ITP – QCP Milton Roy Job n°: 14006006

MRE Doc. n°: 14006006-ITP Rev 01 Page 1 of 2 Client Contract n°: PTV5015/01
Client Doc n°: N/A

INSPECTION
N° OPERATION REFERENCE DOCUMENT ACCEPTANCE CRITERIA FORMAT OF RECORDS VISA / STAMP / DATE / OBS.
I II III IV

1 PUMP Item No. : P-0510

1.a Check of Raw Material EN 10204 EN 10204 3.1 3.1 Certificates R R R
On permanent wetted parts only Equipment Datasheet
Bill of Material

1.b Penetrant Test 100 % ASME V Art. 6 ASME VIII Test Report R R R
Welded flanges ASME VIII div. 1 ASME V Art. 24 div. 1 App
7,8 & 24

1.c X-Ray Examination 100 % ASME V Art. 6 ASME VIII Examination Report R R R
Welded flanges ASME VIII div. 1 ASME V Art. 24 div. 1 App
7,8 & 24

1.d Hydrostatic Test IT/10/201 IT/10/201 Test Report R R R

On liquid-end / dosing head only API 675 API 675 Par. 4.3.2.5 At 240 Barg
With flanged connection(s) if applicable Equipment Datasheet

1.e Performance Test IT/10/202 IT/10/202 Test Report R R R

Flow measurement 100%
(running test for 4 hours) + Leak test

Rev. Date Prepared by III : Contractor / Client or TPI representative

I: Sub-Contractor / Sub-Vendor R: Doc. Review
Name: THIEN PHU ENGINEERING
00 30/05/2014 M.Peugeot H: Hold Point
01 17/07/2014 M. Peugeot Legend IV : End-User / Owner or TPI representative
II : Internal Supervision (Quality Control) W: Witnessed
Name: VINH NAM JOINT STOCK NI or NR : Not Included or Not Required
Name: MILTON ROY EUROPE (manufacturer)
COMPANY

Page 1 of 2 AQFORM 177 A- 10/97

 ITP – QCP Milton Roy Job n°: 14006006

MRE Doc. n°: 14006006-ITP Rev 01 Page 2 of 2 Client Contract n°: PTV5015/01
Client Doc n°: N/A

INSPECTION
N° OPERATION REFERENCE DOCUMENT ACCEPTANCE CRITERIA FORMAT OF RECORDS VISA / STAMP / DATE / OBS.
I II III IV

1.f Noise Level Measurement IT/10/609 85 dBa max Control Report R R R

1.g Vibration test IT/10/612 As per norm ISO 10816-1 Test Report R R R

2 MOTOR Item No. M-0510

2.a Routine Test Manufacturer Standard Manufacturer Standard Test report R R R

2.b Hazardous Area Certification Manufacturer Standard Atex Non-sparkling certificate R R R

Rev. Date Prepared by III : Contractor / Client or TPI representative

I: Sub-Contractor / Sub-Vendor R: Doc. Review
Name: THIEN PHU ENGINEERING
00 30/05/2014 M.Peugeot H: Hold Point
01 17/07/2014 M. Peugeot Legend IV : End-User / Owner or TPI representative
II : Internal Supervision (Quality Control) W: Witnessed
Name: VINH NAM JOINT STOCK NI or NR : Not Included or Not Required
Name: MILTON ROY EUROPE (manufacturer)
COMPANY

Page 2 of 2 AQFORM 177 A- 10/97