Doc. No.

: 26071-100-GQI-GCQ-00011

Job No. : 26071 Rev.003

INSPECTION AND TEST PLAN FOR

ABOVEGROUND PIPING
FABRICATION AND INSTALLATION

PROJECT : Engineering, Procurement and Construction (EPC) Inside

Battery Limits (ISBL) and Outside Battery Limits (OSBL) for
the Refinery Development Master Plan (RDMP) Project
RU V Balikpapan
LOCATION : Refinery Unit V Balikpapan, East Kalimantan,Indonesia
OWNER : PT PERTAMINA (Persero)

003 30 Sep 22 ISSUED FOR CONSTRUCTION J.H.LEE A.ARIFIN J.H.KIM

002 28 Jun 22 ISSUED FOR CONSTRUCTION J.H.LEE A.ARIFIN J.H.KIM

001 25 Dec 21 ISSUED FOR CONSTRUCTION D.H.KIM A.ARIFIN Y.D.KIM

000 25 Sep 19 ISSUED FOR CONSTRUCTION D.H.KIM A.ARIFIN Y.D.KIM

00A 08 Aug 19 ISSUED FOR APPROVAL D.H.KIM A.ARIFIN Y.D.KIM

REV. DATE DESCRIPTION PREPARED CHECKED APPROVED

1 of 27
 Doc. No. : 26071-100-GQI-GCQ-00011

Job No. : 26071 Rev.003

REVISION LOG

REV. NO. DATE PAGE DESCRIPTION

00A 08-Aug-19 - ISSUED FOR APPROVAL

000 25-Sep-19 3~8, 18 ISSUED FOR CONSTRUCTION
ISSUED FOR CONSTRUCTION
001 25-Dec-21 4, 7~9, 21~23 : According to the IPMT Letter No.
3429/KPB1000/2021-S0
4, 6~11, 19,
002 28-Jun-22 ISSUED FOR CONSTRUCTION
25~26
003 30-Sep-22 3~12 ISSUED FOR CONSTRUCTION

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 Doc. No. : 26071-100-GQI-GCQ-00011

Job No. : 26071 Rev.003

1. GENERAL
1.1. Purpose
This is Generic Inspection & Test Plan (ITP) for Aboveground Piping across the Project.
Ongoing ITP’s will be detailed with the specific requirements of each work area and work
construction package, which will have specifications, standard/codes, testing, drawing and
material requirements which will be unique/specific for each package for The Refinery
Development Master Plan (RDMP) Project RU V Balikpapan (hereinafter referred to as
PROJECT).

1.2. Scope
This ITP is applied for aboveground piping installation works including pipe support
installation, welding work, NDE & HEAT TREATMENT, Pressure test, Re-instatement.

1.3. Referenced Documents

The documents listed below shall be a specific reference on ITP prior to inspection :

No. Document Number Descriptions

Specification for Marking of Piping

1 26071-100-3PS-P30-00002
Materials

2 26071-100-3PS-P30-00001 Piping Material Specification

PD&P Shop Fabrication of Piping per

3 26070-100-3SS-PB00-J0003
ASME B31.3

4 26070-100-3SS-PB00-J0004 PD & P Field Fabrication and Installation

5 26070-100-3GS-FB00-JD001 PD&P Bolt Tightening & Bolt Up

Piping Material Specification

6 26071-100-3PS-P30-00001
(Amendment)

7 26071-100-3DG-P50-00001 Specification for Piping Support

Engineering Specification for General

Welding and NDE Requirements for
8 26070-100-3SS-NWP0-J0003
Vendor-Fabricated Piping and Piping
Field Welds
Engineering Specification for Positive
9 26070-100-3SS-NE00-J0001
Material Identification(PMI)

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 Doc. No. : 26071-100-GQI-GCQ-00011

