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Ug Piping

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Inspection & Test Record for Underground Piping

Client: Project No.: Project Name:

Record No.: page of

Subcontractor: Subcontract P.O. No.: Test system No.:

Additional Information: Inspected by: Date of inspection: Reference document: 1.0 Line No. Test pressure: Test medium: kg/cm2

2.0

Iso/Drawing No.

3.0

From To

4.0

Excavation and Backfill

5.0

Prefab and Welding

6.0

Installation

7.0

Field Welding

8.0

Coat and Wrap

9.0

Flushing Velocity M/S h hrs. h h h

10.0

Hydrostatic test duration

11.0

Reinstatement

12.0

Completion

Remarks:

H - Companys presence is mandatory for all activities in section. h - Companys presence is mandatory.

Attachments, No. of pages:

Accepted for Subcontractor


Name: Signature: Date:

Accepted for Company


Name: Signature:

Accepted for Client


Name: Signature:

Date:

Date:

C:\RB_Forms\RB26C04.DOT\

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