QUALITY CONTROL PLAN (QCP)

& WORK COMPLETION REPORT

QCP

WORK DATE WO NO EQUIPMENT NO

REFERENCE
NO
EQUIPMENT DESCRIPTION

ACTIVITY DESCRIPTION

Inspection by Name of inspection authority Control activities

1. Contractor 2. Maint. Supervisor 3. Safety 1. 2. 3. W: Witness V: Verification P: Programming Sm: Simulation Ra: Repair
4. Engineer 5. Cond. Mon 6. Production 7. Fuel & Ash 8. 4. . 5. 6. 7. Ca: Calibration T: Testing Ip: Inspection M: Modification Rl: Replacement
Third Party 9. I&C Tech. 10.Mechanic 11. Electrical Tech. 8. 9. 10. 11. St: Setting N: NDT It: Installation Cl: Cleaning A: Adjustment

Safety Equipment required Special Requirement

Overall PVC Suit Goggles / safety eyes Crane Water Truck
Hard hat Gum boots Rubber apron Scaffold Fire Truck
Safety shoes  Acid resistant overall Leather gloves Forklift Loader/ Dump Truck/ Excavator
Face shield  Safety harness Rubber gloves Gondola Special Tools

Sign Sign
PRE WORK Control activities Duration Date
POMI Contractor
Task
Task Description 1 2 3 4 5 6 7 8 9 10 11
No

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 QUALITY CONTROL PLAN (QCP)
& WORK COMPLETION REPORT

RE-COMMISSIONING WORK
1
2
3
RESULT
Value
Measurement Responsible
As Found OEM/Acceptance Criteria As Left Remark

Note: All reference of technical information details such as: clearances, gaps, tolerances and fits, setting values, engineering drawings, cross sectional
drawings, and other supporting documents shall be attached into this QCP package for control measure of work quality output.

Parts and Consumables (Including other cost) Utilization

Description Qty Stock/PO No Cost $ Comments

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 QUALITY CONTROL PLAN (QCP)
& WORK COMPLETION REPORT

FURTHER ACTION / SUGGESTION :

OTHERS:
Other Requirement :

POMI Personnel Responsibility:

I hereby declare that this QCP has been physically checked and inspected prior to equipment reassemble/reinstatement.

I also declare that the nature and location of this work, as well as all the warning signs, instructions and
mechanical/electrical/instrument & control isolations (temporary) have been removed/restored and the equipment ready for
commissioning.

SIGN OFF
Name Designation Company Signature

Performed By

Checked/Verified By

Approved By

Date Start Time Start Date Complete Time Complete

Job Duration

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 QUALITY CONTROL PLAN (QCP)
& WORK COMPLETION REPORT

Note :
Attached Document/Figure : YES NO

If this form is not adequate to feedback the inspection report, attach the report separately to this document.

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