Job No. : 26071 Rev.003

Engineering Specification for Hydrotesting

10 26070-100-3SS-NF00-J0003
Water Quality and Drying

11 ASME B31.3 Process Piping

12 ASME B31.1 Power Piping

13 ASME B16.5 Pipe Flanges and Flanged Fittings

14 ASME B16.47 Large Diameter Steel Flanges

Qualification Standard For Welding,
Brazing, and Fusing Procedures;
15 ASME Section IX
Welders; Brazers; and Welding, Brazing,
and Fusing Operators
Guidelines for Pressure Boundary Bolted
16 ASME PCC-1
Flange Joint Assembly

17 26071-100-GQI-GAQ-00009 Material Receiving Inspection Procedure

Welder Qualification and Control

18 26071-100-GQI-GAQ-00012
Procedure
General Welding Inspection and NDE
19 26071-100-GQI-GCQ-00001
Procedures

20 26071-100-GQI-GCQ-00002 PWHT and Hardness Test Procedure

21 26071-100-GQI-GCQ-00003 Positive Material Identification Procedure

Procedure for Ultrasonic Examination

in lieu of Radiographic Examination -
22 26071-100-GQI-GCQ-00051
Fabricated Piping and Piping Field Welds
(Based on ASME BPVC : 2019)
Scan Plan for Phased Array Ultrasonic
23 26071-100-GQI-GCQ-00052
Examination

24 26071-100-GPP-FB00-00002 Flange Management Procedure

Procedure for Pipe Flushing, Pressure

25 26071-100-G05-GSX-00006
Test, Blowing, Drying and Reinstatement

26 26071-100-PH-P50-00001 Standard Pipe Support Drawings

Method Statement for Pickling and

27 26071-100-GPP-GCX-00129
Passivation of Stainless Steel

28 26071-100-530-GST-00014 Build Clean Procedure

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 Doc. No. : 26071-100-GQI-GCQ-00011

Job No. : 26071 Rev.003

29 26071-100-400-GSH-00001 Acceptance and Handover Procedure

30 26071-100-GQI-GAQ-00011 Welding Material Control Procedure

Inspection and Test Plan For Earthing &
31 26071-100-GQI-GCQ-00031
Lightning Protection System Work
32 26071-100-V2A-PX12-00005 Installation Manual For GRE Piping
Method Statement For Installation Pipe
33 26071-100-VSC-PF10-00005
GRE
34 Each relevant document number IFC Drawing

35 Each relevant document number Material approval Request (MAR)

36 Each relevant document number Welding Procedure Specification (WPS)

37 Each relevant document number Manufacture Recommendation

38 Each relevant document number Method Statement

39 Each relevant document number Equipment/Tools Certificate

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 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION & INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Project Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022

Description:
- This is the generic Inspection & Test Plan (ITP) for Aboveground Piping across the Project
- This ITP is applied for aboveground piping installation works at all project work area including welding work, NDE & HEAT TREATMENT, Pressure
test, Re-instatement.

Remark:
- The detailed procedures, method statements and drawings will be incorporated by subcontractor on the completion of the actual work ITP.

003 30-Sep-22 ISSUED FOR CONSTRUCTION J.H.LEE A.ARIFIN J.H.KIM

002 28-Jun-22 ISSUED FOR CONSTRUCTION J.H.LEE A.ARIFIN J.H.KIM

001 25-Dec-21 ISSUED FOR CONSTRUCTION D.H.KIM A.ARIFIN Y.D.KIM

000 25-Sep-19 ISSUED FOR CONSTRUCTION D.H.KIM A.ARIFIN Y.D.KIM

00A 08-Aug-19 ISSUED FOR APPROVAL D.H.KIM A.ARIFIN Y.D.KIM

REV. DATE DESCRIPTION PREPARED CHECKED APPROVED

6 of 27
 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI

0 Document Review

0.1 Review PIM Meeting Memo PIM Meeting Memo - - R R R

1 Material Receiving Inspection (Common)

1.1 Verify the material / size / quantity Material Receiving

Inspection Procedure
GQI-GAQ-00009-01
1.2 Check for damage
Specification for Marking Purchase Order (MVIR Report)
Packing List and IRC H W R&S -
of Piping Materials
1.3 Color coding
OSD Report
Piping Material
1.4 Review the material test report Specification
WPS/PQR qualification and/or General Welding
Approved
2 verification Inspection and NDE ASME Sec. IX H H W W
WPS/PQR
(welding process and joint design) Procedure

