Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Select date

  • Add location
  • Initial Inspection

  • Follow-Up Inspection

Description of Location

Safety/Housekeeping

  • Scrap material picked up

  • Proper PPE being worn-Face shields required if shooting into concrete or cutting

Materials

  • Raupex 3/4" cross linked polyethylene

  • PVC Bend Guides at 90 degree bends

  • Nylon Zip Ties

  • Low-e slab shield for slab on grade applications

Installation

  • Minimum bend radius for cold bending shall not be less than FIVE times the outside diameter=4.375"<br>

  • Secure tubing to wire mesh every 2-3' along straight runs and on 180 degree turns at the top of the arc and at each side, 12" from the top of the arc

  • No tubing splices installed

  • Pressurize to 60 psig 24 hours prior to incasement

  • Do not extend pipe through expansion, construction, or working joints

  • Do not tighten manifold fittings more than 1/2 turn after hand tight

  • 9" spacing between tubing per design basis<br>

  • Slab sensor located per Landscape drawings

  • Keep pipe 6" from edge of slab

  • No overlapped pipe

  • Minimum 2" concrete on top of tubing

Misc.

  • Contractor drawings are current set with applicable changes posted

  • Photos attached

  • BIM drawings attached

  • Details attached

  • Incomplete items moved to QUIT log?

  • Add media

  • Add media

Mortenson Signature

  • Add signature

RK Signature

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Additional Signatures

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  • Add signature

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.