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SAUDI ARAMCO ID/PID - 05/18/05 - REV 0 (Standards Cutoff - June 2008) REV 03 30-Jun-08

SAUDI ARAMCO INSPECTION CHECKLIST SAIC NUMBER DATE APPROVED QR NUMBER

SAIC-B-4001 15-Dec-09 PLUMB

PROJECT TITLE WBS / BI / JO NUMBER CONTRACTOR / SUBCONTRACTOR

EQUIPMENT ID NUMBER(S) EQUIPMENT DESCRIPTION EQPT CODE SYSTEM ID. PLANT NO.

LAYOUT DRAWING NUMBER REV. NO. PURCHASE ORDER NUMBER EC / PMCC / MCC NO.

SCHEDULED INSPECTION DATE & TIME ACTUAL INSPECTION DATE & TIME QUANTITY INSP. MH's SPENT TRAVEL TIMESAUDI ARAMCO USE ONLY

SAUDI ARAMCO TIP NUMBER SAUDI ARAMCO ACTIVITY NUMBER WORK PERMIT REQUIRED?

SAUDI ARAMCO INSPECTION LEVEL CONTRACTOR INSPECTION LEVEL

ACCEPTANCE CRITERIA REFERENCE PASS FAIL N/A RE-INSP DATE

A Handling, Storage and Preservation

A1

B Receiving (Units and their accessories)

B1 Schedule"Q"

B2

B3

B4

B5

B6

B7

B8

B9

B10

Emergency Eyewash/Shower Receiving, Handling, Storage and Preservation

ITEM No.

Verify that approved procedures for handling, storage and preservation of emergency eyewash / shower lists all the required inspection schedules for maintaining the quality of the material and /or equipment.

Schedule"Q"Att IV Section

5

Visually inspect all material/equipment for defects / damage

An emergency Shower is equipped with an eyewash. However eyewash does not always have to include a shower (SAES-B-069, Section 6.2)

SAES-B-069 Para 4.1.3

Ensure and Verify that the equipment and materials meet SAES-S-069 and tested in accordance with ANZI Z358.1, Eyewash and Shower Equipment.

SAES-B-069 Para 4.1.4

Eyewash and showers shall be constructed of a material resistant to corrosion in their installed environment

SAES-B-069Para 4.3.1

Verify that the water supply piping shall be consistent with materials provided for the source water system as specified in SAES-L-132

SAES-B-069 Para 4.3.2

Verify that the combination eyewash/shower unit is capable of flowing through both units simultaneously with the flow rate, pressure and temperature requirements specified.

SAES-B-069 Para 5.2.2

Verify that the eyewash nozzles are protected with covers, that can be easily removed, to prevent nozzle contamination and clogging.

SAES-B-069 Para 5.2.5

Verify that the Eyewash / Shower is provided with pressure controllers or self-regulating orifices to ensure that excessive water velocity if the water supply pressure exceeds 207 kPa (30 psig) design flowing pressure in ANSI Z358.1 will not injure the eyes, unless the system is designed such that this pressure could not be exceeded. This needs to be verified with the designers through SAPMT.

SAES-B-069 Para 5.4

Verify that the water supply piping for the Eyewash / Shower is equipped or provided with a cross connection or backflow prevention device in reference to SAES-L-310; SAES-S-040; SAES-S-060 and SAES-S-070 requirements.

SAES-B-069 Para 5.5

Verify whether the Eyewash / Shower is required to be equipped or provided with an Alarm, if yes ensure that flowswitches or other microswitches are provided with the operating valves to transmit signal to display boards in the attended location to identify the location of the emergency.

SAES-B-069 Para 6.5

Page 2 of 2

SAUDI ARAMCO ID/PID - 05/18/05 - REV 0 (Standards Cutoff - June 2008) REV 03 30-Jun-08

SAUDI ARAMCO INSPECTION CHECKLIST SAIC NUMBER DATE APPROVED QR NUMBER

SAIC-B-4001 15-Dec-09 PLUMB

PROJECT TITLE WBS / BI / JO NUMBER CONTRACTOR / SUBCONTRACTOR

Emergency Eyewash/Shower Receiving, Handling, Storage and Preservation

B11

REFERENCE DOCUMENTS:

1-SAES-B-069 -- Emergency Eyewash and Showers, 05 September 2006

2-Schedule "Q" -- Saudi Aramco quality Requirements

3-ANSI Z-358.1 -- American National Standard for Emergency Eyewash and Shower Equipment, 1990

Contractor / Third-Party Saudi Aramco

Name, Initials and Date:Work is Complete and Ready for Inspection:

Name, Initials and Date:T&I Witnessed QC Record Reviewed Work Verified

QC Inspector PID Representative

Name, Initials and Date:Performed Inspection Work / Rework May Proceed

Name, Initials and Date:T&I Witnessed QC Record Reviewed Work Verified

QC Supervisor Proponent and Others

Name, Sign and Date: Quality Record Approved: T&I Witnessed QC Record Reviewed Work Verified

*Person Responsible for Completion of Quality Work / Test Y = YES N = NO F = FAILED

Manufacturer's instruction shall be provided for assembling combination units (eyewash and shower), if shipped with the components separate. (ANSI Z-358.1 Para 9.4.3)

SAES-B-069Section 7

*Acceptable evidence shall be a label or tag on the equipment marked ANSI Z358.1, or a certified test report from a recognized independent testing laboratory indicating that the equipment has been tested and conforms to ANSI Z358.1.

REMARKS:

Construction Representative* PMT Representative

Name, Organization,Initials and Date: