PE Butt Weld Quality Survey
Use this form to record polyethylene butt weld inspection details and assess weld quality.
Weld Identification
Weld Identifier / Serial Number
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Job / Site or Project Reference
Material and Process Details
Pipe size / diameter
*
PE material grade
*
Pipe wall thickness (SDR or mm)
*
Welding machine / operator setup status
*
Verified
Partially verified
Not verified
Quality Assessment
Weld Appearance Rating
*
1
2
3
4
5
Defect Checklist
*
Bead misalignment
Excessive bead
Insufficient bead
Contamination
Ovality
No visible defect
Overall Decision
*
Pass
Fail
Observations / Comments
Submit
Should be Empty: