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COM-EF-844-1

Coatings Inspection Report Form

Rev. Date Description Author Technology Leader


 09/86   R.A. Doyle (Sponsor)
 09/07   P. Hunter (Sponsor)
 05/09  M. Melancon B. Griffin (Sponsor)
1 07/16 General revision. M. Melancon B. Chaloner-Gill

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access
Coatings Inspection Report Form COM-EF-844-1

COATINGS/LININGS INSPECTION REPORT FORM DAILY REPORT


Contractor:       Date:       Attachments
Project/EWO No.:       Chevron Coating/Lining System:       DFT Sheet NCR
Location:       Company Rep.:       Soluble Salts Test
Description:       Project Engineer:       Anchor Profile Report
Specification/COM Number:       Days on Job:      
Description of Work Area & Activities Ambient Conditions
Time of Day                  
Relative Humidity (%)                  
o o
Dry Bulb Temp.: F C                  
o o
Wet Bulb Temp.: F C                  
      o o
Surface Temp., Min/Max F C       /             /             /      
o o
Dew Point: F C                  
Wind Direction / Speed       /             /             /      
Weather Conditions:                  
1. Existing Conditions Inspections and Approvals Performed
Steel Concrete Pitting 1. Existing Conditions Inspections Approved Not Approved
New Maintenance Primed 2. Surface Preparation Monitoring Approved Not Approved
Crevices Sharp Edges Welds 3. Surface Cleanliness / Profile Approved Not Approved
Mill Scale Rust Scale 4. Approved to Paint Approved Not Approved
Existing Coating/ Lining 5. Application Monitoring / WFT Approved Not Approved
      6. Paint Inspection / DFT Approved Not Approved
Degree of Contamination 7. Final Inspection Approved Not Approved
Chlorides Sulfates Nitrates Non-Conformance Report #      
pH Grease Oil Equipment per Application Data Sheet Approved Not Approved
2. Surface Preparation Monitoring 5. Application Monitoring and WFT Measurements
           
Start:       Finish:       ft2 m2 Start:       Finish:       ft2 m2
Solvent Clean Hand Tool Power Wash Primer Intermediate Finish Touch-up
HP Wash       psi bar Wet Abrasive Blast Manufacturer:       Quantity Mixed:      
Abrasive Blast Blast Media Product:       Mix Ratio:      
o o
Air Supply cfm cmh Blotter Test OK Color:       Material Temp.:       F C
Nozzle psi bar Abrasive Analysis OK Reducer:       Induction Time:      
Moisture/Oil Traps OK Equipment Check OK Reducer Batch #:       Pot Life:      
3. Surface Cleanliness and Profile SSPC/ISO Batch Numbers Application Method
SSPC SP-      Surface Preparation Approved A:       B:       Airless Conventional
SSPC VIS-1 SSPC VIS-3 SSPC VIS-4 A:       B:       Brush/Roll Plural
ISO 8501 Visual Standard Specified WFT:       mils Achieved WFT       mils
SA       ST       Blotter Test OK Continuous Agitation
Other:       Coverage:       ft2/gallon m2/gallon Reducer Added
Profile Check 6. Paint Inspection / DFT Measurements
Specified       mils Achieved       mils Coating Inspected:      
Magnetic Base       mils Press-O-Film Test OK Visual Inspection Pass Fail
4. Approved to Paint DFT Gage Calibrated Yes No Shims NIST Tiles
Surface Clean DFT Measurements High Low
Painted Surfaces Defects Detected Yes No
Minimum Recoat Maximum Recoat Overspray Runs/Sags Pinholes Cracking
Overspray Runs/Sags Pinholes Holidays Damage Other:      
Holidays Damage Mileage OK 7. Final Inspection
Other:       Coating System Inspected:      
Final Inspection Pass Fail

QC Inspector Signature: Date:      

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 1 of 10
Coatings Inspection Report Form COM-EF-844-1

PRESS-O-FILM REPORT
Contractor:       Date:      
Project/EWO No.:       Chevron Coating/Lining System:      
Location:       Company Rep.:      
Description:       Specified Anchor Profile:      
Inspector:       Specification Number:      

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Location:       Location:      

Place Tape Here Place Tape Here

Minimum 3 readings for first 100 ft2 (9.3 m2) and 3 readings for
each additional 1000 ft2 (93 m2).
QC Inspector Signature
Note: All readings must be recorded regardless of results. Date:      

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 2 of 10
Coatings Inspection Report Form COM-EF-844-1

SOLUABLE SALTS TEST REPORT


Contractor:       Date:      
Project/EWO No.:       Chevron Coating/Lining System:      
Location:       Company Rep.:      
Description:       Specified Anchor Profile:      
Inspector:       Specification Number:      

Chloride Nitrate Sulfate Date Location


1                              
2                              
3                              
4                              
5                              
6                              
7                              
8                              
9                              
10                              
11                              
12                              
13                              
14                              
15                              
16                              
17                              
18                              
19                              
20                              

Notes:      

Maximum Salt Levels


Immersion Service Non-Immersion Service
Chloride (3 μg/cm2) (5 μg/cm2)
2
Nitrate (5 μg/cm ) (10 μg/cm2)
2
Sulfate (10 μg/cm ) (15 μg/cm2)
QC Inspector Signature

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 3 of 10
Coatings Inspection Report Form COM-EF-844-1

Minimum 3 tests per first 1000 ft2 (93 m2), then 1 reading per Date:      
each additional 3000 ft2 (279 m2).

