CONSTRUCTION CHECK SHEET I-008A

INSTRUMENTS
Instrument Impulse Line
Pressure Test
PROJECT
PROJECT No.
DESCRIPTION
SYSTEM
SYSTEM No.
DESCRIPTION

Instrument Impulse Lines connected to the following Instruments are correctly installed as per Project
HOOK-UP and PEFS Drawings and have been Pressure Tested at 1.5 times Operating Pressure
Seal Line Seal Line
Instrument Test Instrument Test
PEFS No. Pot Drained PEFS No. Pot Drained
Tag No. Pressure Tag No. Pressure
Fitted & Clean Fitted & Clean

TEST EQUIPMENT DESCRIPTION SERIAL NO. CERTIFICATION EXPIRY DATE

REMARKS / OBSERVATIONS:

COMPLETED BY CONTRACTOR APPROVED BY JACOBS ACCEPTED BY CHEMETALL

NAME NAME NAME
COMPANY COMPANY REF. IND.
SIGN & DATE SIGN & DATE SIGN & DATE