No:______

Pre Cover Up Check & Tank Test Sheet

Location: ________________________________
Date:
_______________
_________________________________________
Work to be covered up.________________________________________
Yes

No

Yes

No

Yes

No

MATERIALS IN PLACE AS PER DETAIL

Comments

AREA CLEAR OF DEBRIS

Comments

BACK FILL MATERIAL AS PER SPECIFICATION

Comments

OTHER

SQP11-2

Page 1 of 2

RECORD OF TANK TEST

DATE

TIME

TANK
CONTROL
READING READING

DIFF

LC
INITIALS

Yes

CLIENT
INITIALS

No

ACTION REQUIRED FROM TANK TEST;

Signatures
Engineer

Date
____________________________
_______________

Section Construction
Manager

____________________________
_______________

Other

____________________________

SQP11-2

_______________

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