3 Welder & Welding Operator and Bonder Qualification

As per WPS GQI-GAQ-00012-01

Welder Qualification
3.1 Welder / Welding Operator ASME Sec. IX Welder Qualification H W R W
and Control Procedure
AWS D1.1 Record
Vendor procedure Vendor procedure
(26071-100-V2A-PX12- (26071-100-V2A-PX12-
00005 00005 Mock up Test
3.2 Bonder (qualified by mock up test) H W R -
Report
26071-100-VSC-PF10- 26071-100-VSC-PF10-
00005) 00005)

Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance

GQI-GAQ-0005-01
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 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI

4 ITP For Metalic Item

4.1 Fit-Up Inspection (Metal & Non-Metal)

Material verification (heat number, size,

thickness) ISO number, shop weld/field As per
4.1.1 WPS & ISO DWG.
weld number, welder number, procedure PD&P, Shop Fabrication
number ASME B31.3
of Piping Per ASME
ITR-PI-001
B31.3
4.1.2 Weld Joint Alignment As per Vendor H W S -
Procedure As per PICS
PD & P, Field Fabrication
4.1.3 Dimension verification Installation
PWHT and Hardness
Test Procedure.
4.1.4 Pre-Heat (If required)

4.2 Welding Inspection

PD&P Shop Fabrication of
4.2.1 Check Welding(root, hot pass, fill and cap) Piping Per ASME B31.3 As per
WPS & ISO DWG.
PD & P, Field Fabrication ASME B31.3 ITR-PI-002
4.2.2 Final weld visual inspection
Installation As Per PICS
As per Vendor Procedure
H W S -
4.2.3 Welding repair (If necessary) Spec. for Piping Support
NDE & PWHT
Orifice flange inside inspection Approved WPS & Completed Spool ID
4.2.4 ITR-PI-003
(as applicable) ISO DWG

4.3 Installation / Erection Inspection

Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance

GQI-GAQ-0005-01
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 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI
No Contamination,
Corrosion & Damage
4.3.1 Inside cleaning before installation ITR-PI-005
PD&P Bolt Tightening & Flange management
Bolt Up Procedure
ITR-PI-006 H W S -
Piping Material ASME B31.3 As Per PICS
4.3.2 Flange Joint Verification Specification As per ISO DWG.
Mock up test
Mock up test for Report
Worker qualification

4.4 NDE & PWHT(Hardness)

NDE – RT ( RT Shooting ) H S S -

NDE – RT ( Interpretation ) Engineering Spec. for H R R

General Welding and NDE
4.4.1 Requirements for Vendor-
NDE – PAUT ( Data acquisition ) H S S
Fabricated Piping and Piping
NDE – PAUT ( Interpretation ) Field Welds H R R
NDE & Heat Treatment Each applicable
PD&P Field Fabrication Procedure NDE & PWHT Report
NDE – UT/MT/PT H R R
Installation
4.4.2 NDE (PMI/Ferrite) H R R -
Engineering Specification for
4.4.3 PWHT PMI H R R -
4.4.4 Hardness Test H R R -
Completion of all NDE
required according to the
4.4.5 NDE Clearance Declaration N/A relevant project ITR-PI-014 R R R -
specification and
procedure

Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance

GQI-GAQ-0005-01
9 of 27
 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI

5 ITP For Non-Metalic Item

5. 1 Bonding(Lamination) inspection (Non-Metal)

