Pre-fabricated Equipment Quality Design Assessment Form

EQUIPMENT DESCRIPTION

• This form shall be submitted on all pre-fabricated equipment (skids) after declaring it fit-for-service. Additionally, use this form to communicate rework and design issues regardless of when the issue is discovered.

• Tracking Number

• Initiator Name

• Date

  Date

• Title

• Facility/Project Name

• Physical Location Of Equipment
  Address

• Equipment Fabricator

• Equipment Model Name:

• Serial Number

REWORK

• Any alteration of the skid from its delivered condition (excluding fall off piping, or instrumentation designed to be installed on site). Alterations include repairing damage from transportation to the site or from movement at the site, replacing gaskets , valves, instuments, piping, hardware, paint, etc, alterations due to non conformity with drawings, or ANY replacement/adjustment of components on the skid.

• Skid requires NO Re-work prior to being placed in service (complete section 3)

• Skid requires Re-work prior to being placed into service.

• Check all that apply

• Damaged occurred during transportation to the site

• Skid arrived with non-preferred design

• Skid does not match drawing design

• Damage occurred during movement of skid at site

• Skid had leaks during testing

• Details of Condition (pictures)

  Media

• Rework Required (description)

• Estimated Hours To Rework

• Estimated Cost Of Rework

DESIGN CHANGE RECOMMENDATIONS

• Design change recommendation: Any recommended change to the current design of the pre-fabricated equipment (skid).

• Describe recommendations for future skid design changes:

• Justification/Benefit of Change