Project

Test Pack
Contract
Form : CCL-014 Service Description:
System: Drawing s!
"y#rostatic Test Pne$matic Test Service Test
Doc$ment %e&erence:
Underground Piping Pressure Test Record
Item: Description of Item to be Checked:
Acceptable
1 'ttac( #rawing an# )ine )ist marke# $p to in#icate t(e scope o& t(is Test %ecor#*
Done
+ Con&irm Test Pack prepare# an# approve# , -
. Con&irm a)) -D/ works comp)ete an# accepta0)e
, -
P 1 2D 3perating Press$re
Design Co#e 3perationa) 4e#i$m
Design Press$re Design Temperat$re
Test Press$re Test Temperat$re
4a5 Test Press$re 'm0ient Temperat$re
Test Press$re 6 start Test Press$re 6 comp)etion
D$ration o& Test D$ration o& Test %e7$ire#
Test Instrument Serial # Calibration Range Calibration Date
Press$re %ecor#er C(art Temperat$re %ecor#er C(art 3t(er
Remarks:
Pressure Test as successfull! concluded" itnessed and accepted b! the signatories belo:
Acceptance
Subcontractor SC
#ame #ame
Signature Signature
Date Date