As per approved DWG
Material verification (heat number, size, As per approved DWG
5.1.1
thickness) ISO number, bonder Vendor procedure ITR-PI-002
Vendor procedure H W S -
(26071-100-V2A-PX12- ITR-PI-019
(26071-100-V2A-PX12-
5.1.2 Dimension verification 00005
00005
26071-100-VSC-PF10-
26071-100-VSC-PF10- ITR-PI-002
5.1.3 Bonding(Lamination) Joint 00005) H W S -
00005) ITR-PI-019

5.2 Installation / Erection

Piping Material
Specification
5.2.1 Inside cleaning before installation Vendor procedure ITR-PI-005 H W S -
Vendor procedure (26071-100-V2A-PX12-
(26071-100-V2A-PX12- 00005
00005
26071-100-VSC-PF10-
26071-100-VSC-PF10- 00005) ITR-PI-006
5.2.2 Flange Joint Verification H W S
00005) As Per PICS

6 Others
Pickling and Passivation for Contaminated Method Statement for Method Statement for
6.1 Stainless Steel Pickling and Passivation Pickling and ITR-PI-012 H W R -
(Only for contaminated area) of Stainless Steel Passivation of Stainless
Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance
GQI-GAQ-0005-01
10 of 27
 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI
Steel

As per
Spec. for Piping Support WPS & ISO DWG.
Spool release to painting or storage ASME B31.3
6.2 (Refer to Painting ITP if the spool is issued Thru PICS H R - -
Approved WPS &
for painting) Inside Cleaning &
ISO DWG
End Capping
Spool release from Fabrication ITR-PI-004
6.3 N/A As per ISO DWG H R - -
Shop(Kariangau75) to Field(Refinery) As per PICS
Welding Material Control Welding Material Control
6.4 Welding consumable Procedure Procedure
- S S S
Engineering Spec. for
General Welding and NDE
Welding condition Approved WPS &
6.5 Requirements for Vendor- - S S S
(Welding parameter, welding machine etc.) Fabricated Piping and Piping ISO DWG
Field Welds
Engineering Spec. for
General Welding and NDE
6.6 Leak test on pad (If necessary) Requirements for Vendor- NDE Procedure NDE Report R R R
Fabricated Piping and Piping
Field Welds
Refer to
6.7 Earthing & Lightning Installation 26071-100-GQI-GCQ-00031 - - - - -
E&I ITP
7 Pressure Test (Metal & Non-Metals)
Procedure for Pipe Completion of all
Flushing, Pressure Test, inspection activities
7.1 Test Package Welding Summary ITR-PI-013 R R R -
Blowing, Drying and required according to
Reinstatement the report form
PD&P Field Fabrication As per
7.2 PKG Review ITR-PI-007 R R R -
and Installation. Pressure Test PKG

Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance

GQI-GAQ-0005-01
11 of 27
 INSPECTION AND TEST PLAN
FOR A/G PIPING
FABRICATION AND INSTALLATION
ITP No 26071-100-GQI-GCQ-00011
: EPC ISBL and OSBL for
Job No. Revision No. 003
RDMP PROJECT RU V BALIKPAPAN
Revision Date 30 Sep. 2022
Reference Acceptance Report Inspection Point
No. Description of Inspection or Test
Criteria
Remark
Document Form No. Subcon Contractor IPMT TPI

7.3 Punch list walk through for piping As per H H W -

ISO DWG and P&ID As per
PD&P Field Fabrication Pressure Test PKG
and Installation. Procedure for Pipe ITR-PI-008
7.4 Punch clearance/verification H H W -
Flushing, Pressure
Engineering Spec. for Test, Blowing, Drying
Hydro-testing Water and Reinstatement
7.5 Pressure test Quality and Drying ITR-PI-009 H H W R
As per
Pressure Test PKG
7.6 Internal cleaning (Drain & Dry) ITR-PI-010 H W S -

