Title Page

  • Operator

  • Location
  • Inspector

  • Conducted on

Pipeline Corrosion Report Form

Corrosion Protection Requirements

  • Buried or submerged pipelines (constructed, relocated, replaced, or changed) externally coated

  • All external pipe coating inspected

  • Take photo(s) of external pipe coating

  • Repair any coating damage discovered

  • Coating Damage
  • Brief description

  • Take photo(s) of coating damage

  • Repairs needed/done

  • Adequate cathodic protection of the system

  • Sufficient number of test leads properly installed

  • Take photo(s) of test stations

Sign off

  • Additional Observations

  • Inspector
  • Inspector Name & Signature

  • Site Supervisor Name & Signature

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