:

:
:

Plumbing Fixtures
Urinal

Date Inspected
Location (Attach Key

:
:

ApplicableNot

AvailableNot

ITEM / REQUIREMENT

Plan)

Remarks / Corrective Actions

Due
Date

Close

REF. No.

Open

Plumbing System

ConformNon -

Conform

Building
Element/System
Category
Item/s to be inspected

SUBMITTALS:
A.1

Materials:
1. Type :
2. Brand:
4. Origin:

A.2
B

Shopdrawings

INSTALLATIONS:
B.1

Leveled

B.2

Location as per drawing

B.3

Roughing-in of supply as
required

B.4

Properly supported

B.5

Sealant between fixture and

wall

B.6

Flush valve working properly

B.7

Water pressure

TESTING PROCEDURES:
C.1

Flushing

C.2

Leaks

General Notes, Comments and Recommendations:

Inspected by :

Noted by :

_____________________________________
Site Engineer / Site Architect
Distribution:

Supplier

Concurred by :

_____________________________________
Project-in-Charge

__________________________________________
Supplier / Contractor

Contractor

OPI File

Note: A separate Non-Conformance & Corrective Action Report should be prepared for each and every non-conforming item
identified in this checklist.

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