The Client The Contractor

E0001 – PACKAGE 2S
Railway Integration and System

Inspection and Testing Request

ITR Revision
Inspection Request No.: E0001-S02-GQC-IR-20189 00
Number:
Inspection Date: 10 February 2022 Inspection Time: 10.30a.m
Reference no. Rev Status
Inspection Request Information and Receipt by the Engineer

Method Statement E0001-S02-GCX-PM-00020 00 Code 1

ITP E0001-S02-GQA-PN-00019 01
Documents
References

Code 1
Drawing E0001-FJP-GCX-DS-90010 AA Code 2
Material Approval E0001-S02-GCX-MT-90052 AB Code 1
Others E0001-S02-GQC-IR-20131 00 Code 1
Contact Person: Engg.Imran Mobile No: 0564471473
Details of Inspection
Test/Inspection Stage Installation Testing and Commissioning (T&C)
Power Supply and
Civil Earthing and Bonding
Distribution System
Discipline/ Subsystem: MEP Signalling ICSS
APS Telecommunication Other (Specify)
Package 2B Line Section 2B DMB - Desert Mainline -ZMC to Abu Dhabi/Dubai Border

Site Name ISS TARIFF 3+700 Chainage TARIFF(CH:3+700)

Inspection Point Hold Point Witness Point ITP Item Number 3.5
Item to be inspected: Backfilling up to Cable Covering Tiles for Buried MV Cables connection to ISS,Quantity:31m
Detailed description as per ITP

Inspection Requested By
Name Date / Time Designation Signature
Project (IR Raised By STS/
Engg.Imran 09-02 -2022
Engineer Subcontractor)

Inspection Requested Approved By (STS)

Section Name Date / Time Designation Signature
QC Department ARNOLD 09-02-2022 QA/QC Engineer
ITR Approval by STS

Survey Department
(If Applicable)
Rail Systems Interface
(if required)
STS Comments:
Comment reviewed & closed
(signature and date)

The Work Activity described here has been checked by the Contractor in accordance with Exhibit D, Part 1, Appendix 13.0, Section 6.0, where the contractor shall
plan, perform and record all QUALITY CONTROL activities to ensure that all work is performed in accordance with the QMS documentation reviewed by the
Engineer and in compliance with the requirements of the Contract.
This is to certify that the above referenced work/activity has been inspected and/or witnessed by the Engineer.
Inspection Conducted By (The Engineer’s Representative)
Name:
Approved
Designation:
Approved With Comments
ITR Approval by The Engineer

Date / Time:
Rejected
Signature:

Comments:
Declined
Reason to Decline:
The minimum quota of inspection/witness points required to be
attend by the Engineer has been exceeded, the ITR will be declined by
the Engineer

Others (specify): Comment reviewed & closed

(signature and date)

Template No: E0001-S02-GQC-WX-00002 Rev. 01 Date Issued: 02Jun-21

 EARTHWORKS CHECKLIST Template no. E0001-S02-GQC-WX-00003 Rev 01
Location : TARIFF(3+700)

Element:Buried MV cables Date of Inspection : 10-02-2022

Inspection result Reinspection

SN. Inspection phase description
Yes No N/A date, if applicable
PREREQUISITES
✓
1 Approved drawing available.
Method Statement, ITP are Approved/Approved with ✓
2
comments
✓
3 Approved Permits/NOC from relevant authority available.

Approved Prequalification document of Subcontractor ✓

4
available.
✓
5 Approved Survey Reports

✓
6 Approved Material Approval Request

Tool-Box Talk / Briefing on MS/RA/ITP to have been carried ✓

7
out
✓
8 Tools and Equipment are calibrated

PREWORKS
✓
9 Trial Trench is done and no existing utilities found

Temporary slope stability, access ways and barricades to ✓

10
excavation area is found ok
ACTIVITIES
Excavation Works
The demarked area for excavation is cleared from any form ✓
of surface obstructions for excavation such as buildings,
11
trees, bushes and any other form of vegetation manually or
using machineries.
✓
12 Excavation level is done as per drawing

The required finished ground levels has been clearly mark at ✓

13 the location
Stacking of suitable materials for processing and unsuitable ✓
14 materials are separate.
Backfilling Works
Prior to backfilling, the area to be backfilled had been ✓
15 cleared of all foreign materials including unused building
materials.
The required areas had been backfilled with the approved ✓
16
materials.
UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQC-WX-00003-AA Page 1 of 2
 Required filling had been prepared, compacted and tested ✓
17 prior of back filling with suitable material.

