Record No.

Inspection & Test Record

for Instrument Pre-installation and
Calibration
Client:

Subcontractor:

Project No.:

Subcontract P.O. No.:

Project Name:

Tank No.:

Additional Information:

Type:

Manufacturer:

Service:

Req. no.:

Calibration:

Tag No.:

Reference Document:

Physical check:
Process conn. correct

Pneum./elect. conn. correct

Body material correct

Range/span correct

General condition satisfactory

Air supply setting correct

Earth isolation for RTDs/TCI

Ancillary equipment supplied

Shipping stops removed

Calibration Check:
Input
% Span

Reading or output
Actusl

Rising
Actual

Falling

% Span

Error %

Actual

% Span

Error %

0
25
50
75
100
Ex Certificates available
Settings:
Control action

Direct

Alarm setting

Time delay setting

Limit switch setting - high

Low

Output limit setting - high

Low

Indirect

Corrections:
Automatic temperature correcon range:
S.G./density correction setting:
Zero elevation/suppressing setting:
Thermocouple burn-out drives:

Upscale

Down scale

Shipping stops refitted

Ancillary equipment list:

Remarks:

Accepted for Subcontractor

Name:

Signature:
Date:

Accepted for Company

Name:

Signature:

C:\RB_Forms\RB26K02.DOT\

Date:

Accepted for Client

Name:

Signature:

Date:

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