• Select date


  • Client site: Barwon Water - Black Rock WRP 400 Black Rock road Connewarre

  • Project No: 22884

  • ITP No:

  • ITP description:

ITP/ITC Format

  • Is the ITP format consistent with Client ITP format expectation:

  • Does it show document No. (ie. ITP/ITC No.), issue number and issue date:

  • Are there separate areas for the contractor and Client representatives to sign:

  • Has a specific person/role been designated for signing off hold points and is this person on the Authorised Signature Register:

ITP Approval

  • Is the ITP/ITC approved by an authorised quality representative of the sub/contractor:

ITP Content

  • Does it address OHS / Environmental critical activities:

  • Does this ITP relate to an identifiable work element / work lot type of the WBS of the project:

  • Do all the work activities/steps listed under that work element clearly represent the complete scope of the applicable drawing and not exclude any critical items:

  • Are all the activities under that work element properly listed in a sequence: Eg. Preliminaries / work content / closeout

  • Is the work area or location mentioned on the ITP:

  • Does it incorporate Client Hold & Witness points: Are these points clearly differentiated from the contractor’s own H & W points


  • Does it reference specific clauses and drawing numbers rather than “as per Client specs”

Acceptance Criteria

  • Does it reflect clear and comprehensive acceptance criteria (in term of numerical values) for each activity/step as stipulated in design/drawing, technical specifications and applicable standards:

Inspection Method/Frequency

  • Is the method and frequency of testing clearly listed for each activity:


  • Are the records to be kept as evidence clearly listed:

  • Does the ITP note that photos are required for buried assets and key pipeline connection points as a record:


  • In the Records column, does it clearly reference any checklists for repetitive items rather than having single signoff points which would not produce sufficient evidence of conformance with specifications:

Subcontractor ITP accepted

  • Does this ITP meet client requirements:

  • Any other comment :

ITP Status Inspection

  • Is Agfab inspectorate up to date:

  • Is Customer inspectorate up to date:

  • Is evidence available to verify records are up to date:

Sign off

  • Person completing the checklist

  • Signature of the person completing the checklist

  • Select date

  • Client representative

  • Signature of client representative

  • Select date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.