAF
PMG-G-MSDS-
PMG-A-MST-0
2.3 Accessories fixing and rush coat application prior to plastering I/R H S H S PMG-A-RFI-00
PMG-A-INS-0
2.4 Plastering application I H S W S PMG-A-MST-0

2.5 Curing I H - W S PMG-A-MST-0
PMG-A-MST-0
2.6 Final Inspection after the completion of plaster I/R H - H S PMG-A-RFI-00
PMG-A-INS-0
Note:

Hold point: The organization shall be notified of the timing of inspection or test in advance. Inspection or test shall not be carried out the organization's representative in attendanc
Witness point: The organization shall be notified of the timing of inspection or test in advance. However, the inspection or test shall be performed as scheduled even if the the organiza
Surveillance: The organization to monitor work in progress without notice from contractor / implementor
Document review: Documents are to be submitted to the appropriate inspectorate for review. Note that a document is subject to approval and work shall not proceed until it has been app
PHILIPPINE ASSOCIA
ISABEL

Inspection: A point where all evaluation/verification is made before commencing subsequent activity unless rejected. RFI to inform is required. Visual inspection will be according to
Test: A point where all evaluation/verification is made through lab testing or equipment testing and shall commence subsequent activity unless rejected. RFI may be required
ITP RAISED BY:

Project Engineer Juan Dela Cruz
Contact No(s): 0957-012-3456
Note:
PHILIPPINE ASSOCIA
ISABEL


o Notice of No-Objection(s) o Notice o
be addressed prior to implement
Comments (if any):
RELEASE SIGNATURES:
Project in-charge
Safety in-charge
QAQC Manager
Projects Team Manager
ASSOCIATED SMELTING AND
REFINING CORP
ISABEL, LEYTE
0003 0
RD REFERENCES
k procedures, ACCEPTANCE CRITERIA
y Records, etc)
approved MSDS
A-MSDS-0001-0 approved MST
-A-MST-0001-0 approved SPECS
-A-TES-0001-0 approved SPECS
I-SAF-PR-013 Tool Box Meeting

FM-00-PLW-001
-SAFT-PR-015 approved MSDS

02-HRASAF-006-Rev. 3
G-MSDS-0001-0 PASAR SAFETY
-A-MST-0001-0
-A-RFI-0001-0 approved MST
-A-INS-0001-0
-A-MST-0001-0 approved MST

-A-MST-0001-0 approved MST
-A-MST-0001-0
-A-RFI-0001-0 approved MST
-A-INS-0002-0
n attendance.
the organization's representative is not present
as been approved by the top management.

REFINING CORP
ISABEL, LEYTE
0003 0
according to its responsibility points
be required as per agreement
Date
9/9/2019
REFINING CORP
ISABEL, LEYTE
0003 0
Notice of Objection, please re-submit ITP
Date
PHILIPPINE ASSOCIATED SMELTING AND
INSPECTION AND TEST PLAN (ITP) REFINING CORP
ISABEL, LEYTE
RESPONSIBLE PARTY RECORD REFERENCES

ITEM TASK ACTIVITY TOC (Work procedures, ACCEPTANCE CRITERIA
NO. A B C D Quality Records, etc)
PMG-A-MSDS-0001-0 approved MSDS

1 Material delivery, handling and storage D/I H W W S approved MST
PMG-A-MST-0001-0 approved SPECS
2 Material sampling and testing T/R W - H S PMG-A-TES-0001-0 approved SPECS
SITE INSPECTION
1 Task Launch Meeting D/R H H S - EHSI-SAF-PR-013 Tool Box Meeting

PASAR-FM-00-PLW-001
2 Dissemination of risks to all workforce R H H S - EHSI-SAF-PR-013 Tool Box Meeting

PASAR-FM-00-PLW-001
EHSI-SAFT-PR-015 approved MSDS

3 Scaffolding / platform (if more than 2m high) I H H S H PASAR-FM-02-HRASAF-006-Rev. 3 PASAR SAFETY
PMG-G-MSDS-0001-0
PMG-A-MST-0001-0
4 Accessories fixing and rush coat application prior to plastering I/R H S H S PMG-A-RFI-0001-0 approved MST
PMG-A-INS-0001-0
5 Plastering application I H S W S PMG-A-MST-0001-0 approved MST
6 Curing I H - W S PMG-A-MST-0001-0 approved MST
PMG-A-MST-0001-0
7 Final Inspection after the completion of plaster I/R H - H S PMG-A-RFI-0001-0 approved MST
PMG-A-INS-0002-0

Hold point: QAQC organization shall be notified of the timing of inspection or test in advance. Inspection or test shall not be carried out the QAQC representative in attendance.
Witness point: QAQC organization shall be notified of the timing of inspection or test in advance. However, the inspection or test shall be performed as scheduled if the QAQC representative is not present
Surveillance: QAQC organization to monitor work in progress without notice from contractor / implementor
Document review: Documents are to be submitted to the appropriate inspectorate for review. Note that a document is subject to approval and work shall not proceed until it has been approved by the QAQC organization.
Inspection: A point where all evaluation/verification is made before commencing subsequent activity unless rejected. RFI to inform is required. Visual inspection will be according to its responsibility points
Test: A point where all evaluation/verification is made through lab testing or equipment testing and shall commence subsequent activity unless rejected
Name: Company: Position: Signature: Date:

Prepared by:
Reviewed by:
Endorsed by:
Approved by:

Inspection and Test Plan (Itp) : ITP Number: Project Name: Department / Vendor / Contractor: Project Location

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INSPECTION AND TEST PLAN (ITP)

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

Definition of inspection and test plan legends

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REF

ITP RAISED BY:

even if the the organization's representative is not present

ed until it has been approved by the top management.

tion will be according to its responsibility points

ed. RFI may be required as per agreement

DEPARTMENT PROJECT NUMBER DISCIPLINE

o Notice of No-Objection subject to comments that must

Comments (if any):

TYPE SEQUENTIAL NO REVISION

omments that must o Notice of Objection, please re-submit ITP

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REFER

MATERIAL ACTIVITY INSPECTION

SITE ACTIVITY INSPECTION

Definition of inspection and test plan legends

ITP RAISED BY:

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

o Notice of No-Objection subject to comments that must

Comments (if any):

QC representative is not present

as been approved by the QAQC organization.

according to its responsibility points

Notice of Objection, please re-submit ITP

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

RESPONSIBLE PARTY RECORD REFER

MATERIAL ACTIVITY INSPECTION

1.2 Material sampling and testing (if necessary) T/R W - H S PMG-A-TES-0

SITE ACTIVITY INSPECTION

2.4 Plastering application I H S W S PMG-A-MST-0

Definition of inspection and test plan legends

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

ITP RAISED BY:

DEPARTMENT PROJECT NUMBER DISCIPLINE TYPE

o Notice of No-Objection subject to comments that must

Comments (if any):

-A-TES-0001-0 approved SPECS

I-SAF-PR-013 Tool Box Meeting

-SAFT-PR-015 approved MSDS

-A-MST-0001-0 approved MST

the organization's representative is not present

as been approved by the top management.

according to its responsibility points

be required as per agreement

Notice of Objection, please re-submit ITP

RESPONSIBLE PARTY RECORD REFERENCES

PMG-A-MSDS-0001-0 approved MSDS

1 Task Launch Meeting D/R H H S - EHSI-SAF-PR-013 Tool Box Meeting

2 Dissemination of risks to all workforce R H H S - EHSI-SAF-PR-013 Tool Box Meeting

EHSI-SAFT-PR-015 approved MSDS