8 Re-instatement (after Hydro) (Metal & Non-Metal)

As per
Pressure Test PKG

PD&P Field Fabrication Procedure for Pipe

and Installation Flushing, Pressure
Re-instatement Test, Blowing, Drying
8.1 ITR-PI-011 H H W -
(V/V, instrument, blind, touch-up paint, etc.) and Reinstatement
PD&P Bolt Tightening &
Bolt Up
Flange management
Procedure
(26071-100-GPP-FB00-
00002)
9 Final Dossier
Acceptance and Acceptance and
9.1 Final Document/Dossier - R R R -
Handover Procedure Handover Procedure

Legend: H – Hold W - Witness SW – Spot Witness R – Document Review S - Surveillance

GQI-GAQ-0005-01
12 of 27
 FIT-UP INSPECTION REPORT

Project : Subcon Date :

Report No : Location : (Area or Unit)

No Result Area ISO DWG Rev Shop

Spool No Type Joint Size Sch Class Date Base Mat’l Heat No Remark
ACC REJ /Field

Inspection by Subcontractor Contractor IPMT

Name
Signature
Date
ITR-PI-001

13 of 27
 WELDING INSPECTION REPORT

Project : Subcon Date :

Report No : Location : (Area or Unit)
Result Shop Welder No
No ISO DWG Rev /Field Spool No Type Joint Size Sch/Thick. Mat. Class WPS Date Base Mat’l Heat No Remark
ACC REJ Welder1 Welder2

Inspection by Subcontractor Contractor QC IPMT

Name
Signature
Date
ITR-PI-002

14 of 27
 ORIFICE FLANGE INSIDE
INSPECTION REPORT

Project : Report No. :

Package No. : Date :
Area : System No :
Result
No ISO DWG Rev Joint Tag No Size Remark
ACC REJ

Inspected by Subcontractor Contractor IPMT

Name
Signature
Date
ITR-PI-003

15 of 27
 SPOOL ISSUE SLIP REPORT

Project : Subcon Date :

Report No : Location : (Area or Unit)
Paint Hard Internal
No Area ISO DWG Rev Spool No Size Class Booking No Booking Date Weld NDE PWHT PMI Paint Received Remark
code ness Cleaning

Inspection by Issued by Received by Approved by

Name
Signature
Date
ITR-PI-004
16 of 27
 INTERNAL CLEANING
INSPECTION REPORT

Project : Report No. :

Area : Date :
System No. : Subcon :
Result
No ISO DWG Spool No Size Class Remark
ACC REJ

Inspected by Subcontractor Contractor Construction Contractor QC

Name
Signature
Date
ITR-PI-005
17 of 27
 FLANGE JOINT
INSPECTION REPORT

Project : Report No. :

Package No. : Date :
Area : System No :
Gasket / Flange Bolt Tightening
No ISO DWG Rev Joint
Type Size Rating Req. Value Act. Value Sign

Inspected by Subcontractor Contractor IPMT

Name
Signature
Date
ITR-PI-006

18 of 27
 TEST PACKAGE
TABLE OF CONTENTS

Project : Package No. :

Subcon : System No :

Sub-system No :

No Document Description YES NO Remark

1 Pressure Test Cover Sheet

2 Table of Contents

3 Test Legend and Symbols

4 NDE Clearance Declaration

5 Punch List

6 Pre-Test Check List

7 Pressure Test Report

8 Line Designation Table

9 Marked-up P&ID

10 Marked-up Isometric Drawings

11 Test Package Welding Summary

12 Calibration Report (Pressure Gauge, Relief Valve)

13 Water Analysis Report

14 Test Certificate of Manifold

15 Drying Report

16 Pipe Wall Thickness Report (If Required)

17 Flange Joint Report

18 Orifice Flange Inside Inspection (If Required)

19 Line Reinstatement Report

20
ITR-PI-007

19 of 27
 PUNCH LIST

Project : Package No Test Type :

