PABSTA PO NO.

RN NO.

RELEASE NOTE Date –

PAGE 1 of 1

PROJECT: TPI SERVICES NORTH WEST ZONE Ref Insp Report No:

PABSTA CLIENT: M/s HINDUSTAN P/o NO.:

PETROLEUM CORPORATION LIMITED

MANUFACTURER: P/o NO.:

(Client to MFG.)

RN TYPE: COMPLETELY PARTIALLY BALANCE

SUPPLY/SUBJECT OF INSPECTION ITEM No. QUANTITY

AS PER CALL UP

SCOPE OF INSPECTION:
MTC, Visual, Dimensional, Fabrication ETC.

Refer Inspection Report No.(Details of Inspection Activities): :

CONCLUSION/REMARKS:

The above items have been released in accordance with specifications and purchase order requirements in
force at the time of inspection.

The above items have been released in accordance with specifications and purchase order requirements on
hand at the vendor’s premises at the time of inspection

INSPECTED BY: CHECKED BY:

NAME:

DOI:
DISTRIBUTION OF RN : √ CLIENT MANUFACTURER

Industrial Services
This Note is issued further to inspection whose duration and scope were limited by the terms and conditions of the contract
with PABSTA. This note is NOT an indication that the item(s) is (are)fit for any specific purpose and does not release the
manufacturer, supplier and any party from their respective duty, guarantee, obligation and /or indemnity relating to, without
limitation, patents workmanship, materials, safety, performance in operation and/or reliability.