Grading and levelling had been carried out as per approved ✓

18 method statement.

Smooth surface transition between adjacent existing grade ✓

19 and new grades had been provided.

The final level of all grading and levelling is free from mud ✓
20 and water, trimmed clean, thoroughly compacted and
consolidated.
Fill had been compacted by a suitable plate type vibrator, ✓
21 Pedestrian operated vibrator roller, small tandem roller or
other approved compaction equipment.
The compacted layer had been inspected, checked and ✓
22 tested as required by an In-Situ Dry Density Test, prior to
placing of any further layers of the fill material.
Remarks:

Subcontractor STS Construction STS QC The Engineer (optional)

Name Engg.Imran

Signature
Date 10-02-2022

UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQC-WX-00003-AA Page 2 of 2
 BURIED MV CABLE CHECKLIST
Location: TARIFF(CH:3+700) ITR No. E0001-S02-GQC-IR-20189

Element: Buried MV Cables Date of Inspection:10-02-2022

Inspection result
SN. Inspection phase description Remarks
Yes No N/A
PRE-REQUISITES
Approved drawing available. ✓
1
Method Statement, ITP are Approved/Approved with ✓
2
comments
Approved Prequalification document of Subcontractor ✓
3
available.
Approved Survey Reports ✓
4
Approved Material Approval Request ✓
5
Tool-Box Talk / Briefing on MS/RA/ITP to have been carried ✓
6
out
✓
7 Trial Pit Excavation is done to check existing utilities

Cable Trench Excavation and Sand Bedding

✓
8 Location, depth, width is as per Approved Drawing

No more than two adjacent sections of excavated trench ✓

9
are open at any time
Bottom of excavation / trench is trimmed off and free from ✓
10 sharp objects i.e. stones, boulders, foreign materials prior
sand bedding
✓
11 Depth of sand bedding is as per approved drawing

Cable Trench Excavation and Sand Bedding

Routes / Ducts where the MV cables is to be pulled is ✓
12
inspected as per approved drawing.
Trenches dimension, beddings and routes are check as per ✓
13
approved drawings prior to cable pulling
Cable laying/Pulling
The cable drum number or name plate details & cable size ✓
14
and embossing matched with scheduled drum.
No sharp edges of cable ducts/pipes for debris and ducts are ✓
15
clean
Cable continuity and Insulation Resistance Test on cable ✓
16
drum shall be checked before pulling
Rollers used during the laying of cables have no sharp ✓
17
projecting parts likely to damage the cables.
The cables are laid (cable laying, bending radius, spacing ) as ✓
18
indicated on the approved Drawing

UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQC-WX-00023-00 Page 1 of 3
 Inspection result
SN. Inspection phase description Remarks
Yes No N/A
Cables are laid directly from the drums into the trenches ✓
and special rollers placed at close intervals (maximum 2
19
meters) shall be employed for supporting the cables while
pulling and laying them.
✓
20 MV Cable is pulled off from top of drum

MV Cable is temporarily identified with painting or marker ✓

21
pen at ends during / after the pulling at a suitable interval.
The cable identification numbers complied with the cable ✓
22
schedules, as per the laid cables.
Backfilling up to Cable Covering Tiles Installation
✓
23 Backfilling Compaction is done for each 0.15m layer

Protective cable cover tiles are centered over the cables as ✓

24 per the enclosed drawings and closely interlocked with the
adjacent ones throughout the cable circuits.
Backfilling and Laying of Warning Tape

25 Backfilling Compaction is done for each 0.15m layer

Warning tape is laid at 500mm from ground level or as per

26
approved drawing
Final Backfilling and Cable Route and joint Marker

27 Backfilling Compaction is done for each 0.15m layer

Cable route markers are installed on straight route at

28 distance not exceeding 25m and at the points where the
cable route makes a turn and both side of road crossings.
Cable identification numbers are checked as per approved
29
cable schedules
Approved ducting sealant provided on all cable ducts entry
30
& exit
Cable Jointing, Glanding, Terminations, and Tests
Jointing splicing kit used as per approved material
31 submittals and jointing was done properly as per
manufacturer recommendation

