Medical Gas Piping Verification Inspection - NFPA 99

Verification testing record for medical gas piping systems per NFPA 99, documenting pressure test results, cross-connection verification, particulate cleanliness, final tie-in readiness, and ASSE 6030 verifier sign-off.

Inspection Identification

• Project, facility, and system identification recorded
  Document the project name, facility name, building/wing, system identifier, and service type being verified.
• Inspection date and time recorded
  Record the date and time the verification inspection was performed.
• Verifier identified as ASSE 6030 qualified
  Confirm the inspector/verifier is qualified to perform medical gas verification testing as required by the project and NFPA 99 workflow.

Pre-Test Conditions and Safety

• Permits, shutdown approvals, and AHJ requirements confirmed
  Verify required permits, shutdown notifications, and Authority Having Jurisdiction requirements are in place before testing.
• Piping section isolated and identified for test
  Confirm the test boundary is isolated, tagged, and clearly identified to prevent unintended service interruption or cross-connection.
• Test equipment calibrated and within certification date
  Verify gauges, pressure devices, and any particulate test equipment are calibrated and traceable to current certification.
• System components installed and ready for verification
  Select the components that are installed and included in the verification scope.

Pressure Test Verification

• Test medium matches approved procedure
  Confirm the test medium used for pressure testing matches the approved procedure and project requirements.
• Test pressure recorded
  Record the applied test pressure used for the verification test.
• Pressure hold duration recorded
  Record the duration the system held test pressure during observation.
• No pressure loss or visible leakage observed
  Confirm the piping section maintained pressure with no visible leakage, deformation, or other deficiency during the hold period.

Cross-Connection and Label Verification

• Cross-connection test completed
  Confirm the cross-connection test was performed on the medical gas piping system.
• No cross-connections detected between gas services
  Verify that outlets, piping, valves, and source connections are correctly connected to the intended gas service and no cross-connection exists.
• System labeling and identification are correct
  Confirm piping, outlets, valves, and source components are labeled with the correct gas designation and directional identification where required.
• Terminal units and source points match documented gas service
  Verify terminal units, manifold connections, and source points correspond to the documented medical gas service and installation drawings.

Particulate Cleanliness and Final Tie-In

• Particulate test completed
  Confirm particulate cleanliness testing was completed for the piping section as required by the project specification and verification procedure.
• Particulate test result acceptable
  Verify the particulate test result met the acceptance criteria for the medical gas piping system.
• Final tie-in approved for service
  Confirm the system is approved for final tie-in only after successful verification testing and required corrections are complete.

Deficiencies and Sign-Off

• Deficiencies or non-conformances documented
  Record all deficiencies, non-conformances, corrective actions, and retest requirements.
• Inspector signature
  Signature of the qualified verifier completing the inspection.