6 004 1 pressure test form
LEAK TEST RECORD
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Client/Site:
Project ID#:
System:
Test No.:
Test Type: Hydrostatic Pneumatic
Equipment ID:
Applicable Code: Hydro-Pneumatic (combo)
In-Service
Test Media:
□ Other____
Required Test Pressure: PSIG
| Test Boundary(Partial Test) | |||||
|---|---|---|---|---|---|
| Drawing #/Rev# | Item/Equip/Line # | Std/Spec | From | To: | |
| Pretest Inspection Checklist | N/A | Satisfactory(init/date) | Unsatisfactory(init/date) | ||
| 1. Approved test media source(s) identified/located | |||||
| 2. Chloride content of water verified<50 ppm(stainless and high alloy steels) | |||||
| 3. Items not subjected to test pressure have been isolated from test(e.g.control valves, instruments, etc.) | |||||
| 4. Equipment/piping is properly supported | |||||
| 5. Blinds are proper size/thickness for pressure and correctly installed | |||||
| 6. All deviations to test procedures/codes/standards have been approved and copies of approvals attached | |||||
| 7. Pressure gauge/reorder ranges are>1.5and<4Xreq'd test pressure | |||||
| 8. Required overpressure protection devices have been installed | |||||
| 9. All required welding and NDE has been completed | |||||
| 10. Temperature of equipment and test media stabilized and minimum test temperature verified. |
Date: Ambient temp.:
Metal temp.:
Test Gauge ID#:
Calibration Due Date:
Actual Test Pressure:
Test Duration:
Test Accepted:
QC Representative/Company
Test Vented, Drained, Flushed upon completion of testing:
Owner Representative
Fabricator Representative/Company
N/A