CONSTRUCTION CHECK SHEET PFT – 0025A

PIPING
Flushing & Testing
PROJECT DESCRIPTION n-BUTYL LITHIUM DILUTION FACILITY PROJECT No. 44 – NC – 2900
SYSTEM DESCRIPTION PIPING FLUSHING & TESTING SYSTEM No. 19
SERVICE DESCRIPTION TEST No. PFT-0025A

Description of Item to be completed and Checked Results

Limits of Test in accordance with the Scope Listed on attached Test Index P-01 and marked up
PEFS

System prepared for flushing in accordance with the approved procedure

Flushing completed in accordance with the approved procedure *

System prepared for testing in accordance with the approved procedure

System tested in accordance with the approved procedure. (Note 1)

Test Results and Readings

Test Pressure at start BarG

Ambient Temperature at start Degree C

Start Date and Time Date Time

Test Pressure at end BarG

Ambient Temperature at end Degrees C

End Date and Time Date Time

Test Duration Hours / Mins.

Tested by Contractor Name Signature

Test Witnessed by * (Note2) Name Signature

Test Equipment Calibration

Serial No. : Range : BarG

Test Certificate No. Date of Issue Expiry Date

REMARKS / OBSERVATIONS: * PDO WITNESS POINT

NOTES:

COMPLETED BY CONTRACTOR APPROVED BY JACOBS ACCEPTED BY CHEMETALL

NAME NAME NAME
COMPANY COMPANY REF. IND.
SIGN & DATE SIGN & DATE SIGN & DATE