Gas Main Pressure Test and Tie-In Report

Inspection template for documenting strength and leak testing of new or repaired gas mains, including tie-in readiness, test pressures, duration, leak observations, and final sign-off.

Inspection Identification

• Project, location, and segment identified
  Record the project name, site address or GPS location, and the specific main segment, stationing, or tie-in point being inspected.
• Inspection date and time recorded
  Enter the date and time the pressure test or tie-in inspection was performed.
• Inspector and competent person identified
  Record the inspector name, employer, and the competent person responsible for the work area, if applicable.
• Work scope confirmed
  Select the scope of work covered by this report.

Pre-Test Readiness and Safety

• Test section isolated and secured
  Confirm the test section is isolated from live gas sources and secured for testing.
• Required permits and utility notifications completed
  Verify excavation, utility coordination, and any required permits or notifications are complete before testing or tie-in.
• PPE and hazard controls in place
  Select the hazard controls verified at the worksite.
• Area free of ignition sources
  Confirm the test and tie-in area is controlled for ignition sources and other foreseeable hazards.

Test Equipment and Calibration

• Pressure gauge or recorder calibrated
  Verify the pressure gauge, recorder, or data logger used for the test has current calibration documentation.
• Gauge range appropriate for test pressure
  Confirm the selected gauge range is suitable for the planned test pressure and provides readable resolution.
• Test medium identified
  Select the medium used for the pressure test.
• Test equipment serial number recorded
  Record the serial number or asset ID of the primary test equipment used.

Pressure Test Execution

• Test pressure recorded
  Record the applied test pressure for the gas main.
• Hold duration recorded
  Record the duration the test pressure was held.
• Pressure stabilized before acceptance reading
  Confirm the line was allowed to stabilize before the final acceptance reading was taken.
• No pressure loss beyond allowable limit
  Confirm the test held without pressure loss beyond the project or governing standard limit during the hold period.
• Leak observations documented
  Record any leak indications, repair actions, retest results, or note that no leaks were observed.

Tie-In Verification

• Tie-in points verified against approved drawings
  Confirm the tie-in locations match the approved design, as-built plan, or work order.
• Isolation, purge, and re-pressurization steps completed
  Verify the tie-in procedure included the required isolation, purging, and re-pressurization steps before returning the segment to service.
• Tie-in joints inspected for leaks
  Confirm all tie-in joints, fittings, and closures were inspected for leaks after completion.
• Service restoration authorized
  Confirm the segment was not placed into service until authorized by the responsible supervisor or AHJ, as applicable.

Deficiencies, Corrective Actions, and Sign-Off

• Deficiencies or non-conformances recorded
  Document any deficiencies, non-conformances, or exceptions identified during the inspection.
• Corrective actions completed or assigned
  Record corrective actions taken, responsible party, and target completion date if any item failed or required follow-up.
• Inspector signature
  Inspector signs to attest the report is complete and accurate.