System Pre-Commissioning Sign-Off

Michael Lonsdale Group Part 2: Pre-Commissioning Test Pack

Project Name & No: Paddington Cube, ME2905 Task Undertaken : OLBI Supply System

System: Electrical Floor / Zone Ref:

MJL Pack Ref : 7000-MJL-E-ATP-209 Client Pack Ref:

Issued By:

Name: Steve Cowley Signature:

Date: Position: Trainee Engineer

This certifies that the above system has been pre-commissioned in accordance with the specification and relevant codes of practice and is
available for commissioning.

Demonstrated / Witnessed by:

Company Name Signature Date Comments Ref

Status Snags Completed Minor Snags - Does not affect commissioning

starting

By: Cleared: Accepted:

Ref. Comments / Exceptions
Initial Org Initial Date Initial Date

Attachments :
Pre-commissioning Test Sheets
Calibration Certifcates (if applicable)
Pre-commissioning Certificate

Form Ref. MJL/COMM/002 REV02 27.05.2021