Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Valve Type: Gate
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Task: Cycle through operating range
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Frequency (Months): 6
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Task: Inspect for leaks.
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Frequency (Months): 6
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Task: Lubricate stem packing.
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Frequency (Months): 6
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Task: Check/Replace valve packing.
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Frequency (Months): 6
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Task: Check stem alignment.
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Frequency (Months): 6
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Valve Type: Globe and Angle
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Task: Cycle through operating range.
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Frequency (Months): 3
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Task: Inspect for leaks.
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Frequency (Months): 3
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Task: Adjust packing nut.
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Frequency (Months): 6
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Task: Test for tight shut-off.
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Frequency (Months): 6
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Valve Type: Butterfly
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Task: Cycle through operating range.
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Frequency (Months): 6
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Task: Inspect stem for leaks.
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Frequency (Months): 6
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Task: Test for tight shut-off.
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Frequency (Months): 6
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Valve Type: Plug
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Task: Cycle through operating range.
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Frequency (Months): 3
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Task: Inspect for leaks.
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Frequency (Months): 3
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Task: Lubricate.
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Frequency (Months): 3
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Valve Type: Ball
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Task: Cycle through operating range.
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Frequency (Months): 3
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Task: Inspect for leaks.
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Frequency (Months): 3
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Task: Lubricate packing gland.
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Frequency (Months): 3
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Valve Type: Diaphragm
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Task: Cycle through operating range.
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Frequency (Months): 6
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Task: Inspect valve stem.
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Frequency (Months): 6
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Task: Test for tight shut-off.
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Frequency (Months): 6
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Valve Type: Pinch
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Task: Cycle through operating range.
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Frequency (Months): 6
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Task: Inspect valve stem.
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Frequency (Months): 6
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Task: Test for tight shut-off.
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Frequency (Months): 6
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Valve Type: Swing and Lift Check
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Task: Disassemble and inspect.
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Frequency (Months): 24
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Task: Clean.
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Frequency (Months): 24