32 Cable glands was installed tighten properly

Cable properly sleeved with appropriate colour coding at

33
terminal ends

34 Proper crimping is carried out for lugs with proper sleeves

35 Final tightening of lugs with connector is satisfy

Cable continuity and Insulation Resistance Test after

36
glanding and before termination are done

37 Hi-pot Test are done and recorded properly

UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQC-WX-00023-00 Page 2 of 3
 Inspection result
SN. Inspection phase description Remarks
Yes No N/A
All termination are completed and torquing was done on all
38
terminals and recorded properly.
Remarks:

Subcontractor STS Construction STS QC The Engineer (optional)

Name Engg.Imran

Signature
Date 10-02-2022

UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQC-WX-00023-00 Page 3 of 3
 INSPECTION AND TEST PLAN
FOR BURIED MV CABLES

Reference Documents Intervention Points

Test / Inspection Requirements
No Activity Description (Drawing / Spec / MS / Frequency Verification Document No.
and Criteria
Standard / Code) SC STS Engineer
 Soil thermal resistivity (max)= 120 °C
cm/W
 Backfilling Compaction: each 0.15m
layer
 No mechanical punner shall be used
Method Statement
 Backfilling shall be done as per E0001-
E0001-S02-GCX-PM-00020
S02-GQA-PN-30051- ITP for Soil 3rd Party Test Report +
Earthworks Compaction: each Buried MV Cable Checklist
Method Statement for
3.5 Backfilling up to Cable Covering Tiles  Protective cable cover tiles shall be 0.15m layer up to H W W E0001-S02-GQC-WX-00023 +
Earthworks
carefully centered over the cables as Covering tiles Earthworks Checklist E0001-
E0001-S02-GCX-PM-30051
per the enclosed drawings and shall be S02-GQC-WX-00003
closely interlocked with the adjacent
As per ADDC Specification
ones throughout the cable circuits.
If the excavation is in green area and re-
instatement:
 Trench should be filled with sweet
sand, levelled and cleaned.
Method Statement
E0001-S02-GCX-PM-00020
 Protective cable cover tiles shall be
carefully centered over the cables as Soil 3rd Party Test Report +
Method Statement for
3.6 Cable Covering Tiles Installation per the enclosed drawings and shall be After compaction H W S Buried MV Cable Checklist
Earthworks
closely interlocked with the adjacent E0001-S02-GQC-WX-00023
E0001-S02-GCX-PM-30051
ones throughout the cable circuits.
As per ADDC Specification
Method Statement
 As per Approved Shop Drawing
E0001-S02-GCX-PM-00020 Buried MV Cable Checklist
Compaction: each
Method Statement for E0001-S02-GQC-WX-00023 +
3.7 Backfilling up to Warning Tape level  Backfilling shall be done as per E0001- 0.15m layer up to H W S
Earthworks Earthworks Checklist E0001-
S02-GQA-PN-30051- ITP for warning tape level
E0001-S02-GCX-PM-30051 S02-GQC-WX-00003
Earthworks
As per ADDC Specification
 Warning tape to be laid at 500mm from Method Statement
Buried MV Cable Checklist
3.8 Laying of Warning Tape ground level or as per approved E0001-S02-GCX-PM-00020 After compaction H H W
E0001-S02-GQC-WX-00023
drawing As per ADDC Specification

UNLESS SPECIFIED OTHERWISE, THIS PRINTED COPY OF THIS DOCUMENT IS UNCONTROLLED AND FOR REFERENCE PURPOSE ONLY
E0001-S02-GQA-PN-00019-01 PAGE 10 OF 15
 1 2 3 4 5 6 7 8
797400.000 797600.000 797800.000 798000.000
TO SHEET-04

E=797886.397
N=2659876.860

EXIT PIT

A A
- The copying, reproduction and use of this work in any form whatsoever
is forbidden without the written authorization of Hitachi Rail STS S.p.A.
© Property of Hitachi Rail STS S.p.A, 2020, all rights reserved.

