PROJECT DEVIATION FORM

Project Name Document Number:

Contractor
PO number
Supplier
Deviation form

Originator Date
Position
Subject
Reference Specification
Category Pressure Vessel  QA/QC
 Piping  Electrical
 Rotating  Corrosion and Material
 Instrument  Pipe fittings
 Civil  Thermal Insulation
 Structure  HVAC

Description of the Deviation

Justification

Impact of the deviation

  Health and Safety  Environment  Integrity  Process Safety  Project Schedule

Contractor Signatures

Originator: ………………………………………………………………………………………………………………………….

Project Engineer: ………………………………………………………………………………………………………………..

Project Manager: ………………………………………………………………………………………………………………..

Owner Approval

Justification for Approval:

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Approved By

Discipline Engineer: …………………………………………… Signature…………………………… Date ………………………………

Inspection Engineer: ………………………………………. Signature………………………… Date…………………………………

Engineering Manager: ……………………………………… Signature………………………………………………………….

Inspection Manager ………………………………………… Signature ………………………………………………………….