Form No.

: ICS‐VT‐0001                  
Edition No.: 05                                
 Edition Date: 2018/01/01             

            
Inspection Visit Report
Iranian Classification Society

Client: Office: IVR No.:

Project: Supplier: Notification No.:
Main Order No.: Sub Supplier: Job File No.:
Inspection Date: Inspction Place:

1) Material/ Equipment Inspected:
Material ID
Heat/  Serial/  Reference
No. Material Full Description Batch/  Tag/ Unit Qty. Brand
(MTO/ PO/ PI etc.)
Lot No. ID No.

Notes:

2) Scope Of Inspec on
Meeting Quantity Packing
Visual Inspection Review Of Documents Loading Shipping
Dimensional Control Hydrostatic Test PMI
Fit Up Pneumatic Test Performance
Welding Inspection Fabrication Inspection SAT
Marking Check Surface Preparation FAT
Raw Material Inspection Coating Inspection Hardness Test
PWHT/ PFHT Insulation Sampling
PT Material Analyses Wiring Checking
MT Balance Test Hi‐Pot Test
UT MRT Megger Test
RTI Technical Spec. Check Function Test
WQT Phase Array Corrosion Monitoring
Other (see note)
Notes:

3) Applicable Documents (Inspec on Reference):
Project's Specifications and Documents (ITP, QCP, DWG, Procedure, Data Sheet, etc.):
No. Reference No. Title Revision Approved Status

Codes and Standards:
No. Reference No. Title Revision/ Edition

Notes:

Inspector's Name & Signature:   Approved By:

Tel: +98 21 421 86 000                
Fax: +98 21 883 24 734               
Add: #5.,Shanbam Alley.,Ghaemmagham Email: info@ics.org.ir                  
Farahani Ave.,Tehran   P.O.Box: 1589675951
 Form No.: ICS‐VT‐0001                  
Edition No.: 05                                
 Edition Date: 2018/01/01             

            
Inspection Visit Report
Iranian Classification Society

Main Order No.: Visit Report No.: Page: 2 of 3

4) Instruments used:
No. Name Brand Model Serial No. Calibration Cert. No.

Notes:

5) Inspec on Performed:

5.1. Scope Of Inspection
            Test Frequency/ Sample Size:
            Reference:
            Acceptance Criteria:
            Description:
            Result:

Inspector's Name & Signature:   Approved By:

Tel: +98 21 421 86 000                
Fax: +98 21 883 24 734               
Add: #5.,Shanbam Alley.,Ghaemmagham Email: info@ics.org.ir                  
Farahani Ave.,Tehran   P.O.Box: 1589675951
 Form No.: ICS‐VT‐0001                  
Edition No.: 05                                
 Edition Date: 2018/01/01             

            
Inspection Visit Report
Iranian Classification Society

Main Order No.: Visit Report No.: Page: 3 of 3

6) Further Progress:
Yes
No
Up to client
Notes:

7) Conclusion:
Satisfactory Unsatisfactory Conditional

8) A achments:
No. Title/ Doc. No. Document No. Type and Status (Copy or Original) Sheets/ Qty.

Notes:

9) Photos:
Notes:

This IVR does not relieve the supplier of their responsibility to comply with client's requirement to supply the item(s) concerned in full 
compliance with the requirement of their purchase order / pro forma invoice specifications. This document is issued by the company 
under its General Conditions of Service accessible at http://www.ics.org.ir. Attention is drawn to the limitation of liability, 
indemnification and jurisdiction issues defined therein

Inspector's Name & Signature:   Approved By:

Tel: +98 21 421 86 000                
Fax: +98 21 883 24 734               
Add: #5.,Shanbam Alley.,Ghaemmagham Email: info@ics.org.ir                  
Farahani Ave.,Tehran   P.O.Box: 1589675951