Information
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Z- Tech Ref: Q
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Asset Name/SOM Number:
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Site Name:
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Conducted on
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Personnel
CUSTOMER INFORMATION
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Customer
- Thames Water
- Anglian Water
- Severn Trent
- Scottish Water
- Veolia Nevis
- Veolia Central
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Type of Work
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Thames Water SAP Id:
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Type of work
SITE INFORMATION
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Address
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GPS Position
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Access Requirements
- 36 Key
- 000 Kaba
- 001 Kaba
- X Key
- Waterspace Key
- NLAR Keys
- TWRM Fob
- LRED
- Special Arrangement
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Special Arrangements details
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Control Centre
- Bourne End
- LWCC North
- LWCC South
- LWCC Ring Main
- Coppermills
- Other
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Details
CHAMBER DETAILS
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Cover Lifters
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Chamber Type
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Other details
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Chamber Size (H x W x D)
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Chamber Condition
- Good
- Ok
- Poor
- Flooded
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Type Of Pump Required
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Enter Requirements
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Pipe OD
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Pipe Material
- Ductile Iron
- Cast Iron A/B
- Cast Iron C/D
- MDPE
- HDPE
- Steel
- Asbestos Cement
- Other
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Wall Thickness
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Wall Thickess
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Wall Thickness
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Wall Thickness
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Wall Thickness
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Wall Thickness
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Liner Information
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Steel Type
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Wall Thickness
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Wall Thickess
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Wall Thickness
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Liner Information
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Other details
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Confined Space
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Entry Type
- Class 0
- Class A
- Class B
- Class C
- Class D
- Other
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Other details
FLOWMETER DETAILS
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Process Flowmeter
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ICA & PTW Required
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Manufacturer
- ABB
- Krohne
- Fisher Porter
- Panametrics
- Siemens
- Kent
- Calaray
- Sarasota
- Danfoss
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Calaray Flowmeter Type
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Krohne Flowmeter Type
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ABB Flowmeter Type
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Location ID
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FI Value
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FP Value
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Location ID
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FI Value
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FP Value
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Fischer & Porter Flowmeter Type
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Panametrics Flowmeter Type
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Siemens Flowmeter Type
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Kent Flowmeter Type
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Sarasota Model Number
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Danfoss Model Number
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Sensor Serial No.
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Sensor Installation Photos
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Chamber Location Photos
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Flow Converter Serial No.
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Flow Converter Installation Photos
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Flow Converter Location Photos
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Telemetry Method
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Radcom ID
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RTAP Alias
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Rack No
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Slot No
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Input No
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Logger Manufacturer
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Model
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Model
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Details
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Other Details
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Protocol
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RTU/PLC Type
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Model
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Model
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Model
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Model
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Details
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Operating Units
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Operating Range
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Output Range
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Pulses/unit
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Power Supply
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Supply Voltage
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Taken from? (DB No/Spur or other)
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Auxilliary Outputs
Verification Details
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Secondary Verification
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Verification position Photos
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Location Details
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Poor (low-confidence) location details?
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Test Equipment
- Siemens FUP1010
- Panametrics PT878
- Aquaprobe II
- Hydrins Insertion Probe
- DF868
- AT868
- RIver Surveyor
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Reason For Poor Diagnostics
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Location ID
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Location FI
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Location FP
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Reason For Poor Location
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Number Of Traverses Completed (Minimum Of Ten Required)
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Flow Converter Output Logged
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Visual Inspection carried out
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IP Check (seals, glands & potting)
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Action taken?
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Manufacturers Diagnostic Check
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Serial No.
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Earthing & Bonding
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Action taken?
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Terminations & Insulation
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Action taken
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Loop Check
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Bi-Directional?
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0% Actual
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25% Actual
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50% Actual
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75% Actual
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100% Actual
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-100% Actual
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-50% Actual
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0% Actual
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50% Actual
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100% Actual