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Doc. No FORM-04-QA-C036 Inspection Form Doc. Status For Project Revision 00 Date 11-Apr-18 Inspection Form
Doc. No
FORM-04-QA-C036
Inspection Form
Doc. Status
For Project
Revision
00
Date
11-Apr-18
Inspection Form Steel Pipe
Page
1 of 1
PROJECT/ PT Registration No : : LOCATION Day / Date : : CONTRACT NO. Location
PROJECT/ PT
Registration No :
:
LOCATION
Day / Date
:
:
CONTRACT NO.
Location
:
:
CONTRACTOR
:
C
Unit = mm
B
A
T1
L
T4
T2
T3
Note : The tip measurement (a, c) is made at least 50 mm from the edge
Minimum sample size is 10% of each size
MATERIAL SPESIFICATION
Merk
:
HDPE
Galvanis
Baja Carbon
Stainless
PVC
Type
:
Seamless
ERW
PN
2 5
PN 1 0
Rating
:
PN
1 6
PN
3 0
PN
2 0
SCH. 1 0
SCH. 8 0
Schedule
:
SCH.
4 0
ASTM A 106 gr.B
ASTM A 53 gr.A
Material
:
Size
:
Ø
Meteran
Tools
:
Thickness tester
Caliper
Factory Brand
Gunung Garuda
Krakatau Steel
Sample No.
No :
No :
No :
No :
No :
No :
No :
T
1
T
2
A
T
3
T
4
T
1
T
2
Thick of Pipe
B
T
3
T
4
T
1
T
2
C
T
3
T
4
A
Diameter
B
C
Length ( mm )
L
Inspeksi Visual
Good :
Damage :
Received
Not Received
Mill Certificate
Mill Certificate No :
Heat No :
Toleransi :
L = ±………(mm) D = ±…
(mm)
t =
±…
(mm)
Accepted
Rejected
Contractor
Owner
PT. …………………………………………
PT. ………………………………………………………
Site Engineer
Site Manager
Construction Assistant
Construction Manager
(………………………)
(………………………)
(………………………)
(………………………)