Hopper Coordination Form - Complete

• Prepared by

• Box Number

• Hopper #

• Phase #

  1

  2

• Conducted on

  Date

1.

• Have all hopper structural repairs been completed and signed off by Contractors Quality Control Representative and HRC? (N/A if no repairs were required)

  Yes

  No

  N/A

• Please add comment and / or annotated picture

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Hopper Heaters

• Have all hopper heaters been installed, tested, and signed off by Contractors Quality Control Representative

  Yes

  No

  N/A

• Please enter comment and / or annotated picture of the issue

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Wire Mesh

• Has all the wire mesh been installed and inspected by the Contractors Quality Control Representative

  Yes

  No

  N/A

• Please enter comment and / or annotated picture of the issue

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Heater Testing

• Have all heaters been retested to ensure that the previous Contractor has not disturbed the unit or wiring during their work scope?

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

• Has all the insulation been installed and inspected by the Contractors Quality Control Representative

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Hopper Heater Testing - Post Insulation

• Have all the heaters been retested to ensure that the previous Contractor has not disturbed the unit or wiring during their work scope?

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Final Insulation Inspection

• Has a final inspection been performed of all insulation activities associated with the hopper by the Contractors Quality Control Representative?

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Hopper Flanges

• Have all hopper flanges (and outlet piping flange) been inspected?

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign

Flange Machining

• Have all Flanges been machined and inspected? (N/A if no machining was required)

  Yes

  No

  N/A

• Add media

  Media

• QC Rep. Signature

  Sign

• QA Rep. Signature

  Sign