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FIELD INSPECTION REPORT
Quality Control Form
INSPECTION TYPE

INSPECTION/TEST FOR CATHODIC SYSTEM MMO GRID (TANK)

INSPECTION NOTICE NO.: DRAWING NO(S):

ITP No.: Inspection Gr. Report No. Date WORK No. ITEM No. LOCATION

SIGNATURE
COMPANY / /
CONTRACTOR SUBCONTR

ACCEPTANCE CRITERIA: AS PER VENDOR PROCEDURE

Tested date:
INPECTION AND TEST REQUIREMENT
A. SITE INSTALLATION CHECK FOR HDPE LINER

Weather:
Unit Acceptable Criteria

Temp.
Measurement /Result Data

C
Remarks

1 Has HDPE Liner been installed Yes/No Required Before installation measure the Hydrant/Pipe Natural Potential w.r.t. Cu2 MV CuSo4 Reference Electrode. B. SITE INSTALLATION CHECK FOR SAND (Band Layer between HDPE Liner and Anode) 1 Depth mm (+/-) 10 % 2 Compaction Required C. SITE INSTALLATION CHECK FOR MMO RIBBON ANODE 1 Total Length of Ribbon Installed 2 Total No.s of Ribbon rows 3 Spacing between Ribbon to Ribbon 4 Distance of Ribbon from Tank Wall 5 Depth of Ribbon from the Liner 6 Distance of Ribbon from Sump D. SITE INSTALLATION CHECK FOR CONDUCTOR BAR 1 Total Length of Conductor Bar 2 Total No. of Rows of Conductor Bar 3 Spacing between the conductor Bars 4 Is perpendicular center Conductor Bar in center point 5 Spot Welder Voltage and Time Set for welding 6 Spot welder Time Set for welding Has continuity of at least 80% of the spot welds checked (Conductor to 7 Conductor and Conductor to Anode) m No.s m mm mm mm m No.s m Volts Sec. Yes/No See Note#1 See Note#1 See Note#1 25-75mm (+/-) 10 % >150mm See Note#1 See Note#1 See Note#2 Yes/No
Vendor spec Vendor spec

<0.5

REMARKS:

Note: 1. As per dwg. (Min.)

2. As per dwg. (Max.)

Legend

NA.: Not Applicable

www.Inspection-for-Industry.com
FIELD INSPECTION REPORT
INSPECTION TYPE

INSPECTION/TEST FOR CATHODIC SYSTEM MMO GRID (TANK)

INSPECTION NOTICE NO.: DRAWING NO(S):

ITP No.: Inspection Gr. Report No. Date WORK No. ITEM No. LOCATION

SIGNATURE
COMPANY / /
CONTRACTOR SUBCONTR

ACCEPTANCE CRITERIA: AS PER VENDOR PROCEDURE

Tested date:
INPECTION AND TEST REQUIREMENT
A. SITE INSTALLATION CHECK FOR POWER FEEDS 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Spot Welder Voltage for welding power feeds. Spot Welder Time Set for welding of power feeds. Has continuity of 100% of the spot welds checked Has power feed connections been tagged Continuity between individual Power Feed: Length of Cable: P1/ Location P2/Location P3/ Location P4/ Location P5/ Location Continuity of Power Feed Cable with Conductor Bar: P1 P2 P3 P4 P5

Weather:
Unit Acceptable Criteria
(+/-) 10% (+/-) 10% (+/-) 10% (+/-) 10% (+/-) 10% <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5 <0.5
Vendor spec Vendor spec

Temp.
Measurement /Result Data

C
Remarks

M M M M M Volts Sec. Yes/No

P 1 P2 P 2 P3 P 3 P4 P 4 P5 P 5 P1

<0.5 -

REMARKS:

Legend

NA.: Not Applicable

www.Inspection-for-Industry.com
FIELD INSPECTION REPORT
INSPECTION TYPE

INSPECTION/TEST FOR CATHODIC SYSTEM MMO GRID (TANK)

INSPECTION NOTICE NO.: DRAWING NO(S):

ITP No.: Inspection Gr. Report No. Date WORK No. ITEM No. LOCATION

SIGNATURE
COMPANY / /
CONTRACTOR SUBCONTR

ACCEPTANCE CRITERIA: AS PER VENDOR PROCEDURE

Tested date:
INPECTION AND TEST REQUIREMENT

Weather:
Unit Acceptable Criteria
(+/-) 10% Required See Note#1 See Note#2 (+/-) 10% (+/-) 10% (+/-) 10% (+/-) 10% (+/-) 10%
(+/-)10%mV

