In-Place Gasketing Inspection Form
Inspect in-place gasketing, record condition and findings, and capture any follow-up actions using the In-Place Gasketing Inspection Form.
Inspection Details
Equipment or Asset Identifier
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Location or Area Inspected
*
Inspector Name
*
Inspection Type
*
Please Select
Routine
Post-Maintenance
Pre-Shutdown
Follow-Up
Other
Gasket Condition Review
Gasket Condition Rating
*
Excellent
Good
Fair
Poor
Evidence of Wear or Damage
*
Cracks
Compression Set
Tears
Contamination
Misalignment
No Visible Issues
Seal Continuity Assessment
*
Pass
Needs Attention
Fail
Leak Evidence Observed
*
None
Minor Seepage
Active Leak
Inspector Comments
Actions and Sign-Off
Corrective Action Required
*
Yes
No
Corrective Action Details
Priority Level
*
Please Select
Low
Medium
High
Inspector Sign-Off
First Name
Last Name
Submit Form
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