Job No.

OneBase Report No.

Hydrostatic Test Rcord Date

Page 1 OF 1

Pressure Gage Ser. No. Procedure No.

Pressure Gage Range Procedure Issue./Rev

Pressure Gage Calib. Date\ due date

Parameters Required Actual Remarks

Test Medium.

TestTemp.

Test Pressure

Holding Time

Close test Pressure

S. No. Dwg. No. Item No. Remarks

Leak Test have been performed and the result of the Hydrostatic Test
found :

Prepared By Approved By Reviewed By

Name : Name : Name :

Title : Title : Title :

Signature Signature Signature

Date : Date : Date :

WA QC Manual Rev.: 0 Date: 17/09/2023 Exhibit No. 05-02