Client:

Form No.
EEHA-Insp-01
HAZARDOUS AREA
Site: INSPECTION Project:

Tag No. Work Order No. Man Hrs.

Plant /Area/Module: Function / Location:
Cat. Serial
Manufacturer:
No. No.
Certifying Cert
Authority: No:
Temp
AREA CLASSIFICATION: Zone: Gas Group:
Class:
Temp
Equipment Classification Ex Technique: Ex - Gas Group:
Class:
IP Rating: Zone / Location DWG No.
GRADE OF INSPECTION PERFORMED (circle):
DETAILED CLOSE VISUAL
Notes: 1) Inspections shall only be performed by personnel deemed “skilled person” in accordance with IECEx / AS/NZ Standards.
2) All fields are to be completed. Any non-applicable fields shall state “NA”. Comments are required for ‘Reject’ columns ONLY.
3) An Inspection Sheet should be completed for EACH individual item of Equipment.
Inspection
INSPECTION RESULTS
ITEM EQUIPMENT – All Techniques Type
D C V OK NA Reject COMMENTS
1 Equipment is clearly marked with acceptable Ex compliance plate * * *
2 Equipment Gas Group and Temp Class is correct for the Area * *
3 Equipment and glands have IP rating appropriate to location (washers etc.) * *
4 Installation in accordance with documentation (incl. conditions on cert. - X) * * *
5 Equipment Ex Technique Appropriate for Area Classification * *
6 Equipment ID Label (structure) & Cable ID label is present & Correct * *
7 Sealing gaskets or compounds on glasses / windows are satisfactory *
8 Enclosure gaskets condition is satisfactory (clean, undamaged) *
9 Equipment NOT obviously damaged, No Visible Unauthorized Modifications * * *
10 Circuit ID conductor ferrules are installed & correct *
11 Equipment (bolts, covers) appear to be correct type, complete and tight * *
12 Unused entries have correct type plug for Ex technique (complete and tight) * *
13 Lamp rating and position are correct (check all are operating for visual) * * *
14 Cable glands have correct Ex rating identified (d or de) and installed correctly *
15 Cables / conduits not obviously damaged (immediate visible area only) * * *
16 Cable type is appropriate and Installed in accordance with Specification * *
17 All unused cores are terminated in spare terminals & earthed at one end *
18 Electrical connections are correct (Clearance, creepage, tightness) *
19 All cable cores are fitted with correct type Lugs, Spade, Crimp pin, etc. *
20 Equipotential Bonding satisfactory. Cable, Lug, Fixings, Grease (if required) * * *
21 Insulation resistance is as per requirements (sight test documents) *
22 Equip protected against corrosion / weather / vibration / etc * * *
23 No undue accumulation of dust and moisture * *
24 Electrical insulation is clean and dry (Internal equipment check) *
25 Motor fans and couplings are not rubbing on cowls/guards * *
26 All moving parts are free and have no obvious mechanical damage * *
27 Electrical Protection Devices set correctly and operate within permitted limits *
Extra Ex d checks
28 Ex d conduits seals are fitted to all conduits and satisfactorily sealed *
29 Cable glands are compound barrier type and correctly installed (where applic) * *
30 Adaptors, nipples, tees, glands etc. are all certified Ex d (where applicable) * *
31 No obstacles within permitted limits of flange joints (dependent on Gas Group) * * *
32 Flame paths are clean and undamaged *
33 Flange gap dimensions are within tolerances *
Extra Ex e checks
34 All Equipment is Ex e certified (including components within Enclosure) * * *
The No. of Components within Enclosure does not exceed permitted
35 *
maximum
Page 2 of 2
 Inspection
INSPECTION RESULTS
ITEM Type
D C V OK NA Reject COMMENTS
36 Bridging links do not reduce creepage / clearance and are allowed *
37 Power conductors are not bunched together causing possible hot spots *
38 Unused Terminals are tightened down *
Extra Ex n checks
39 All Terminals are Ex n certified (if required on certificate) *
40 Bridging links do not reduce creepage / clearance and are allowed *
41 Hermetically sealed and Enclosed Break devices are undamaged *
Extra Ex nR (Restricted Breathing) checks
42 Gaskets and seals are in good condition *
43 Restricted breathing properties satisfactory (conduct vacumn test) *
Extra Ex p checks
44 Pressurisation Gas is correct type * *
45 Actual pressure is within maximum and minimum settings for Equipment * *
46 Timers set as per certification documentation *
47 Spark and/or flame arrestors are installed in accordance with specifications * *
48 Check intake & exhaust in NON – HAZARDOUS areas * * *
49 Alarms and Trip functions operate correctly as per certification Documentation *
Extra Ex i (Intrinsically Safe – IS) checks
50 Equipment has adequate Circuit Identification for ‘IS’ Installation * * *
51 Point-to-Point checks are OK (sight test Documentation). *
52 All cable cores are uniquely labeled (Check loop termination schedules) *
53 Cable screens are isolated at one end as per specification or as required *
54 All Cable Screens and associated equipment are earthed as per requirement *
55 Cable length for entire Loop is stated (and less than max allowable Length) *
56 Separation and segregation is maintained between IS and non-IS Circuits * * *
57 Earth Free test for IS installation (to prove IS earth) *
58 IS Barrier, energy limiting devices, fuses are Certified / approved * *
59 IS Calculation correct (view documentation) *
60 Make: Model:
BARRIER:
Authority: Cert No: Type:
REMEDIATION ACTIONS
FL FLAMEPATH IN INCORRECT INSTALLATION
EN ENCLOSURE ED EQUIPMENT DAMAGE
IP INGRESS TE TERMINATIONS
EB EARTH BOND GL/PL GLANDS/PLUGS
UM UNAUTHORISED MODIFICATION OT OTHER (please specify)
COMMENTS / DEFECTS (list item No.):
Item No.

ACCESS (List any special access restrictions or requirements):

Extension
Ground Steps Ladder Scaffold Harness Other:
Ladder
INSPECTION SURVEY COMPLETED BY:
NAME & EW LICENCE NUMBER (print):
COMPANY / POSITION TITLE:
SIGNATURE:
DATE: