The Velosi Group

Inspection Report
www.applusvelosi.com

Client: Haifa Industrial Services Co. LLC Vendor: -----

Project: ----- Sub-Vendor: ----
PO No.: 18000026 Location: Rusayl, Muscat
Client Reference: 18/008/HI/YS/GEN Assign No.: ---- Report No: 04
Client Contact: Mr.Ibrahim SO No.: ------ Date of Visit : 11.01.2018
Work Order No.: TPL-2018-002 Vendor Ref.: ------ Next Visit Date: TBA
MATERIAL INSPECTED THIS VISIT
Item Quantity Description Tag No., Batch No.,
Code Serial No., Cast,
Heat No.
Witnessed Burst Test for Cylinders
1 A 89977
(Batch No. LPG/26.5 L/380 - SR.No: A 89756 — A 90258
Witnessed Burst Test for Cylinders
1 A 90470
(Batch No. LPG/26.5 L/381 - SR.No: A 90259 — A 90761
Witnessed Burst Test for Cylinders
1 A 90980
(Batch No. LPG/26.5 L/382 - SR.No: A 90762 — A 91264
Witnessed Burst Test for Cylinders
1 A 91483
(Batch No. LPG/26.5 L/383 - SR.No: A 91265 — A 91767
Witnessed Burst Test for Cylinders
-- 1 A 91974
(Batch No. LPG/26.5 L/384 - SR.No: A 81768 — A 92270
Witnessed Burst Test for Cylinders
1 A 92483
(Batch No. LPG/26.5 L/385 - SR.No: A 92271 — A 92773
Witnessed Burst Test for Cylinders
1 83565
(Batch No. LPG/26.5 L/238 - SR.No: 83344 — 83846
Witnessed Burst Test for Cylinders
1 84070
(Batch No. LPG/26.5 L/239 - SR.No: 83847 — 84349
Witnessed Burst Test for Cylinders
1 84565
(Batch No. LPG/26.5 L/240 - SR.No: 84350 — 84852
RESULTS OF Accepted Not ORDER STATUS: Complete Incomplete
INSPECTION: Compliant
1.0 SUMMARY:
Inspection visit was made at Haifa Industrial Services Co LLC. Workshop ,Rusayl to witness Burst Test &
Mechanical tests as per the client’s request.

Please refer Page 02 & 03 for more details about inspection.

Balance Full PO
ATTACHMENTS: NCR Punchlist Partial Release
Release Release
RECORD OF HOURS
Vendor / Report Hours: 1 Visit Travelling Hours: Distance Travelled:
Inspecting Engineer: Rahul M Reviewed by: Girish Kumar HM Agreed Expenses: Yes No

Date: 11.01.2018 Date: 11.01.2018 Page 1 of 3

L5-FMT-046 Rev. 03
 THE VELOSI GROUP
Inspection Report
Continued
Client: Haifa Industrial Services Co LLC PO No.: 18000026 Page 2 of 3

1.Report Headings: 2.Persons Present 3.Documentation Used /Approval Status 4.Inspection Carried Out 5.HSE Feedback
on the Vendor 6.Results/Conclusions 7.Overall Order Status 8.Next Visit/Exit Call 9.Attachments/Photos

2.0 PERSONS PRESENT:

 Mr.Yogindhar - Haifa Industrial Services Co. LLC.
 Mr. Rahul Moottolikandy - TPI, Velosi Oman LLC

3.0 DOCUMENTATION USED / APPROVAL STATUS:

 BS EN 1442 : 2006
 ISO 22991:2008

4.0 INSPECTION CARRIED OUT (reference ITP clause if applicable):

 Witnessed Burst Test for the below mentioned cylinders with Achieved Result :-

Burst Standard
Cylinder
Pressure
Capacity Serial No.
Achieved
(Liter)
(Bar)
26.5 A 89977 102.62 BS EN 1442 : 2006
26.5 A 90470 102.12 BS EN 1442 : 2006
26.5 A 90980 101.62 BS EN 1442 : 2006
26.5 A 91483 102.62 BS EN 1442 : 2006
26.5 A 91974 103.62 BS EN 1442 : 2006
26.5 A 92483 103.62 BS EN 1442 : 2006
26.5 83565 100.12 ISO 22991:2008
26.5 84070 103.62 ISO 22991:2008
26.5 84565 102.12 ISO 22991:2008

 Mechanical Tests & Burst test pressure value for above all meets the standard requirements -
Found accepted.
 Verified & Reviewed calibration certificate of pressure gauge – Found valid.

 CALIBRATION OF INSTRUMENTATION USED:

Type of Equipment Manufacturer Serial N° Date Last Current Calibration

Calibrated Calibration Expiry Certificate N°
Date
Pressure Gauge CALTROLS 150856383 23/04/2017 22/04/2018 --

5.0 HSE FEEDBACK ON VENDOR: General HSE is followed by the client.

6.0 RESULTS / CONCLUSIONS: Satisfactory .

7.0 OVERALL ORDER STATUS: Ongoing

DELIVERY:

PO Delivery Current Scheduled Delivery Delivery Point Comments

L5-FMT-046 Rev. 03
 THE VELOSI GROUP
Inspection Report
Continued
Client: Haifa Industrial Services Co LLC PO No.: 18000026 Page 3 of 3

1.Report Headings: 2.Persons Present 3.Documentation Used /Approval Status 4.Inspection Carried Out 5.HSE Feedback
on the Vendor 6.Results/Conclusions 7.Overall Order Status 8.Next Visit/Exit Call 9.Attachments/Photos

Date
N.A N.A N.A N.A

8.0 NEXT VISIT / EXIT CALL (must give estimated date if no fixed date; include stage/activity details): TBA

9.0 ATTACHMENTS: PO 18000026

- End of Report -

L5-FMT-046 Rev. 03