Page :

' PROJECT NAME ' Inspect Date :

CATHODIC INSPECTION REPORT

CLIENT : REPORT NO :
SYSTEM : REFF. DRAWING :
AREA : CATHODIC TYPE : SACRIFIAL ANODES

VISUAL CHECK

NO INSPECTION CHECK YES NO N/A REMARKS

Check that cathodic system is installed in compliance with approved construction
1
drawings.

2 Check that materials which supplied in compliance with design drawing.

3 Check that cable connections is installed properly

4 Check that sacrifial anode is buried to correct depth

5 Check that cable termination in terminal test point

6 Measure value of potensial each point

POTENSIAL MEASUREMENT
RESULT
TEST POINT
NO PASS REMARKS
NO. VALUE (mV)
/FAIL

Prepared & Inspected by Inspected by PT PP Accepted by Client

Subcontractor

Name
Date