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PRV inspection Procedure

Inspection, Testing, & Repair Form


Inlet/Outlet Inspection Date
Tag # Unit
Size & Location
Basic Data

Set-Pressure
Leak Pressure Back Pressure Media
CDTP
Manufacturer Class Last Dismantle
Work Order
Type (C/BB/P/V) Interval Date PM CM

Inlet Piping Outlet Piping Atmospheric


Inspection

Weep Halls
Condition Condition Covers
Field

Support Condition Bolts Condition Flange / Thread Paint Condition

Pre-Test Done Waived Justification

Result
Actual Pop (As per Construction
(Shall not Exceed 150% CDTP)
Code)
Un-Satisfactory (If failed to open within acceptance criteria)

Leak Test Result Pass Failed Leakage Rate


(As per API 527)
A Good C Eroded E Broken G Plugged I Bent
As Found

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

Inspector Date Time Signature

Satisfactory
Final Test CDTP Result Justification
Un-Satisfactory
Final
Test

Satisfactory Spring
Leak Test Result Leakage Rate Adjustment
Un-Satisfactory
(±MM)

Previous Inspection Result


Interval
Change
Recommendatio

Additional
Next Recommendation
Current Inspection Interval
n

Inlet /
Tested By Signature Shipping Tagged Outlet Shipped On
Covered

Accepted By Signature By Signature

SAP Record Update Signature Calibration


Recor

(Area Planner)
Interval Change
ds

Signature
Meridium Update Signature Raised By
(Static Inspector)

C: Conventional BB: Balanced Bellow P: Pilot V: Breather Valve/Vacuum valve

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This Form is controlled document under PRD Management System.

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