SPAN - 9
2659800.000

2659800.000
DRUM NO-9
DRUM NO : 12532180
2 WAY NDRC DRUM LENGTH : 285M
LENGTH = 160 M
CABLE LOOP:-
CABLE LAID :237M
TRENCH EX.:65M
0+100
NDRC DUCT : 172
0+000

160M
B 4+200 B

4+100

X X
4+000

3+900

3+800

SPAN - 4(LEFT)

ACK ℄

ETISLALT LINE
3+700

ACK ℄
DRUM NO-4

77.28M
FROM TR
4 WAY DUCT BANK
TRACK CEN
TER LINE
DRUM NO : 12535065

77.41M
LENGTH = 12.70M

FROM TR
3+600
DRUM LENGTH : 614M

ACK ℄
C BALANCE:-155M C
CABLE LAID :459M

77.80M
38.5M

FROM TR
1M
TRENCH EX.:459-15-3=44 E=797837.994

2.00M
E=797457.210 11KV CABLE N=2659712.370
PROPOSED
TERMINATION
ISS TARIF
N=2659688.127 11kV CABLE JOINT # 3
-4 NOS 380.6M E
ROW

mm XPLE Cu.
BLES
-46
M-2 TO NMGR E

10.1M
(10M CABLE LOOP 01

FROM TR

U.G. 11kV CA
25 SELF-CONTAINED
STATION
EYE WASH

14 13
27

ROW
AT INSIDE THE SUBSTATION)
F
20 02

12.7M
Aux Trasformer

17 16
Incoming Feeder

21
SPARE
Feeder

Bus Coupler

Feeder
Feeder

Bus Riser
Bank

1
Feeder

2
SPARE

Incoming
Capacitor

Outgoing

08
09
F
31
F

28

O TRM-1
24
26 07
05
29
MV 12

A L43/IC-1 T
05 10
See Note 06
30
F
18 03
11
LV
04
MV

FROM AB
LV

FENCE
F 19

E=797458.934

D 3C x 240sq.
N=2659676.785
ROW A
6.7M

67.1M
2.00M

SPAN - 3(RIGHT)
D 4 WAY DUCT BANK DRUM NO-3 D

OSE
LENGTH = 6.7M E=797459.911
DRUM NO : 125340990
2659600.000

2659600.000
2 Nos. PROP
N=2659669.461
E=797459.603
DRUM LENGTH : 478M PROPOSED
11kV CABLE JOINT # 2
N=2659670.289 CABLE LOOP:-
CABLE LAID :478M (3M LOOP FOR
0M
TRENCH EX.:478-15-3=46 STRAIGHT JOINT)

FGL

7.09M FROM
B B ROAD EDGE
E SELECTED BACK
E
FILL MATERIAL

REFER TO ENLARGED
500 (VARIES)

16-16mm Ø TOP & BOTTOM

STEEL REINFORCEMENT
DETAIL-A
1000 (VARIES)

STIRRUPS Ø 8 @200

CONCRETE
ROUTE MARKER (TYP)
75

GRADE C 40-20
150

200MM Ø UPVC PIPE

200

PROPOSED 3C x 240sq.mm
XPLE Cu. 11kV U.G. CABLES
150

50MM THICK
LEAN CONCRETE

F GRADE C 20-25
F

DETAIL - 1
150 200 100 200 100 200 100 200 150

1400

SECTION C-C
FOR ROAD CROSSING (SINGLE LAYER)
(2 NOS OF 11kV CABLES)

1 Nos. PROPOSED
3C x 240sq.mm XPLE Cu.
U.G. 11kV CABLES
2659400.000

2659400.000
TO TRM-1
G

4
FROM ABL-43 TO ABL-4

FROM ABL43/IC-1
TO SHEET-03
797400.000 797600.000 797800.000

LEGEND: REFERENCE DWG NO: S00X.0102154.D05.01EN - 11KV CABLE ROUTE KEYPLAN: DUBAI Rev. Date CO Revision Description Drwn Vrfr Appr Atzr
PREPARED PROJECT
ETIHAD RAIL STAGE 2 & 3 PROJECT DRAWING TITLE

