Project Name

PN: XXXXX
HYDRANT / PIV / DELUGE STATION
INSTALLATION

System / Package No. Testpack No.

P&ID/Dwg No. Room No.

Equipment Name / Tag No.

NOTE: If a section is NOT relevant enter N/A

Item Yes No N/A Remarks
1. Is the nameplate correct?
2. Is the equipment free from physical / visual
damage?
3. Is the equipment clean and free from debris?
4. Has the equipment been aligned and levelled
and all civil works are complete?
5. Is the equipment position acceptable?
6. Have the protection bollards been erected?
7. Are the protection bollards painted correctly?
8. Have the temporary shipping items been
removed?
9. Is the pipework complete and tested, including
flanges, bolts and gaskets?
10. Are the valves free to operate and is greased?
11. Is the equipment installation in accordance
with the installation drawings, P&ID’s and
manufacturers’ recommendation?

Comments: (If there are NO ADDITIONAL remarks enter NONE, initial and date)
Reason to be written in comments section and, where applicable, raised as an exception or outstanding issue as
part of the system handover. If resolved prior to handover comments to be marked appropriately and signed of
accordingly.

Completed by Witnessed by Approved by Accepted by

Company
Signature
Print Name
Date

XXXXX 3 CON 8749 REC 12 –Hydrant PIV Deluge Station Installation

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 1 of 1
Create Date: 22-Dec-2011 Revision: 2