CONSTRUCTION CHECK SHEET I-005A

INSTRUMENTS

Orifice Plate
Pre-Installation Check
PROJECT
PROJECT No.
DESCRIPTION
SYSTEM
SYSTEM No.
DESCRIPTION
SERVICE
TAG No.
DESCRIPTION

MANUFACTURER MODEL No.

SERIAL No. REQN. No.
ORIFICE SIZE PEFS No.
Item Description of check Result
1. Check Orifice Plate is not damaged or corroded and is supplied as per Data Sheet
2. Check ‘UPSTREAM’ is clearly marked on correct side of Orifice Tag Plate
3. Check Tag Number as per Data Sheet is clearly marked on Orifice Tag Plate
4. Check ANSI Flange Class and ‘RF’ are clearly marked on Orifice Tag Plate
5. Check Nominal Size in DN (in mm) and Measured Orifice diameter are clearly marked on Orifice Tag
Plate
6. Check that the surface finish of the Throat and Plate are free from visible scratches and indentations
7. Check Throat Edges are sharp and free from burrs
8. Check that location and size of bleed/vent hole conforms to requirements for Orifice type
9.* Measure and confirm diameter of Orifice at ‘d’ on upstream flange face and note readings
10.* Check and confirm any two measurements of Plate thickness ‘t’ are within 0.001DN and note readings

Orifice Diameter at ‘d’

Horizontal
mm
80 deg. Axis
mm
d 120 deg. Axis
mm

Plate Thickness at ‘t’

1. mm 2. mm t

REMARKS / OBSERVATIONS: * Measurements 9 and 10 shall be witnessed by PDO

COMPLETED BY CONTRACTOR APPROVED BY JACOBS ACCEPTED BY CHEMETALL

NAME NAME NAME

COMPANY COMPANY REF. IND.

SIGN & DATE SIGN & DATE SIGN & DATE

REF. DEP 62.10.08.11-GEN.