Project Name: Umm Wu’al Phosphate Project 000 509 F75201

Contract Number: 16-KB-023

Project Location: Wa’ad Al shammal,KSA

PRESSURE TEST REPORT Report No.

Tag Description: Tag No.:
P. O. No.: Inspection Classification Turnover System:
Contractor: GAC GAC  MPC  Sub – System:
PMC  Other  Location:

Test Package No.: ___________________ Description: _____________________________________________________

Test Boundaries
P. &I.D. No.(s) R P. &I.D. No.(s) R P. &I.D. No.(s) R P. &I.D. No.(s) R

ISO No.(s) Sht R ISO No.(s) Sht R ISO No.(s) Sht R

Vessels or Equipment in test boundary:

Test Conditions
Test Medium _______________________________ Chlorine Content __________________
Test Media/Metal Temp Min._____________ Max.__________________ Actual______________
Ambient Temp. Min.____________________ Actual_________________
Test Pressure Min.________________ Max.______________ Actual_____________ Relief Valve Setting_______________
Holding Time: Min. ______________ Actual_____________

Test Gage M.T.E.________ Date Last ______________ Test Gage Low_______ High_______
Number: M.T.E.________ Calibrated: ______________ Range: Low_______ High_______

Pre-Test Inspections/Release
Pre-Test Walkdown Complete: Pipe Engineer Date
NDE, PWHT, PMI (if required) Complete/Accepted: QC Inspector Date

Verification of Satisfactory Test Results

QC Inspector Date
Client Inspector Date

Verification of Line Restoration

Pipe Engineer Date
Client Representative Date

Remarks:

For coordinate boundaried system such as oil water sewer, test beginning and ending coordinates shall be indicated on the attached
drawings.