Instrument Loop Check Sheet

Inspection template for verifying the full instrument signal chain from field device to DCS, including calibration, point-to-point continuity, alarm response, and final control element stroke verification.

Inspection Setup and Loop Identification

• Loop tag, service, and equipment numbers match the work package
• Loop type identified as cold check or hot check
• Permit, LOTO, and test authorization verified
• Required test equipment calibrated and within current certification

Field Instrument and Calibration Verification

• Instrument installed correctly and process connections secure
• Calibration as-found value recorded
• Calibration as-left value recorded
• Applied input or simulated signal at field device
• Field device output responds smoothly across test points

Signal Path and DCS Verification

• Wiring continuity and terminal terminations verified
• DCS input tag and scaling match loop documentation
• DCS indicated value at low test point
• DCS indicated value at mid test point
• DCS indicated value at high test point

Alarm, Interlock, and Control Response

• Alarm low setpoint annunciates at the correct value
• Alarm high setpoint annunciates at the correct value
• Interlock or permissive logic responds as designed
• Final control element strokes correctly from DCS command
• Valve travel or actuator response time recorded

Deficiencies, Corrective Actions, and Signoff

• Deficiencies or non-conformances documented
• Corrective action completed and retest passed
• Inspector comments and punch list reference
• Inspector signature