PIPE INSULATION

PROJECT NO. : FORM NO . : QC-6

PROJECT NAME : QA / QC FORM DATE :

REPORT NO. : SITE INSPECTION & TEST REPORT SHEET OF

INSUL. THK.(mm)
ITEM COVER SURFACE
NO. LINE NO. PIPE CLASS QTY. (ML)
THK.(mm) (m2) REMARKS
HOT COLD

10

11

12
APPROVED BY :
CONTRACTOR : INSPECTOR :
NAME : NAME :

DATE / SIGN. : DATE / SIGN. :