Project Name

PN: XXXXX
Piping Inspection Form

Inspection Form Serial no.:

 Contractor:

 System:

 Type of Inspection:

 Location:

Yes No NA Remarks

1. Pipe installation substantially completed?

2. All other branch/tee off closed?

3. Pipe inspected as installed?

4. Pipe inspected on the floor. Spool piece identified?

5. Pipe inspected identified on drawings?

(Drawing to be attached)

6. Pipe internal cleaned during branching & joining?

7. Pipe internal satisfactorily cleaned & branching

cut-outs accounted?

Remarks:

We certify that the line has been inspected by the following persons and that the internal of pipe is
satisfactorily clean for work downstream.

Completed by Witnessed by Approved by Accepted by

Company

Signature

Print Name

Date

XXXXX 3 CON 8749 REC 120 – Piping Inspection Form

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 1 of 1
Create Date: 22-Sep-2015 Revision : 2