HE CABLE ROUTE LAYOUT OF

SYMBOLS DESCRIPTION SYMBOLS DESCRIPTION S00X.0102154.D18.00EN - 11KV SLD - ISS TARIF REV.B ISS TARIFF KPZ
E0001 - PACKAGE 2S
ISSUED FOR APPROVAL (VER 00.00) DATE 19-DEC-2021
Design & Build Contract INFEED SUBSTATION - TARIF
H PROPOSED 11kV CABLES ROW
C0303-GMA-ERA-DS-42581-00 SS ACCESS ROAD - PLAN AND PROFILE
3+700 DM
B 00 19-JUN-2021 -- HE MI DT AA
VERIFIED
NOTES: (Railway Integration and Systems)
ABU DHABI ISSUED FOR APPROVAL (VER 01.00) A.ELGOHARY
EXISTING ELECTRICAL CABLES ROAD EDGE 1. ALL DIMENSIONS ARE IN METRES UNLESS OTHERWISE NOTED. 01 21-DEC-2021 -- HE MI DT AA CLIENT PMC SHEET No SCALE ORIGINAL SIZE
DMA

DATE 19-DEC-2021
PROPOSED 11kV CABLE JOINT 2. COORDINATE REFERENCE SYSTEM WGS84 UTM39N. 2 of 9 1 :1000 A1
TRACK CENTER LINE ICA QUALITY PROCESS APPROVAL
3. ANY OBSTRUCTION DURING THE EXECUTION WITH OTHER UTILITIES, SUITABLE PROTECTION SHALL BE PROPOSED. D PROJECT STAGE DOCUMENT STATUS
C.ORTIZ MAIN CONTRACTOR
EXISTING DUCT PROPOSED NDRC DUCT 4. CONNECTION POINTS DURING THE PRE INSPECTION / SHUTDOWN SHALL BE CONFIRMED BY ADDC. C DATE 19-DEC-2021 DCP3 Issued for Acceptance
GM AL AIN ENGINEER DRAWING No REVISION
- ROUTE MARKER @ 30 INTERVAL APPROVED ELECTRICAL SUB CONTRACTOR
- JOINT MARKER M. ESPOSITO
JUPITER EMC LLC.
ELECTRO MECHANICAL CONTRACTING
E0001-FJP-GCX-DS-90010 AB
P.O.Box : 128150 Tel. : 02-6419541
DATE 19-DEC-2021 Abu Dhabi Fax. : 02-6419542 FILE NAME: E0001-FJP-GCX-DS-90010-AC.dwg

1 2 3 4 5 6 7
 1 2 3 4 5 6 7 8
797600.000 797800.000 FROM SHEET-06 798000.000 798200.000

A A
- The copying, reproduction and use of this work in any form whatsoever
is forbidden without the written authorization of Hitachi Rail STS S.p.A.
© Property of Hitachi Rail STS S.p.A, 2020, all rights reserved.

1 Nos. PROPOSED 3C x 240sq.mm XPLE Cu.

U.G. 11kV CABLES

B B
EXISTING 2 WAY DUCT BANK
D D
2660200.000

2660200.000
C C

DETAIL - 1
SPAN - 8
DRUM NO-5
DRUM NO : 12534405
DRUM LENGTH : 601M
CABLE LOOP:-

46
4
FROM ABL-43 TO ABL-4

FROM TRM-2 TO NMRG

CABLE LAID :601M
TRENCH EX.:601M
D D
TO SHEET-06

ROUTE MARKER (TYP)

7.11M FROM
ROAD EDGE

E E
2660000.000

2660000.000
F F

E=797889.972
N=2659936.995

G
PROPOSED
11kV CABLE JOINT # 4

(2x1M LOOP FOR

STRAIGHT JOINT)

FROM SHEET-02
797600.000 797800.000 798000.000 798200.000

LEGEND: REFERENCE DWG NO: S00X.0102154.D05.01EN - 11KV CABLE ROUTE KEYPLAN: DUBAI Rev. Date CO Revision Description Drwn Vrfr Appr Atzr
PREPARED PROJECT
ETIHAD RAIL STAGE 2 & 3 PROJECT DRAWING TITLE

HE CABLE ROUTE LAYOUT OF

SYMBOLS DESCRIPTION SYMBOLS DESCRIPTION S00X.0102154.D18.00EN - 11KV SLD - ISS TARIF REV.B ISS TARIFF KPZ
E0001 - PACKAGE 2S
ISSUED FOR APPROVAL (VER 00.00) DATE 19-DEC-2021
Design & Build Contract INFEED SUBSTATION - TARIF
H PROPOSED 11kV CABLES ROW
C0303-GMA-ERA-DS-42581-00 SS ACCESS ROAD - PLAN AND PROFILE
3+700 DM
B 00 19-JUN-2021 -- HE MI DT AA
VERIFIED
NOTES: (Railway Integration and Systems)
ABU DHABI ISSUED FOR APPROVAL (VER 01.00) A.ELGOHARY
EXISTING ELECTRICAL CABLES ROAD EDGE 1. ALL DIMENSIONS ARE IN METRES UNLESS OTHERWISE NOTED. 01 21-DEC-2021 -- HE MI DT AA CLIENT PMC SHEET No SCALE ORIGINAL SIZE
DMA

