Corrologic AST Questionnaire Form

Corrologic AST Questionnaire
The questionnaire contains a series of items that help define the scope and set the project standards. The information provided in response to this questionnaire will be treated as customer confidential and will only be used by Cortec middle east.

General Information
Topic
Case id
Case number
Reviewer mail id
Customer Information
i

X
This field should be filled with Clients Name as per the email signature. The address should be at least city and country. This information can be found in the email signature of contact person from the client’s side. Example is the following:

Operating Company: Saudi Aramco

Field or Facility: Yanbu Refinery

City: Yanbu

Country: Saudi Arabia
End user
Sold to party
Country
City
Contact
i

X

All information most of the time can be found in the email signature of the person we are in communication with from the client’s side
First name
Last name
Job title
Email
example@example.com
Mobile phone

Tank General Info
i

X
The information from this section will help the tech support engineer develop a better understanding of the tank under consideration. It is also required to right the scope section in the technical proposal. In case of missing information, assumptions need to be made and clearly mentioned in the proposal.

i

X
It is usually mentioned in the tank data sheet or taken directly from the client. For other possible resources please refer to the comment above

i

X
It is usually mentioned in the tank data sheet, tank General Arrangement Drawing (GAD) and the foundation drawing.
Tank NO.*
Construction date
Tank diameter(m)
Tank datasheet

Cancelof
Product stored
Operating temperature (°C)*
Specify (°C)

Tank Foundation & Floor Details
Desired application type*
Other application type
Foundation drawings available?*

YesNo
Foundation drawings*

Cancelof
Ring wall type
Other ring wall type
Ring wall thickness (mm)
Reinforcement details
Grade type*
Other grade type
Grade type thickness (mm)
Does the tank have a release preventive barrier?

YesNo
Leak detection

YesNo
Depth (mm)
Floor layout

Cancelof
Comments

Tank Chime Area Seal System
Is a chime area seal system required?*

YesNo
Is there a drip ring?

YesNo
Seal system type
Chime area details
Gap height (mm)*
Gap depth (mm)*
Cartridge size*
Cartridge size*
Chime area seal system drawings and files

Cancelof
Comments

Tank Monitoring System
Is a corrosion monitoring system required?*

YesNo
Data logger type*
Probe type*
Data logger quantity*
Total length
Probe sensing element installation

Embedded in SandSuspended in Air
Desired probe embedment depth
Embedment depth
Data collection frequency
Custom frequency
Corrosion monitoring report submission frequency
Specify frequency
Based on "Custom" option from CMR frequency
Comments

Cathodic Protection System
Is there a CP system?*

YesNo
Current status of CP system*

OnOff
CP system status
Are CP related reports and drawings available ?

YesNo
Upload CP drawings and reports*

Cancelof
CP system type
Comments

Tank Inspection and repair Data
i

X
Upload available inspection data such as soil analysis, bottom plate metallurgical analysis, or corrosion product analysis etc…
Restrictions inside tank
Upload current and previous MFL & UT floor scan reports

Cancelof
Upload current and previous and inspection reports

Cancelof
Upload current and previous repair plans

Cancelof
Upload available inspection data

Cancelof
Comments

Field Services Resources & Execution Planning

Activities*

	Mobilization 1	Mobilization 2	Mobilization 3	Mobilization 4
Injectors
Slurry injection
Monitoring sys
Seal sys

Activities*

	Mobilization 1	Mobilization 2	Mobilization 3	Mobilization 4
Ring assembly
Junction box
Slurry injection
Monitoring sys
Seal sys

Resources

	Mobilization 1	Mobilization 2	Mobilization 3	Mobilization 4
Field service engineer
Project manager

	Mobilization 1	Mobilization 2	Mobilization 3	Mobilization 4
Loss/Extra days
Travel time

E COMMENTS
Provide copies of relevant Company HSSE regulations, requirements and standards.

Cancelof
Comments

Technical Inputs
Appendix A *

Cancelof
Tank additional details
Appendix A file name *
i

X
Please enter the Appendix file name same as the uploaded Appendix file from the above field

BOQ Information
Distance between two inj. points (m)*
Dosage rate (kg/m²)*
Viscowrap length (ft)*
Drilling/Fogging/Welding per hole (hr)
Drilling time per probe (hr)*
Shift hours *
Diffusion distance (m)*
Drilling time per port (hr)*
Injection rate (L/min)*
Instal time per ring (hr)*
Instal time per jun box (hr)*
Injection time (L/min)*
Instal time per probe (hr)*

Completed By
Name*
Creator email*
example@example.com
Signature

Clear
Signature upload

Cancelof
Date

MonthDayYear
Form status
If you do not have all the information available to fill-in, change the status as 'Draft'
Reviewer status*
Reference # *

Button section
Should be Empty: