SAUDI ARAMCO MOBIL REFINERY CO., LTD.

INSPECTION & EQUIPMENT RELIABILITY SECTION

REQUEST Inspection Form
REFERENCE FOR INSPECTION No. 03
FEQA TO BE RAISED BY MAINTENANCE / CONTRACTOR RFI NO:
PROCEDURE AND THEN TO BE SUBMITTED TO AFL-025
INSPECTION GROUP LEADER
T8-020 Date :
8/16/2020

TSR / W.O No. : C-2019-012-01 PROJ. / MAINT. ENG. : Hassan Al-Harbi

TSR / W.O Title : 12-G-03 ABC Seal Flush Upgrade CONTRACTOR : Arabian Fal Company
Equipment / Line : Flush Upgrade Equipment / Line No :

INSPECTION REQUISITION

DESCRIPTION: DATE REQUIRED: 16-Aug-20

APPROXIMATE TIME
AVAILABLE FOR
NDE RT Test Film Review and result of Seal INSPECTION : 10:00 AM
Flush Joints (5 joints)

REQUESTED BY: ISRAR HUSSAIN Arabian Fal QC Inspector

NAME COMPANY POSITION

APPROVED BY:
MAINTENANCE / OPERATIONS / CONTRACTOR SUPERVISOR

INSPECTION ASSIGNMENT (TO BE COMPLETED BY INSPECTION GROUP)

INSPECTION GROUP LEADER'S INSTRUCTIONS:

INSPECTORS

TYPE OF INSPECTION PERFORMED:

DATE COMPLETED:

INSPECTION REPORT NO. OR

ANY OTHER ACTION RECOMMENDED:

DOES A FOLLOW-UP INSPECTION IS REQUIRED: YES NO

FEED BACK: INSPECTOR APPROVED: INSPECTION GROUP LEADER

NAME: NAME:

SIGNATURE: Date: SIGNATURE: Date: