Pipeline Deposit Inspection & Cleaning Efficiency Survey
Please provide detailed feedback on your recent pipeline inspection and cleaning process to help us improve our operations.
Pipeline Identifier or Location
*
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type(s) of Deposits Observed
*
Scale
Wax
Sand
Organic Material
Other
Deposit Severity Rating
*
1
2
3
4
5
Cleaning Method Used
*
Please Select
Mechanical Pigging
Chemical Cleaning
Hydro Jetting
Manual Removal
Other
Cleaning Effectiveness Rating
*
1
2
3
4
5
Did the cleaning meet your expectations?
*
Yes
Partially
No
Rate the following aspects of the cleaning process
*
Rows
Accessibility
Residue Removed
Time Efficiency
Poor
1
2
3
Fair
4
5
6
Good
7
8
9
Very Good
10
11
12
Excellent
13
14
15
Observed Challenges or Issues
Additional Comments or Suggestions
Submit Survey
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