DATE 19-DEC-2021
PROPOSED 11kV CABLE JOINT 2. COORDINATE REFERENCE SYSTEM WGS84 UTM39N. 5 of 9 1 :1000 A1
TRACK CENTER LINE ICA QUALITY PROCESS APPROVAL
3. ANY OBSTRUCTION DURING THE EXECUTION WITH OTHER UTILITIES, SUITABLE PROTECTION SHALL BE PROPOSED. D PROJECT STAGE DOCUMENT STATUS
C.ORTIZ MAIN CONTRACTOR
EXISTING DUCT PROPOSED NDRC DUCT 4. CONNECTION POINTS DURING THE PRE INSPECTION / SHUTDOWN SHALL BE CONFIRMED BY ADDC. C DATE 19-DEC-2021 DCP3 Issued for Acceptance
GM AL AIN ENGINEER DRAWING No REVISION
- ROUTE MARKER @ 30 INTERVAL APPROVED ELECTRICAL SUB CONTRACTOR
- JOINT MARKER M. ESPOSITO
JUPITER EMC LLC.
ELECTRO MECHANICAL CONTRACTING
E0001-FJP-GCX-DS-90010 AB
P.O.Box : 128150 Tel. : 02-6419541
DATE 19-DEC-2021 Abu Dhabi Fax. : 02-6419542 FILE NAME: E0001-FJP-GCX-DS-90010-AC.dwg

1 2 3 4 5 6 7
 NATURAL SOIL FILLING
TO THE NORMAL LEVEL

GORUND LEVEL

300
WARNING TAPES

600
850

50
250

CABLE COVERING TILES 1000

PROPOSED 3Cx50sq.mm
XLPE AL. 11kV U.G. CABLE

SIEVED SAND BEDDING

250 250
500

SECTION A-A
1 NO. 11kV CABLE TRENCH DETAILS
 Capital Gate, 6th Floor, Khaleej Arabi Street (30)
PO Box 989, Abu Dhabi, UAE
Tel: +971 (0)2 499 9999 Web: www.etihadrail.ae

Transmittal Number: S23-IFIA-JBS-HIT-06358

Project Reference: S23

To: HIT-Hitachi Rail Issue Date: 29/06/2021 11:03:31

From: JBS-Jacobs Engineering Group Return By Date: -

Issue Reason: IFIA-Issued for Implementation-Action

Summary: E0001-S02-GCX-MT-90052-AB Material Approval for LPDE Cable Protection Tile (M/s Al
Samir Plastic Factory LLC)
Notes/Instructions:

Attached Documents:

Document Number Rev Title Contract Number Acceptance Code

E0001-S02-GCX-MT- AB Product and Material E0001-Package 2S Railway 01-Accepted
90052 Approval – LPDE Cable Integrations and Systems
Protection Tile (M/s Al
Samir Plastic Factory
LLC)

Distribution:

Name Reason Delivery Method

Dejan Dobrosavljevic N - Notification System Notification

Djamel Attoui N - Notification System Notification

DCC N - Notification System Notification

DCC1 EGS N - Notification System Notification

DCC1 HIT N - Notification System Notification

DCC2 EGS N - Notification System Notification

DCCJBS E0001 N - Notification System Notification

Acknowledgement of Receipt:

Recipient: __________________________ Date: _________________ Kindly acknowledge receipt of this

Page 1 of 2 Transmittal: S23-IFIA-JBS-HIT-06358

 Capital Gate, 6th Floor, Khaleej Arabi Street (30)
PO Box 989, Abu Dhabi, UAE
Tel: +971 (0)2 499 9999 Web: www.etihadrail.ae

Transmittal Number: S23-IFIA-JBS-HIT-06358

transmittal by returning a signed

copy of this form to:

dcc@etihadrail.ae

Page 2 of 2 Transmittal: S23-IFIA-JBS-HIT-06358