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INSTRUMENT PRE-INSTALLATION CALIBRATION SHEET Project No.: H0403600 Prepared By: Type: Instrument Tag No.

: Precalibration Physical Checks Process Connections Correct Electrical Connections Correct Pneumatic Connections Correct Electrical Supply Setting Correct Body Material Correct Instrument General Condition Satisfactory Instrument Complete With Ancillary Equipment Calibration Check Cycle Input Output(Rising) 0% 25% 75% 100% Control Function Fitted Proportional Differential Gap Reset Auto Temperature Correction Range S G Or Density Correction Set At Other Functions Fitted Burnout Set At: Upscale Downscale Set Point Ancillary Equipment List Of Ancillary Equipment % Error Client: CLNG Location: Cameron Parish, LA Purchase Order: Manufacturer: Report No.: Date: Service: Model No.: Serial No.:

Signal Range Dial/Chart Range Range Correct Remarks

Shipping Stop Removed Input 100% 75% 25% 0% Output(Falling) % Error

Derivative Time Delay Setting Limit Switches Set At Alarm Setting Elevation/Suppression Set At Minimum Stop Set At Maximum Stop Set At Remarks

Sub-Contractor QA/QC Rep. By Date

AK/IHI QA/QC Rep. By Date

CLNG Rep. By Date

CP-5803.073

Rev 3

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