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Inspection Testing Repair Form
Inspection Testing Repair Form
Set-Pressure
Leak Pressure Back Pressure Media
CDTP
Manufacturer Class Last Dismantle
Work Order
Type (C/BB/P/V) Interval Date PM CM
Weep Halls
Condition Condition Covers
Field
Result
Actual Pop (As per Construction
(Shall not Exceed 150% CDTP)
Code)
Un-Satisfactory (If failed to open within acceptance criteria)
Condition
B Corroded D Dirty F Fouled H Pitted J Stuck
Overhaul Adjustment
Overall Result
Yes No Yes No
Disc Spindle Cap Gasket
Broken / Damaged Nozzle Seat O-Rings Pilot Kit Tested By
Spring Bellow Guide Orifice
Pallets
Sticking Corroded Normal
Condition
Vacuum Breakers Notes
Flame
Fouled Plugged Normal
Arrestors
Flange Re-
Cleaned Lapped Machined
Faced
Parts Replaced
Repairs
Other Remarks
Additional Spares
Satisfactory
Final Test CDTP Result Justification
Un-Satisfactory
Final
Test
Satisfactory Spring
Leak Test Result Leakage Rate Adjustment
Un-Satisfactory
(±MM)
Additional
Next Recommendation
Current Inspection Interval
n
Inlet /
Tested By Signature Shipping Tagged Outlet Shipped On
Covered
(Area Planner)
Interval Change
ds
Signature
Meridium Update Signature Raised By
(Static Inspector)
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