NEW TECHNOLOGY EQUIPMENT PRE- INSTALLATION AUDIT FORM

This check sheet is to be completed by the Operator & the Subject Matter Supervisor in charge of the new technology
to be deployed. A copy of this form is to be submitted for site EHSQ when requesting a Permit to Work. The original
form is to be kept on location along with copies of all test certificates and supporting documents.
Company: Date:
Location: Operation:
ITEM Certification Remarks
Technology Checked Document No.
Outline of the goal OK 
Functional Specification OK 
Layout drawings with position numbers, part list and materials OK 
identification
Materials specifications and performance in the intended operating OK 
conditions. Validate if service experience in these conditions exists
Quality Assurance/Quality Control Plan OK 

Design Criteria Checked

References with justification to applied standards, rules and OK 
regulations
Reference to other criteria OK 

Manufacturing and Installation Checked Document No.

Material Specification certificate OK 
Installation procedures and records (within and/or outside Nigeria) OK 
Installation personnel qualification OK 
Manufacturing records OK 

Operation Checked Document No.

Relevant operational procedures OK 
Range of allowable environmental and operating conditions OK 
Relevant operational, quality and failure records (within and/or OK 
outside Nigeria)
Specification of intended inspection, maintenance and repair OK 
strategy and inspection and maintenance procedures.

Technology qualification Condition Document No.

Composition of the technology and evaluation of elements OK 

involving aspects of new technology
Risk assessment including specification of personnel competence OK 
and failure mode register
List of all assumptions made in the final risk assessment. OK 
Evidence of schedule and milestones, regulatory requirements, OK 
third party or subcontractor involvements.
Results from the qualification activities carried out in a live/test well OK 
and witnessed by Seplat representative(s).
Documentation of resulting probabilities of, or margins to, failure OK 
modes, or margins to specified minimum performance
requirements.
Limiting values (maximum or minimum) for functions in the OK 
analyses and tests, such as the capacity of a pump

NOTE: Certification should cover load testing, pressure testing and NDT testing as appropriate for the equipment.
All certification must be traceable to the unique serial number on the piece of equipment.
Operator’s Name: Operator’s
Signature/Date:

Supervisor: Supv.
Signature/Date: