Title Page

  • Audit Title

Job/Fuser Information

  • Ticket Number

  • Company on Site

  • Fuser ID #

  • Fuser Name

  • Peer Emp #

  • Peer Fuser

  • Pipe Size

  • Address
  • County

  • Inspection Date and Time

  • Con Ed Supervisor/Inspector's Emp #

  • M&S Plate

  • Number of Fuses Inspected

  • Pressure

  • Year Installed

Pipe Inspection

    Add a Fuse
  • Joining Type

  • Type of Inspection

Process Inspection

  • Is Iron free of scratches?

  • Fuse Failed!

  • Is the Fuser OQ'd in Butt Fusion?

  • Fuse Failed!

  • We're the correct temperatures used?

  • Fuse Failed!

  • Was the iron Temperature checked?

  • Fuse Failed!

  • We're the proper pressures used?

  • Fuse Failed!

  • Was the fuse peer inspected and signed by peer inspector?

  • Instruct them that this is required for every fuse or mechanical joining.

  • Was the fuse signed by the Fuser?

  • Instruct them that this is required for every fuse or mechanical joining.

Visual Inspection

  • Uniform Roll Back completely around pipe?

  • Fuse Failed!

  • Is the Fuser OQ'd in Butt Fusion?

  • Fuse Failed!

  • High/Low Okay?

  • Fuse Failed!

  • Properly aligned pipe? (No miter Joints)

  • Fuse Failed!

  • Is bead size sufficient for size of the pipe?

  • Fuse Failed!

  • Fusion clear of any contamination?

  • Fuse Failed!

  • Was the fuse signed by the Fuser?

  • Instruct them that this is required for every fuse or mechanical joining.

  • Was the fuse signed by the peer inspector?

  • Instruct them that this is required for every fuse or mechanical joining.

  • Any other visual indications of a poor fuse observed? If yes, please make documentation below

Process Inspection

  • Is Iron free of scratches?

  • Fuse Failed!

  • Is the Fuser OQ'd in Butt Fusion?

  • Fuse Failed!

  • We're the correct temperatures used?

  • Fuse Failed!

  • Was the iron Temperature checked?

  • Fuse Failed!

  • We're the proper pressures used?

  • Fuse Failed!

  • Uniform Roll Back completely around pipe?

  • Fuse Failed!

  • High/Low Okay?

  • Fuse Failed!

  • Properly aligned pipe? (No miter Joints)

  • Fuse Failed!

  • Is bead size sufficient for size of the pipe?

  • Fuse Failed!

  • Fusion clear of any contamination?

  • Fuse Failed!

  • Was the fuse peer inspected and signed by peer inspector?

  • Instruct them that this is required for every fuse or mechanical joining.

  • Type of Electrofuse?

  • Type of Inspection

Process Inspection

  • Was the pipe properly faced?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly cleaned? Removed all debris and wiped with an alcohol pipe that meets standards.

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly measures and marked?

  • Fuse failed! Needs to be fuse out and redone.

  • Did the Fuser check to ensure pipe meets dimensional requirements? Does not exceed 5% ovality.

  • Fuse failed! Needs to be fuse out and redone.

  • Was pipe properly marked?

  • Fuse failed! Needs to be fuse out and redone.

  • Was pipe properly scraped?

  • Fuse failed! Needs to be fuse out and redone.

  • Is fusing equipment current on inspections and calibrations?

  • Fuse failed! Needs to be fuse out and redone.

  • We're clamps used sufficiently to ensure proper alignment?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse allowed specified amount of time to cool?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse marked with time to remove clamps?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse Peer checked?

  • Fuse failed! Needs to be fuse out and redone.

Visual Inspection

  • Proper alignment?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly scraped?

  • Fuse failed! Needs to be fuse out and redone.

  • Pipe inserted properly?

  • Fuse failed! Needs to be fuse out and redone.

  • Did the Fuser sign the pipe properly?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the fuse peer checked and signed?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the fuse signed by the Fuser?

  • Instruct them that this is required for every fuse or mechanical joining.

Process Inspection

  • Was the pipe properly faced?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly cleaned? Removed all debris and wiped with an alcohol pipe that meets standards.

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly measures and marked?

  • Fuse failed! Needs to be fuse out and redone.

  • Did the Fuser check to ensure pipe meets dimensional requirements? Does not exceed 5% ovality.

  • Fuse failed! Needs to be fuse out and redone.

  • Was pipe properly marked?

  • Fuse failed! Needs to be fuse out and redone.

  • Was pipe properly scraped?

  • Fuse failed! Needs to be fuse out and redone.

  • Is fusing equipment current on inspections and calibrations?

  • Fuse failed! Needs to be fuse out and redone.

  • We're clamps used sufficiently to ensure proper alignment?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse allowed specified amount of time to cool?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse marked with time to remove clamps?

  • Fuse failed! Needs to be fuse out and redone.

  • Was fuse Peer checked?

  • Fuse failed! Needs to be fuse out and redone.

Visual Inspection

  • Proper alignment?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the pipe properly scraped?

  • Fuse failed! Needs to be fuse out and redone.

  • Pipe inserted properly?

  • Fuse failed! Needs to be fuse out and redone.

  • Did the Fuser sign the pipe properly?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the fuse peer checked and signed?

  • Fuse failed! Needs to be fuse out and redone.

  • Was the fuse signed by the Fuser?

  • Instruct them that this is required for every fuse or mechanical joining.

  • Add media

  • Pipe Size

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.