Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
GHAZIABAD I&C
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- Type of Connection (Commercial / Industrial) :
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- Contract Pressure:
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- Address:
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- MRS CHECK POINTS
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WALL MOUNTED
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MRS SKID
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LOCATION OF MRS
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a) Outside the premises
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b) Just Inside the premises (Inner side of Premises )
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c) Inside the premises : (Approx. Length of MDPE )
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Condition of MRS OK / NOT OK
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Any TAP-OFF point in UPSTREAM of Meter
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Seal Status of Meter & Regulator
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By-Pass line closed & Sealed
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Cage & Lock Status
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Electrical Installation near MRS
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Clear Accessibility to MRS
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Safety Sign boards Availability
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- IPW AND SAFETY CHECK POINTS
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IPW Painting/Clamping/Rusting etc. Status
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IPW Concealed
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Electrical cables/socket nearby IPW
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Proper Ventilation available
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Fire Extinguisher availability
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- TOTAL NOS. OF EQUIPMENTS/APPLIANCES RUNNING ON NATURAL GAS
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BURNER
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OVEN
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BOILER
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THERMOSTAT
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OTHERS
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- AVAILABILITY/ARRANGEMENT OF ALTERNATE FUEL
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Name of Alternate Fuel -
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Remarks
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- SAFETY OBSERVATION (if any)
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REMARKS:
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- NAME:
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- DESIGNATION:
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- SIGNATURE:
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- CUSTOMER
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- IGL PNG REPRESENTATIVE
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- FIRE & SAFETY
