Run Instrument Loop Check Sheet — Free

Inspection Setup and Loop Identification

Loop tag, service, and equipment numbers match the work package critical (required)

Yes No N/A

Loop type identified as cold check or hot check critical (required)

Note (optional)

Permit, LOTO, and test authorization verified critical (required)

Yes No N/A

Required test equipment calibrated and within current certification critical (required)

Yes No N/A

Field Instrument and Calibration Verification

Instrument installed correctly and process connections secure critical (required)

Yes No N/A

Photo evidence (optional)

Calibration as-found value recorded

Note (optional)

Calibration as-left value recorded

Note (optional)

Applied input or simulated signal at field device

Field device output responds smoothly across test points critical (required)

Yes No N/A

Signal Path and DCS Verification

Wiring continuity and terminal terminations verified critical (required)

Yes No N/A

DCS input tag and scaling match loop documentation critical (required)

Yes No N/A

DCS indicated value at low test point critical (required)

Note (optional)

DCS indicated value at mid test point critical (required)

Note (optional)

DCS indicated value at high test point critical (required)

Note (optional)

Alarm, Interlock, and Control Response

Alarm low setpoint annunciates at the correct value critical (required)

Yes No N/A

Alarm high setpoint annunciates at the correct value critical (required)

Yes No N/A

Interlock or permissive logic responds as designed critical (required)

Yes No N/A

Final control element strokes correctly from DCS command critical (required)

Yes No N/A

Valve travel or actuator response time recorded

Note (optional)

Deficiencies, Corrective Actions, and Signoff

Deficiencies or non-conformances documented

Note (optional)

Corrective action completed and retest passed critical (required)

Yes No N/A

Inspector comments and punch list reference

Inspector signature critical (required)

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Run: Instrument Loop Check Sheet

Inspection Setup and Loop Identification

Field Instrument and Calibration Verification

Signal Path and DCS Verification

Alarm, Interlock, and Control Response

Deficiencies, Corrective Actions, and Signoff

Get your results