Format No.

VT/01

SHREE SATYANARAYAN INDUSTRIAL Report

SSIS/VT/
SUPPLIERS PVT. LTD. No.
Date
Page 1 of 1
VISUAL EXAMINATION REPORT

Client: Project No :
Equipment No: Drawing No:
Component : Stage & Extent:
Material: Thk : Procedure No. & Rev.:
Applicable code Edition :
Technique: Direct/ Remote
Surface condition & Temperature:
Surface Preparation:
Lighting Equipment : Light Intensity :
Post Cleaning: Date of Examination:
Sr. Identification of Part Interpretation Evaluation
No. Type Size Location

Map or Record of Indications :

Examined By : Reviewed and Accepted By: TPI / AI :

Name : Name : Name :

Level : Level : Level :
Date : Date : Date :