Title Page

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Unit information

  • Mfg. Date

  • Last Recertification Date

  • Part Number

  • Serial Number

  • What type of material is the Plug made of?

Inspection items

  • Is the Shackle in acceptable condition?

  • What is wrong with the Shackle?

  • Explain Other response and what is the recommendations?

  • Add photo if Possible

  • Is the Bull/Pear Ring in acceptable condition?

  • What is wrong with the Bull/Pear Ring?

  • Explain Other response and what is the recommendations?

  • Add photo if Possible

  • Are the External Threads Acceptable?

  • What is wrong with the External Threads?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

  • Are the Internal Threads Acceptable?

  • What is wrong with the Threads?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

  • Is the Stem/Stem Threads Acceptable?

  • What is wrong with the Stem/Stem Threads ?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

  • Are the Ears Acceptable?

  • What is wrong with the Ears?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

  • Are the Tags Acceptable?

  • What is wrong with the Tags?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

  • Are the Bellows Acceptable?

  • What is wrong with the Bellows?

  • Explain Other response and what is the recommendations?

  • Add Photo if Possible

Additional information

  • Notes and Recomendations

  • Add any Photos that would help explain issues

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