Method Statement Review Form

Project Name: Internal Roads & Infrastructure in Al Samha East

Client: Musanada Consultant:

Contractor: Al Geemi & Partners Cont. Co.
Date:
LLC
Transmittal No.: Revision No.:

Review Method Statement:

Sl. No. Description Yes No N/A

☒ ☐ ☐
1 Scope of work covered?
References (relevant Specifications & Shop Drawings). ☐ ☒ ☐
2
Clarified?
☐ ☐ ☐
3 Subcontractor utilized (If applicable)?
☒ ☐ ☐
4 Products required (materials). Clarified?
☒ ☐ ☐
5 Tools and equipment required. Clarified?
☒ ☐ ☐
6 Prior activities to be completed. Clarified?
Personnel required and designated responsibilities. ☒ ☐ ☐
7
Clarified?
☒ ☐ ☐
8 Safety hazards and precautions to be taken. Clarified
☐ ☐ ☐
9 Quality control measures. Clarified?
☒ ☐ ☐
10 Procedure, step by step sequence of work. Clarified?

11 Temporary Works;
☐ ☐ ☒
11.1 Pedestrian and vehicular traffic control and diversions
☐ ☐ ☒
11.2 Protection of adjacent existing structures
☒ ☐ ☐
11.3 Dewatering systems and discharge routes
Dealing with existing services : Special requirements ☐ ☐ ☒
11.4 of other services for example, oil and gas lines, fibre
optic cables and existing sewers should be checked.
☐ ☐ ☒
11.5 Concreting Sequence
☐ ☐ ☐
11.6 Pipe line test sections and methods
☐ ☐ ☐
11.7 Formwork
☐ ☐ ☒
11.8 Trench less construction arrangement
☒ ☐ ☐
11.9 Phasing works
 Method Statement Review Form

ACTION CODE RECOMMENDATION

☐ A - Approved ☐B – Approved as Noted ☐C – Revise and re-submit
☐ D– Returned ☐E - Rejected
Incomplete
COMMENT/S:

No attached drawings

REVIEWED AND CHECKED BY:

Signature and date:

Project Manager: Name

Signature and date:

Note: The above comments and/or approvals shall not relieve the Contractor from his obligation in the contract to
ensure conformance to the Specifications. Any specification deviations found subsequent to approval are to be
corrected by the Contract to the satisfaction of the OWNER/ENGINEER.
This Method of Statement is issued for the above work and locations ONLY and ONLY on the condition that all required
documentation (e.g. risk assessment) and permits have been completed and the requirements thereof communicated
to all involved persons