Form 3815 Gas Main Installation Quality Control Review Sheet

• Gas Main Installation Quality Control Review Sheet (Form 3815)
  
  *Reviews are to be completed on all main projects (service only projects are excluded)

• Document No.

• Conducted on

  Date

• Prepared by

Project Description

• Project Description:

• SAP Order Number:

• Date of Review:

  Date

• Crew Foreman:

• Company:

Design

• Installed per Design?

  Yes

  No

  N/A

• Field modifications approved by design engineer?

  Yes

  No

  N/A

Work Site

• Restoration (landscaping, grade, etc.) acceptable?

  Yes

  No

  N/A

• Installation within ROW boundaries?

  Yes

  No

  N/A

• ROW left in reasonable manner?

  Yes

  No

  N/A

Installation Per Standards

Materials Used as Specified:

• Pipe/Fittings (52-A, 53-A, 53-B)

  Yes

  No

  N/A

• Line Markers, Locate Stations (55-F)

  Yes

  No

  N/A

• Key Valves (61-B to 61-E)

  Yes

  No

  N/A

• Test Stations (55-F)

  Yes

  No

  N/A

Joining Method(s):

• Procedure(s) Used per Construction Standards:

• Welding (53-P)

  Yes

  No

  N/A

• Fusion (52-P)

  Yes

  No

  N/A

• Mechanical (52-P)

  Yes

  No

  N/A

Tapping/Stopping (53-K, 3130):

• Verify coupons were retrieved and Internal Inspection Form completed (Form 3170)

  Yes

  No

  N/A

Tracer Wire (52L):

• Taps Solder to Main Wire

  Yes

  No

  N/A

• Western Union Splice

  Yes

  No

  N/A

• DBY Splice Kits

  Yes

  No

  N/A

• Burial depths and separation met per Construction Standards (55-B):

  Yes

  No

  N/A

• Riser and meter set installed per Construction Standards (59-A):

  Yes

  No

  N/A

Backfilling

• Backfill Used (55-E):

  Native

  Imported

  Slurry

• Adequate Compaction (55-E):

  Yes

  No

  N/A

Special Crossings

• If applicable, verify all standards and/or requirements are met (road/rail/transmission):

  Yes

  No

  N/A

• Reviewed By

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