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Run: Gas Distribution Leak Survey Bar Hole Log

Log bar-hole and surface gas leak survey readings, instrument checks, leak classifications, and follow-up actions in one field-ready record. Use it to docume...

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Inspection Details and Survey Scope

Survey date and start time recorded critical (required)

Survey route, main segment, or stationing identified critical (required)

Survey type selected critical (required)

Weather and ground conditions noted

Survey performed by competent person or qualified technician critical (required)

Yes No N/A

Reference work order, map, or SOP documented

Instrument Verification and Calibration

Gas detection instrument identified by make, model, and serial number critical (required)

Instrument bump test or functional check current critical (required)

Yes No N/A

Calibration date within required interval critical (required)

Note (optional)

Measurement mode selected correctly critical (required)

Sampling probe, hose, or bar-hole adapter inspected for damage and leaks critical (required)

Yes No N/A

Bar-Hole and Surface Readings

Reading location recorded with stationing or offset critical (required)

Bar-hole depth or probe insertion depth recorded critical (required)

Note (optional)

Peak gas reading recorded in ppm

Note (optional)

Peak gas reading recorded in % LEL

Note (optional)

Odor, hissing, dead vegetation, bubbling, or other leak indicators observed

Adjacent structures, valves, services, or appurtenances checked

Yes No N/A

Repeat reading taken when initial reading exceeded action threshold critical (required)

Yes No N/A

Leak Classification and Immediate Actions

Leak classification assigned critical (required)

Note (optional)

Area secured or traffic/pedestrian controls established when needed critical (required)

Yes No N/A

Utility notification or escalation completed for confirmed leak critical (required)

Yes No N/A

Emergency response or excavation hold placed when required critical (required)

Yes No N/A

Disposition, Corrective Action, and Sign-Off

Follow-up disposition documented critical (required)

Note (optional)

Corrective action details entered for any deficiency or non-conformance

Inspector signature completed critical (required)

Supervisor review required for critical leak or failed instrument check

Yes No N/A

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