Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Serial Numbers of hoses checked

  • Enter hose details here:

Hose Marking

  • Is the hose label present and in good condition?

  • Is the hose unique I.D number clearly visible?

  • Is the hose pressure rating clearly visible?

  • Does the hose have a green cable tie attached?

  • Is the intended test medium clear? (Oil based / Water based)

  • Is the inspection date clear and visible?

Hose condition

  • Is there any visible damage of hose outer cover, scoring, exposed wire, crush, kink?

  • Is there any visible abrasion, deformation or cut to hose exterior?

  • Is there any hose outer cover bulge?

  • Is there hose outer cover delamination?

  • Are end-fitting seal surfaces damaged?

  • Are end-fitting threads damaged?

  • Are end-fittings corroded?

  • Does the hose have whip checks fitted, and are they in good condition?

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