Title Page

  • Client / Site: Barwon Water - Black Rock WRP Inlet Works Upgrade 400 Black Rock Connewarre Cable ID No:

  • Conducted on

DETAILS

  • Inspection Area

  • Reference: BW Technical Specification Rev 0 Clause:

  • Document No. CA-CS-013_2 ITP No:

TESTING

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

  • Rack

  • Slot

  • Input/Output

  • Input change test verified

  • Output energise verified

APPROVALS

  • Actions to be taken:

  • Entered on Punch List

  • Punch list Reference Number:

  • Item No:

  • Meter Make & Model:

  • Meter Serial Number:

  • Calibration Date

  • Person Completing the Checklist

  • Signature:

  • Agfab Approval By:

  • Signature:

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