Work Order No :

Level Transmitter Calibration Check Sheet

Location Instrument Type Level Transmitter

Facility Tag No
Service Model / Serial No
Date Input Range (C)
Calibrated by
Assurance Value
(Name / Company)

TEST EQUIPMENT
Item Description Model No. Serial No. Calibration Certificate No. Expiry Date

INSPECTION RESULTS
Result
External Condition Remarks
(Good / Moderate / Bad)
Visual Condition
EX Integrity
Grounding

CALIBRATION RESULTS
NOTE: Perform a 3-point check for linearity / accuracy; a 5-point check for after calibration.
AS FOUND AS LEFT
Nominal
INPUT OUTPUT INPUT OUTPUT

Input Nominal Actual Error of Error of Nominal Actual Error of Error of

Input Reading Reading Span Input Reading Reading Span
bar / psi bar / psi % % bar / psi bar / psi % %
% (A) (B) (A-B)/A *100 (A-B)/C*100 (D) (E) (D-E)/D*100 (D-E)/C*100

0
RISING

25
50
75
100
100
FALLING

75
50
25
0

Performed / Witnessed By: Signature Date

Overall Result PASS FAIL

Remarks:

Verified By OIM / WS / CRO: Signature Date