GasSO Ref: EMSD/GSD-B/ Page 3 of 4 For Item D4 - Date of Pipework Test/Inspection Underground LPG pipes Exposed LPG pipes within Compound/Store within Compound/Store Date of pressure test Comply with requirement? (dd/mm/yyyy) Date of inspection Comply with requirement? (dd/mm/yyyy) For Item D5 - Date of HPRV replacement Batch No. 1 Batch No. 2 Batch No. 3 Batch No. 4 Number of HPRV Comply with Comply with Comply with Comply with requirement? requirement? requirement? requirement? (dd/mm/yyyy) * delete as appropriate For Item F3 - Date of Replacement of Flexible Gas Tubings Batch No. 1 Batch No. 2 Number of Flexible Gas Tubings Last replacement Comply with Comply with date of flexible gas requirement? requirement? tubing (dd/mm/yyyy) For Item G - Summary of Irregularities Observed/Other Information (e.g. unsafe/adverse conditions, overdue examination/testing etc.) * delete as appropriate Section III Recommendations and Remedial Work Recommendations by Competent Person Remedial work done by Owner (Tick if completed or put down planned Checklist Description completion date)# Item Note: # Remedial work should be completed as soon as possible and in any case not later than 3 months from the date of inspection. Otherwise, substantiation should be provided. The Gas Authority may conduct follow up inspection on the irregularities. GasSO Ref: EMSD/GSD-B/ Page 4 of 4
GasSO Ref: EMSD/GSD-B/ Page 3 of 4 For Item D4 - Date of Pipework Test/Inspection Underground LPG pipes within Compound/Store Exposed LPG pipes within Compound/Store Date of pressure test (dd/mm/yyyy) Comply with requirement? Date of inspection (dd/mm/yyyy) Comply with requirement? For Item D5 - Date of HPRV replacement Batch No. 1 Batch No. 2 Batch No. 3 Batch No. 4 Number of HPRV (dd/mm/yyyy) Comply with requirement? Comply with requirement? Comply with requirement? Comply with requirement? * delete as appropriate For Item F3 - Date of Replacement of Flexible Gas Tubings Batch No. 1 Batch No. 2 Number of Flexible Gas Tubings Last replacement date of flexible gas tubing (dd/mm/yyyy) Comply with requirement? Comply with requirement? For Item G - Summary of Irregularities Observed/Other Information (e.g. unsafe/adverse conditions, overdue examination/testing etc.) * delete as appropriate Section III Recommendations and Remedial Work Recommendations by Competent Person Remedial work done by Owner (Tick if completed or put down planned completion date)# Checklist Item Description Note: # Remedial work should be completed as soon as possible and in any case not later than 3 months from the date of inspection. Otherwise, substantiation should be provided. The Gas Authority may conduct follow up inspection on the irregularities. GasSO Ref: EMSD/GSD-B/ Page 4 of 4
Form109.docx