*W = Witness Point; H = Hold Point; H(A) = Inspection/Test by Authority; U(C) = Inspection/Test by Consultant; S = Surveillance or monitoring; X = Self inspection by performer of work. Checklist INSPECTION AND TEST PLAN CHECKLIST for: (To be completed by the person(s) directly responsible for the work) Contract Number: Work area: Checklist Number: Contract/Project Name: Contractor: Subcontractor Work Items/activities to be verified Reference Initialled/OK Comments I have carried out all necessary inspections and verify that the above items/activities conform Name: to the contract specification/documents Signature: Date: I have carried out all necessary inspections and verify that the above items/activities conform Name: to the contract specification/documents Signature: Date: I have carried out all necessary inspections and verify that the above items/activities conform Name: to the contract specification/documents Signature: Date: I have carried out all necessary inspections and verify that the above work for this work area Name: has been completed and conforms to the contract specification/documents Signature: Date: EXAMPLES Inspection and Test Plan Customer: INSPECTION AND TEST PLAN for: PAINTING Insert Contractor Identification and/or Contract Number: Work area: (Insert work area) Logo Contract/Project Name: Stage/ Requirement/ Acceptance Inspection/ Ref Operation or stage of work Records Inspection *what/who frequency standard/ criteria test Description Characteristics Employee Service Customer specification procedure provider 1 Incoming materials Conform to order Each Delivery Orders as GPC Check H W inspection delivery dockets/ placed approved & against Checklist colour sched. orders 2 Storage and As specified Each Checklist Specification, as Safe, secure/ Visual X S S protection week attached adequate protection Preliminary Each Specification, as All tasks 3 Task completion Checklist Visual H W S activities work area attached, WHS completed practice & Regulation 4 Surface Ready to paint, Each Checklist Specification, as Smooth and Visual H H W preparation clean and smooth work area attached clean 5 Painting Full & uniform Each Checklist Specification, as Checklist and Visual X S, H(C) S cover, smooth, work area attached test panel colour Pre-handover All matters Each Specification, as Completed to Final 6 Checklist H H H activities finalised, clean work area attached spec/ clean inspection and tidy and tidy
*W = Witness Point; H = Hold Point; H(A) = Inspection/Test by Authority; U(C) = Inspection/Test by Consultant; S = Surveillance or monitoring; X = Self inspection by performer of work. Checklist INSPECTION AND TEST PLAN CHECKLIST for: (To be completed by the person(s) directly responsible for the work) Contract Number: Contract/Project Name: Contractor: Subcontractor Work area: Checklist Number: Work Items/activities to be verified Reference Initialled/OK Comments I have carried out all necessary inspections and verify that the above items/activities conform to the contract specification/documents Name: Signature: Date: I have carried out all necessary inspections and verify that the above items/activities conform to the contract specification/documents Name: Signature: Date: I have carried out all necessary inspections and verify that the above items/activities conform to the contract specification/documents Name: Signature: Date: I have carried out all necessary inspections and verify that the above work for this work area has been completed and conforms to the contract specification/documents Name: Signature: Date: EXAMPLES Inspection and Test Plan Customer: Contract Number: Contract/Project Name: INSPECTION AND TEST PLAN for: PAINTING Work area: (Insert work area) Insert Contractor Identification and/or Logo Ref Operation or stage of work Stage/ frequency Records Requirement/ standard/ specification Acceptance criteria Inspection/ test procedure Inspection *what/who Description Characteristics Employee Service provider Customer 1 Incoming materials inspection Conform to order Each delivery Delivery dockets/ Checklist Orders as placed GPC approved & colour sched. Check against orders H W 2 Storage and protection As specified Each week Checklist Specification, as attached Safe, secure/ adequate protection Visual X S S 3 Preliminary activities Task completion Each work area Checklist Specification, as attached, WHS practice & Regulation All tasks completed Visual H W S 4 Surface preparation Ready to paint, clean and smooth Each work area Checklist Specification, as attached Smooth and clean Visual H H W 5 Painting Full & uniform cover, smooth, colour Each work area Checklist Specification, as attached Checklist and test panel Visual X S, H(C) S 6 Pre-handover activities All matters finalised, clean and tidy Each work area Checklist Specification, as attached Completed to spec/ clean and tidy Final inspection H H H