GHAZIABAD I&C

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

undefined

• Yes

  No

  N/A

• Yes

  No

  N/A

• - Type of Connection (Commercial / Industrial) :

  Yes

  No

  N/A

• - Contract Pressure:

  Yes

  No

  N/A

• - Address:

  Yes

  No

  N/A

• - MRS CHECK POINTS

  Yes

  No

  N/A

• WALL MOUNTED

  Yes

  No

  N/A

• MRS SKID

  Yes

  No

  N/A

• LOCATION OF MRS

  Yes

  No

  N/A

• a) Outside the premises

  Yes

  No

  N/A

• b) Just Inside the premises (Inner side of

  Yes

  No

  N/A

• premises)

  Yes

  No

  N/A

• c) Inside the premises : (Approx. Length of MDPE

  Yes

  No

  N/A

• boundary wall )

  Yes

  No

  N/A

• Condition of MRS

  Yes

  No

  N/A

• OK / NOT OK

  Yes

  No

  N/A

• Any TAP-OFF point in UPSTREAM of Meter

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• Seal Status of Meter & Regulator

  Yes

  No

  N/A

• OK / NOT OK

  Yes

  No

  N/A

• By-Pass line closed & Sealed

  Yes

  No

  N/A

• YES / NO / NA

  Yes

  No

  N/A

• Cage & Lock Status

  Yes

  No

  N/A

• OK / NOT OK

  Yes

  No

  N/A

• Electrical Installation near MRS

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• Clear Accessibility to MRS

  Yes

  No

  N/A

• OK / NOT OK

  Yes

  No

  N/A

• Safety Sign boards Availability

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• - IPW AND SAFETY CHECK POINTS

  Yes

  No

  N/A

• IPW Painting/Clamping/Rusting etc. Status

  Yes

  No

  N/A

• OK / NOT OK

  Yes

  No

  N/A

• IPW Concealed

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• Electrical cables/socket nearby IPW

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• Proper Ventilation available

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• Fire Extinguisher availability

  Yes

  No

  N/A

• YES / NO

  Yes

  No

  N/A

• - TOTAL NOS. OF EQUIPMENTS/APPLIANCES RUNNING ON NATURAL GAS

  Yes

  No

  N/A

• BURNER

  Yes

  No

  N/A

• OVEN

  Yes

  No

  N/A

• BOILER

  Yes

  No

  N/A

• THERMOSTAT

  Yes

  No

  N/A

• OTHERS

  Yes

  No

  N/A

• - AVAILABILITY/ARRANGEMENT OF ALTERNATE FUEL

  Yes

  No

  N/A

• YES/NO

  Yes

  No

  N/A

• Name of Alternate Fuel -

  Yes

  No

  N/A

• Remarks

  Yes

  No

  N/A

• - SAFETY OBSERVATION (if any)

  Yes

  No

  N/A

• REMARKS:

  Yes

  No

  N/A

• - NAME:

  Yes

  No

  N/A

• - DESIGNATION:

  Yes

  No

  N/A

• - SIGNATURE:

  Yes

  No

  N/A

• - CUSTOMER

  Yes

  No

  N/A

• - IGL PNG REPRESENTATIVE

  Yes

  No

  N/A

• - FIRE & SAFETY

  Yes

  No

  N/A