Project Name

PN: XXXXX
CLEANING TREATMENT REPORT

System / Package No. Testpack No.

P&ID/Dwg No. Room No.

Equipment Name / Tag No.

1.0 Pre- Cleaning Controls Initial & Date

1.1 Ascertain all incompatible materials are removed. YES NO

1.2 Installation of test spool(s) for 'ferroxyl' test YES NO

Line check of the entire loop circuit to ensure the
1.3 YES NO
same as the planned circuit
Temporary equipment verified and accepted as
1.4 YES NO
'clean'

2.0 Pre-Flushing & Leaking Test Initial & Date

Conductivity
Type of water
2.1 ≤ ________
used
us/cm
Flow
Circuit supply velocity
2.2
line pressure Min.
______ m/s
2.3 Start Date / Time
2.4 End Date / Time
Outgoing
Incoming water
2.5 flush water
pH value
pH value

Degreasing Treatment
3.0 Initial & Date
Circuit Volume + 10 % =
Conductivity
Type of water
3.1 ≤ ________
used
us/cm
Flow
Circuit supply velocity
3.2
line pressure Min.
______ m/s
3.3 Type of chemical agent(s) Quantity
3.3.1 Trisodium phosphate 1.0% wt.

XXXXX 3 CON 8749 REC 105 –Cleaning Treatment

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 1 of 4
Create Date: 22-Dec-2011 Revision: 2
Project Name
PN: XXXXX
CLEANING TREATMENT REPORT

3.4 Start Date / Time

3.5 End Date / Time

3.6 Strength & Concentration verified / Date

Type of water Solution Temp.
3.7
used Max. _______ oC
Circuit supply pH Value
3.8
line pressure ______ to ______

4.0 Post Degreasing Water Flushing Initial & Date

Type of water Conductivity
4.1
used ≤ ________ us/cm
Circuit supply Flow velocity
4.2
line pressure Min. ______ m/s
4.3 Start Date / Time

4.4 End Date / Time

Incoming water Outgoing flush
4.5
pH value water pH value

Pickling Treatment
5.0 Initial & Date
Circuit Volume + 10 % =
Type of water Conductivity
5.1
used ≤ ________ us/cm
5.2 Type of chemical agent(s) Quantity

5.2.1 Citric acid 3.0% wt.

Circuit supply Flow velocity
5.3
line pressure Min. ______ m/s
5.4 Start Date / Time

5.5 End Date / Time

5.6 Strength & Concentration verified / Date

Solution Temp. Solution Temp.
5.7
Min _______oC Max. _______ oC
pH Value
5.8 Contact Time
≤ _______

XXXXX 3 CON 8749 REC 105 –Cleaning Treatment

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 2 of 4
Create Date: 22-Dec-2011 Revision: 2
Project Name
PN: XXXXX
CLEANING TREATMENT REPORT

6.0 Post Pickling Water Flushing Initial & Date

Type of water Conductivity
6.1
used ≤ ________ us/cm
Circuit supply Flow velocity
6.2
line pressure Min. ______ m/s
6.3 Start Date / Time

6.4 End Date / Time

Incoming water Outgoing flush
6.5
pH value water pH value

Passivation Treatment
7.0 Initial & Date
Circuit Volume + 10 % =
Type of water Conductivity
7.1
used ≤ ________ us/cm
7.2 Type of chemical agent(s) Quantity

7.2.1 Nitric acid 20.0% wt.

Circuit supply Flow velocity
7.3
line pressure Min. ______ m/s
7.4 Start Date / Time

7.5 End Date / Time

7.6 Strength & Concentration verified / Date

Solution Temp. Solution Temp.
7.7
Min _______oC Max. _______ oC
pH Value
7.8 Contact Time
≤ _______

8.0 Post Passivation Water Flushing Initial & Date

Type of water
8.1
used
Circuit supply
8.2
line pressure
8.3 Start Date / Time

8.4 End Date / Time

Incoming water Outgoing water
8.5
pH value pH value

XXXXX 3 CON 8749 REC 105 –Cleaning Treatment

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 3 of 4
Create Date: 22-Dec-2011 Revision: 2
Project Name
PN: XXXXX
CLEANING TREATMENT REPORT

Final Water Flushing

9.0 Initial & Date
(Inclusive of all Point-of-Use)
Incoming water
Outgoing flush
9.1 conductivity
water conductivity
≤ ______ us/cm

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 105 –Cleaning Treatment

Prepared By: Amalina Kamal Revision Date: 16-Mar-2020 Page 4 of 4
Create Date: 22-Dec-2011 Revision: 2