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TEM-025 Example Installation Qualification Report Sample

This document is an installation qualification report that details requirements for instrument calibration reports, preventative maintenance programs, acceptance testing reports from factory and site tests, and commissioning reports. It also requires specifications to be listed along with any file names or numbers, as well as details for discrepancies observed and signatures of all personnel involved in verification and commissioning activities to be logged.

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Arnold
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250 views1 page

TEM-025 Example Installation Qualification Report Sample

This document is an installation qualification report that details requirements for instrument calibration reports, preventative maintenance programs, acceptance testing reports from factory and site tests, and commissioning reports. It also requires specifications to be listed along with any file names or numbers, as well as details for discrepancies observed and signatures of all personnel involved in verification and commissioning activities to be logged.

Uploaded by

Arnold
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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TEM-025

Issue date
Installation Qualification Report
(Ref.VAL-005)

8. Instrumentation
Attach all items requiring calibration.
Attach calibration reports for all critical items and non critical items requiring calibration with their serial no.
9. Preventative Maintenance
Record all Preventative Maintenance Programs.
For each piece of equipment attach the maintenance program and maintenance period
10. Acceptance Tests and Commissioning Overview
Attach copies of the Factory Acceptance Testing report (FAT) and the Site Acceptance Testing report
(SAT) as appropriate.
Attach a commissioning report stating the test procedure undertaken during the commissioning of tests.
· Fill out a signature log for all people involved in the acceptance and commissioning tests.
· Detail any issues observed and the resulting actions using a discrepancy form.
List specific product or process non conformities observed and describe the relevant remedies taken to
prevent reoccurrence using a discrepancy form
11. Handover of Specifications

Specifications File name and no Completed


User Requirement Specification(s)
Functional Specification(s)
Software Design Specification(s)
Software Module Design
Specification(s)
Hardware Design Specification(s)
Operator’s Control Panel
Specification(s)
Mechanical Specification(s)

12. Discrepancies
Detail any discrepancies/variations that have been observed between the design/ demand/ functionality
specifications and the actual equipment as installed in a Discrepancy Form (Form-370).
Discrepancy Forms should be included as attachments.
Number of Discrepancy Forms =
13. Signature Log
A signature log is to be signed by every person working on verification activities (including commissioning
and IQ) associated with the project.

Name Sign Date

File Location: Date Printed: Page 3 of 4

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