MCK. KUTTY ENGINEERS Pvt. Ltd.

Form No. QSR/MECH/ (Rev. 00/00)

QUALITY SURVEILLANCE RECORD

MECHANICAL WORK

CHECK LIST FOR PIPELINES: ERECTION

Report No.: ………..…………….. Date:…………

1. Project :

2. Name of Job :

3. Name of Contractor :

4. LOA No. / Work Order No. :

5. Unit / Location :

6. Drawing No. :

7. Line No. / Service :

8. Size and length of pipe :

9. Welder’s test certificates scrutinised and :

accepted (indicate date of qualification/
re-qualification / re-validation and
position qualified)

10. Total No. of butt weld joints :

11. Total No. of other joints :

12. No. of butt welds Radiographed / :

Accepted

13. No. of other welds UT Accepted :

14. Indicate other NDT (DP/MPT) conducted, :

if any

15. No. of supports as per drawing :

16. No. of supports provided :

qsr mech-doc (Issue 00/00- Dec'12) Sheet 1 of 2

 MCK. KUTTY ENGINEERS Pvt. Ltd.

Form No. QSR/MECH/ (Rev. 00/00)

17. Pressure testing of valves done, checked

: YES / NO
& accepted (before installation)

18. Pipelines checked, accepted & cleared for

: YES / NO
Pressure testing

19. Remarks, if any :

EMPLOYER DASTURCO CONTRACTOR

qsr mech-doc (Issue 00/00- Dec'12) Sheet 2 of 2