No ISO DWG Description Category Issue by Issue Date Clear Date Sub-con Contractor IPMT Remark

10

11

12

13

14

15

Category Legend : A – Before Pressure Test B – Before Reinstatement C – Before Commissioning

ITR-PI-008
20 of 27
 PRESSURE TEST REPORT

Project : Package No. :

Subcon : System No :
Area : Sub-system No :
Pressure Gauge Details Type of Test
Instrument Instrument No. Calibration On Calibration Due Date Hydrostatic
Pneumatic
In-Service
Visual
Other( )
Test Pressure Test Medium Holding Time (Required time: )
Design Test Start Time Date Finish Time Date

No ISO DWG Rev P-Partial / F-Full Remark

1
2
3
4
5
6
7
8

9
10
For detail guidance to control of pressure gauge, refer to 26071-100-GQI-GAQ-00004 Inspection, Measuring and
testing Equipment Control Procedure

Inspection Result: : □ Accept □ Reject

Inspected by Subcontractor Contractor IPMT
Name
Signature
Date
ITR-PI-009

21 of 27
 DRYING REPORT

Project : Package No. :

Date : System No :
Area : Sub-system No :
Drying Method
Dry Air Dry Gas Vacuum Drying Others

Data
Test Medium Test Date

Inspection Result: : □ Accept □ Reject

Inspected by Subcontractor Contractor IPMT
Name
Signature
Date
ITR-PI-010

22 of 27
 LINE REINSTATEMENT
REPORT

Project : Package No. :

Date : System No :
Area : Sub-system No :
No Description Accept Reject N/A Remark
1 Drain & Dry completed
2 Gasket & Bolts Installed as per ISO DWG.
3 All Instruments and valves reinstalled
4 Temporary blind flanges removed
5 Temporary pipes removed
6 Test gauges and fitting removed
7 Blind flanges Installed as per latest P&ID
8 Bolt torqueing done
9 Spring supports adjusted to cold position
10 Vents and drains plugged as specified
11 Conformance with final P&ID ensured
Filters, strainers, traps, check valves, globe
12
valves & control valves Installed for correct flow
13
14
15

Inspected by Subcontractor Contractor IPMT

Name
Signature
Date
ITR-PI-011

23 of 27
 PICKLING AND PASSIVATION
FOR CONTAMINATED STAINLESS
STEEL REPORT

Project : Package No. :

Date : System No :
Area : Sub-system No :
No Description Accept Reject N/A Remark

1 Pickling and Passivation Material

To swab the pickled area after the completion

2
of pickling

3 No contamination after Pickling

Inspected by Subcontractor Contractor IPMT

Name
Signature
Date
ITR-PI-012

24 of 27
 Test Package Welding Summary

Project : Test PKG : Area :

ISO No. : Rev.No. :

Report No.
Joint Material- Material- Heat Heat Weld Welder1 Welder3 WPS
S/F Type Size Sch. Thick Mat.Class No-1 No-2
No. 1 2 Date Welder2 Welder4 No.
WIR RT/UT MT/PT PWHT PMI Ferrite

Inspected by Subcontractor Contractor QC IPMT

Name

Signature

Date
ITR-PI-013

25 of 27
 NDE CLEARANCE
DECLARATION

Project : Package No :

System No. : Sub-system No. :

1. SHOP

NDE
Lot Joint Summary Welding Date
Welder No Rate Result
(%) Q’ty
Total Shot Ratio From To

2. FIELD

Welding NDE STATUS

NDE WELDER
(JT) RT MT/PT
Rate
(%) PMI FE PW
Butt Fillet Required Shot Result Required Shot Result TOTAL Verified Result

REVIEWED BY APPROVED BY

Name Name

Signature Signature

Date Date

ITR-PI-014

26 of 27
 ITR-PI-019

27 of 27