Sample of Form MDR
Sample of Form MDR
Sample of Form MDR
Location : Item
SAMPLE
1
2
3
4
5
6
Results
7
8
9
10
Min
Max
EMK
Page
RECEIVING MATERIAL INSPECTION REPORT
1 of 1
Project :
CERTIFICATE VISUAL
NO. DESCRIPTION QTY BRAND HEAT NUMBER REMARKS
NO. DATE RESULT DATE
PL E
SA M
Prepared by Inspected by, Reviewed by,
Date : Client :
Location : Job No :
Drawing :
Project :
Welding
Non Destructive Examination
Joint No.
SPOOL
P LE
SA M
Date : Client :
Location : Job No :
Drawing :
Project :
Welding
Non Destructive Examination
Joint No.
SPOOL
Date : Client :
Drawing No :
Project :
DIMENSION ( INCH )
JOINT/POINT DEVIATION STANDARD
NO. DRAWING NO. SPOOL/ITEM REFERENCE RECOMMENDED
NO. ACTUAL ( mm ) (mm)
DRAWING
Acceptable
Acceptable
L E
Acceptable
P
Acceptable
M
Acceptable
SA
Acceptable
Acceptable
Acceptable
Acceptable
Acceptable
Acceptable
Acceptable
Acceptable
EMK
Document Title :
E
No. Time DESCRIPTION Results
Recorder Gauge Ambient (ºF)
L
1
P
2
M
3
SA
4
10
12
Reviewed by
Client Reps
Company Document Title
Date : Client :
Location : Job No :
Drawing No :
Project :
Welding
Joint No.
SPOOL
P L E
SA M
Prepared by, Inspected by, Reviewed by,
2. CHECK THAT CORRECT BOLTS AND GASKETS ARE INSTALLED AT ALL MECHANICAL JOINTS.
3. CHECK THAT ALL VENTS AND DRAINS ARE CORRECTLY INSTALLED AND ALL TEMPORARY
VENTS / DRAINS REMOVED.
4. CHECK THAT ALL PROCESS BLINDS AND SPADES HAVE BEEN CORRECTLY INSTALLED AS
INDICATED ON P. & I.D. AND SPECTACL BINDS ARE IN THE CORRECT FLOW POSITION.
5. CHECK THAT CONTROL VALVES HAVE BEEN INSTALLED IN THE CORRECT 'FLOW' POSITION.
6. CHECK THAT SPECIFIED BLOCK VALVES HAVE LOCKING DEVICES / CHAIN WHEELS
CORRECTLY INSTALLED AS INDICATED ON P & ID.
7. CHECK THAT ALL VALVES ARE FUNCTIONING PROPERLY AND THAT EXTENDED SPINDLES
ARE FITTED AS REQUIRED AND HAVE BEEN COATED WITH 'COPA-SLIP' OR EQUAL
WHERE SPECIFIED.
8. CHECK THAT ALL RELIEF VALVES HAVE BEEN CORRECTLY INSTALLED.
10. CHECK THAT RESTRICTION AND ORIFICE PLATES HAVE BEEN CORRECTLY INSTALLED.
11. CHECK THAT PUMPS SUCTION STRAINERS HAVE BEEN CORRECTLY INSTALLED.
12. CHECK FOR CORRECT FLOW THROUGH FILTERS AND STRAINERS, TRAPS,
CHECK VALVES AND GLOVE VALVES.
13. CHECK THAT ALL GAGS HAVE BEEN REMOVED FROM SPRING-LOADED PIPE SUPPORTS
AND EXPANSION BELLOWS AND ALL TEMPORARY SUPPORTS REMOVED.
17. ENSURE CHECKS CARRIED OUT ON PRE - TEST CHECKLIST REMAIN VALID FOR
AS - BUILT STATUS.
WITNESS BY NAME / SIGNATURE DATE
PT. APECO
ADARO
EPORT NO :
OB NO :
ATE :
EVISION NO :
YES NO N/A
REMARKS
REPORT NO
18. CHECK THAT ALL CHAINWHEELS AND EXTENDED SPINDLES AND LOCKING DEVICIES
REQUIRED FOR SPECIFIED VALVES HAVE BEEN INSTALLED.
20. CHECK THAT ALL SPRINKLER HEADS, ROSETTES AND NOZZLES HAVE BEEN REMOVED
AND CONNECTIONS PLUGGED.
WITNESS BY NAME / SIGNATURE DATE
PT EMK
ADARO
:
:
:
:
YES NO N/A
REMARKS