Temp.
Measurement /Result Data

C
Remarks

A. SAND LAYER BETWEEN ANODE LEVEL AND REF. ELECTRODE LEVEL/ MONITORING PIPE LEVEL 1 2 1 2 3 4 5 6 7 8 9 10 11 12 Depth Compaction Total No. of Reference Electrodes Has Reference Electrode wetted before installation Length of Reference Electrode R-1 / Location Length of Reference Electrode R-2 / Location Length of Reference Electrode R-3 / Location Length of Reference Electrode R-4 / Location Length of Reference Electrode R-5 / Location Portable (Cu-CuSo4) Reference Cell Potential w.r.t. R-1 (Cu-CuSo4) Portable (Cu-CuSo4) Reference Cell Potential w.r.t. R-1 (Zinc Ref.cell) Portable (Cu-CuSo4) Reference Cell Potential w.r.t. R-2 (Cu-CuSo4) Portable (Cu-CuSo4) Reference Cell Potential w.r.t. R-2 (Zinc Ref.cell) Portable (Cu-CuSo4) Reference Cell Potential w.r.t. R-3 (Cu-CuSo4) ------ Continued next sheet ------mm Yes/No M M M M M mV mV mV mV mV

B. SITE INSTALLATION CHECK FOR REFERENCE ELECTRODES

>0900mV
(+/-)10%mV

>0900mV
(+/-)10%mV

REMARKS:

Note: 1. As per dwg. (Min.)

2. As per dwg. (Max.)

Legend

NA.: Not Applicable

www.Inspection-for-Industry.com
FIELD INSPECTION REPORT
INSPECTION TYPE

INSPECTION/TEST FOR CATHODIC SYSTEM MMO GRID (TANK)

INSPECTION NOTICE NO.: COMPANYS INSPECTOR: CONTRACTORS INSPECTOR: SUBCON.S INSPECTOR: DRAWING NO(S): ACCEPTANCE CRITERIA: AS PER VENDOR PROCEDURE

ITP No.: Inspection Gr. Report No. Date WORK No. ITEM No. LOCATION

SIGNATURE
COMPANY / /
CONTRACTOR SUBCONTR

Tested date:
INPECTION AND TEST REQUIREMENT
---- front sheet continued ----13 14 15 16 17 18 1 2 3 4 5 6

Weather:
Unit
mV mV mV mV mV Yes/No M
10/20feed

Temp.
Acceptable Criteria
>-900mV (+/-) 10% >-900mV (+/-) 10% >-900mV (+/-)5 % See Note#1 -

C
Remarks

Measurement /Result Data

Portable (Cu-CuSo4) Reference Cell Potential w.r.t.R-3 (Zinc Ref. Cell) Portable (Cu-CuSo4) Reference Cell Potential w.r.t.R-4 (Cu-CuSo4) Portable (Cu-CuSo4) Reference Cell Potential w.r.t.R-4 (Zinc Ref. Cell) Portable (Cu-CuSo4) Reference Cell Potential w.r.t.R-5 (Cu-CuSo4) Portable (Cu-CuSo4) Reference Cell Potential w.r.t.R-5 (Zinc Ref. Cell) Reference Electrode connections been tagged Total Length of Monitoring Pipe Length used Distance of Monitoring pipe from Tank Center (North) Did you use PVC cement for joining Has draw wire been installed Has End Caps and elbow been installed

C. SITE INSTALLATION CHECK FOR MONITORING PIPE

M Yes/No Yes/No Yes/No

Note: 1. (+/-) 50mm from drawing REMARKS:

Legend

NA.: Not Applicable

www.Inspection-for-Industry.com
FIELD INSPECTION REPORT
INSPECTION TYPE

INSPECTION/TEST FOR CATHODIC SYSTEM MMO GRID (TANK)

INSPECTION NOTICE NO.: DRAWING NO(S):

ITP No.: Inspection Gr. Report No. Date WORK No.: ITEM No. LOCATION

SIGNATURE
COMPANY / /
CONTRACTOR SUBCONTR

ACCEPTANCE CRITERIA: AS PER VENDOR PROCEDURE

Tested date:
INPECTION AND TEST REQUIREMENT
1 2 1 2 3 4 5 Depth Compaction Has sand been properly laid Angle (location) of exit for Power Feed / RE Depth of Liner from Bottom Plate Is Sump Covered with HDPE Liner

Weather:
Unit
mm Yes/No
-

Temp.
Acceptable Criteria
(+/-) 10% Required as per dwg. as per dwg. as per dwg. No continuity

C
Remarks

Measurement /Result Data

A. SAND LEVEL BETWEEN REF. ELECTRODE LEVEL AND TANK BOTTOM PLATE LEVEL.

B. GENERAL CHECK

mm Yes/No -

Check Electrical discontinuity between Bottom Plate and Power Feed

REMARKS:

Legend

NA.: Not Applicable