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Run: Excess Flow Valve Installation Verification

Use this EFV installation verification template to confirm whether an excess flow valve is required, installed correctly, and documented for annual reporting...

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Inspection Details and Service Line Identification

Service location and customer account identified critical (required)

Enter the service address, customer account, or work order reference used to identify the gas service line.

Service line work type confirmed critical (required)

Identify whether the work was a new installation, replacement, repair, or other service activity.

Service line serves single-family residence or small commercial customer critical (required)

Confirm whether the service line falls within the customer classes typically subject to EFV installation requirements.

Yes No N/A

Inspection date recorded

Record the date and time of the field verification or record review.

Inspector name and role recorded

Enter the inspector's name, title, or role performing the verification.

EFV Applicability and Eligibility Review

EFV applicability reviewed against applicable service criteria critical (required)

Verify that the line was evaluated for EFV applicability based on service type, customer class, and work scope.

Yes No N/A

No documented exemption or exception applies critical (required)

Confirm that no approved exemption, exception, or documented non-applicability applies to this service line.

Yes No N/A

EFV eligibility determination documented critical (required)

Record the final eligibility determination for the service line.

Note (optional)

Eligibility basis documented in record

Describe the basis for the eligibility decision, including customer class, service work type, or exemption rationale.

Supporting record reviewed

Select the records used to verify EFV applicability and installation status.

EFV Installation Verification

EFV installed on applicable service line critical (required)

Verify that an excess flow valve is installed on the applicable gas service line.

Yes No N/A

Photo evidence (optional)

Installation location matches approved design or standard detail critical (required)

Confirm the EFV location matches the approved installation detail, service configuration, or utility standard.

Yes No N/A

Valve orientation and connection appear correct critical (required)

Verify the valve is installed in the correct flow direction and connected without visible defects, leaks, or improper fittings.

Yes No N/A

Installation evidence captured

Attach a photo showing the EFV installation or supporting field evidence.

Note (optional)

Installation completion date recorded

Record the date the EFV installation was completed or verified complete.

Documentation, Reporting, and Records

EFV installation status entered in system of record critical (required)

Confirm the EFV installation status has been entered into the utility's official record system.

Yes No N/A

Annual reporting data field completed critical (required)

Verify the data needed for annual EFV reporting has been completed and is ready for aggregation.

Yes No N/A

Deficiency or non-conformance documented when applicable

Document any missing EFV, ineligible service, or record discrepancy as a deficiency or non-conformance.

Yes No N/A

Note (optional)

Corrective action assigned for unresolved deficiency

Describe the corrective action, responsible party, and target completion date if a deficiency was identified.

Safety, Compliance, and Sign-Off

Inspection completed without unresolved critical items critical (required)

Confirm there are no unresolved critical deficiencies remaining at closeout.

Yes No N/A

Inspector signature critical (required)

Inspector signs to confirm the accuracy of the verification.

Supervisor or compliance reviewer approval

Optional supervisory sign-off for compliance review and annual reporting validation.

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