Information

  • Location
  • Conducted on

  • Does the Asset Number match what is on record?

  • Please enter the updated Asset Number:

  • Work Order No:

  • Document No.

  • WORKING STREAM (Inspection only):

  • Inlet Pressure (kPa):

  • Outlet Pressure (kPa):

  • STANDBY STREAM (Inspection only):

  • Inlet Pressure (kPa):

  • Outlet Pressure (kPa):

  • General Inspection:

  • Check site housekeeping, DRS enclosure cleaned out.

  • Check data loggers are secure in cabinet.

  • Spray for weed control where applicable.

  • Check for leaks on all joints, valves, etc.

  • Functional check that standby stream kicks in.

  • Visual inspection of pig launchers/receivers.

  • Check, installed equipment on site all secure to prevent unauthorized usage.

  • Check signs (warning/no smoking/etc) are functional.

  • Check DRS enclosure for damage & water ingress.

  • GENERAL REPORT AND CONDITION:

  • IS THERE WORK TO DO?

  • MAINTENANCE WORK ORDER NO:

  • DO YOU NEED A PERMIT?

  • WORK PERFORMED:

  • OBTAIN A PERMIT

  • PERMIT NO:

  • WORK PERFORMED:

  • Work Order Complete - Name and Sign:

  • THE INSPECTION AND FUNCTION TESTS HAVE BEEN COMPLETED AS INDICATED:

  • Note: If Work Order is raised, additional database entry required when work approved as complete.

  • Work Completed By:

  • Report Checked By:

  • Report Approved By:

  • As-Inspected Report Database Entry By:

  • Work Order Complete Database Entry By:

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.