DRY FILM THICKNESS MEASUREMENTS REPORT


Contractor:       Date:      
Project/EWO No.:       Chevron Coating/Lining System:      
Location:       Company Rep.:      
Description:       Specified Anchor Profile:      
Inspector:       Specification Number:      

Dry Film Thickness Gage Calibration Record


Manufacturer:       Model:       Calibration Standard:       Calibration Shims NIST Tiles
Type:       Serial #:       DFT of Tile/Shim:       Gage DFT:      
WSE Number:       Condition:       Gage Adjustment:       Calibrated:      

Test Location:       Average Test Location:       Average


Test Spot A                   0.00 Test Spot A 0.00             0.00
Test Spot B                   0.00 Test Spot B 0.00             0.00
Test Spot C                   0.00 Test Spot C 0.00             0.00
Test Spot D                   0.00 Test Spot D 0.00             0.00
Test Spot E                   0.00 Test Spot E 0.00             0.00
Number Spot Tests:       Total Average DFT: 0.00 Number Spot Tests:       Total Average DFT: 0.00

Test Location:       Average Test Location:       Average


Test Spot A                   0.00 Test Spot A 0.00             0.00
Test Spot B                   0.00 Test Spot B 0.00             0.00
Test Spot C                   0.00 Test Spot C 0.00             0.00
Test Spot D                   0.00 Test Spot D 0.00             0.00
Test Spot E                   0.00 Test Spot E 0.00             0.00
Number Spot Tests:       Total Average DFT: 0.00 Number Spot Tests:       Total Average DFT: 0.00

Test Location:       Average Test Location:       Average


Test Spot A                   0.00 Test Spot A 0.00             0.00
Test Spot B                   0.00 Test Spot B 0.00             0.00
Test Spot C                   0.00 Test Spot C 0.00             0.00
Test Spot D                   0.00 Test Spot D 0.00             0.00
Test Spot E                   0.00 Test Spot E 0.00             0.00
Number Spot Tests:       Total Average DFT: 0.00 Number Spot Tests:       Total Average DFT: 0.00

Test Location:       Average Test Location:       Average


Test Spot A                   0.00 Test Spot A 0.00             0.00
Test Spot B                   0.00 Test Spot B 0.00             0.00
Test Spot C                   0.00 Test Spot C 0.00             0.00
Test Spot D                   0.00 Test Spot D 0.00             0.00
Test Spot E                   0.00 Test Spot E 0.00             0.00
Number Spot Tests:       Total Average DFT: 0.00 Number Spot Tests:       Total Average DFT: 0.00

Test Location:       Average Test Location:       Average


Test Spot A                   0.00 Test Spot A 0.00             0.00
Test Spot B                   0.00 Test Spot B 0.00             0.00
Test Spot C                   0.00 Test Spot C 0.00             0.00
Test Spot D                   0.00 Test Spot D 0.00             0.00
Test Spot E                   0.00 Test Spot E 0.00             0.00
Number Spot Tests:       Total Average DFT: 0.00 Number Spot Tests:       Total Average DFT: 0.00

Inspector Signature

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 4 of 10
Coatings Inspection Report Form COM-EF-844-1

Date:      

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 5 of 10
Coatings Inspection Report Form COM-EF-844-1

HOLIDAY TEST REPORT


Contractor:       Date:      
Project/EWO No.:       Chevron Coating/Lining System:      
Location:       Company Rep.:      
Description:       Specified Anchor Profile:      
Inspector:       Specification Number:      
Holiday Test
Accept Reject Notes:
Holiday Tester      
Manufacturer:      
Model:      
Calibrated: Yes No
Voltage:      
DFT Testing Standard: SP0188 RP0274

100% holiday testing shall be conducted on all internal lined vessels


and pipe, coatings under insulation, and external coatings in immersion
service.
Contract Q/C Signature Date:      

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 6 of 10
Coatings Inspection Report Form COM-EF-844-1

NON-CONFORMANCE REPORT
Verbal Notification Date:      
Contractor:       Date:      
Project/EWO No.:       Chevron Coating/Lining System:      
Location:       Company Rep.:      
Description:       Specified Anchor Profile:      
Inspector:       Specification Number:      

Failed Inspection Description Corrective Action Description


           

Classification of Non-Conformance: Approval Based on Classification: Initials Date


Does not affect the performance of the system. Use As Is Approved:            
Can be reworked or repaired to an acceptable condition. Rework/Repair Approved:            
Can't be reworked or repaired to an acceptable condition. Reject Approved:            

Final Disposition and Approval: Copy Distribution:


Comments:      
           
     
     
     
     
     
     
     
     

QC Inspector Signature Date:       Chevron Representative Signature Date:      

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 7 of 10
Coatings Inspection Report Form COM-EF-844-1

July 2016 © 19832016 Chevron U.S.A. Inc. All rights reserved. Confidential – Restricted Access 8 of 10

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