Title Page

  • Conducted on

  • Prepared by

  • Location

Qaulity Assurance Inspection Form - Industrial low temp application

  • JOB #:

  • JOB NAME:

  • JOB DESCRIPTION

MATERIAl RECEIVING

  • Are materials correct per the scope of work?

  • Are materials all accounted for/backlogged on the shipper?

MOBILIZATION/SAFETY

  • Has foremen received proper information for work location, safety ect?

  • Has jobsite hazards been identified?

  • Does crew have PTP cards prior to Job startup?

  • Are the proper safety precautions in place (I.E. Fall Protection)

MATERIAL INSPECTION

  • Are ends square?

  • Is factory applied Vapor Barrier intact and puncture free?

  • Has material been stored in a dry secure location?

PIPING INSULATION APPLICATION

  • Has the piping system been bought off with a written release?

  • Is the correct piping insulation and thickness applied to the service?

  • If it is a double layer application, are joints staggered correctly?

  • If applicable, have joints been buttered with specified joint sealant?

  • Has vapor barrier been installed and inspected?

  • Has protective jacketing system been installed correctly?

  • If applicable, Is band spacing correct?

  • If applicable, has PVC weld adhesive been applied as specified?

  • Has overall jacketing system been installed weathertight and sealed?

EQUIPMENT INSULATION APPLICATION

  • Has the item been bought off with a written release?

  • Is the correct insulation and thickness applied to the service?

  • If it is a double layer application, are joints staggered correctly?

  • If applicable, have joints been buttered with specified joint sealant?

  • Has vapor barrier been installed and inspected?

  • Has protective jacketing system been installed correctly?

  • If applicable, Is band spacing correct?

  • If applicable, has PVC weld adhesive been applied as specified?

  • Has overall jacketing system been installed weathertight and sealed?

DEMOBILIZATION

  • Has any installed work been damaged?

  • Has the work area been cleaned and swept of work related debris?

  • Are all tools accounted for and sent to the warehouse?

  • QA/QC Signature:

  • DATE:

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