Information
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Instrument Description
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Instrument Number
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Project Name
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Project Number
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Conducted on
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Prepared by
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Installed at correct location?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Installed at correct orientation?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Instrument/ valve functions properly?
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Fail safe - CLOSE?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Fail safe - OPEN?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Instrument/ valve calibrated per manufacturer's specifications?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Gasketing/ sealing in place as required?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Locks in place as required?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Control wires installed correctly?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
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Instrument/ valve tag installed?
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Checked by?
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Select date
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Re-checked by?
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Select date
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Remarks
Signatures
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Weitz Representative
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Controls Representative
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Owner Representative
