Form QT6(a)

FINAL JOINT INSPECTION REPORT (EXTERNAL PIPELINE) Page 1 of 3

(Valid for six (6) months prior taking over date)

Name of Development :
:
:
Project Reference No. :
Approval Plan No. :
(Attach approved plan and as-built plan of pipeline)
Date of Inspection :
Phase/ Name of Location
pipeline checked :

Work Discription Remarks

Type of Diameter Satisfactory Unsatisfactory
A) Pipelines Lenght (m) Comments
pipe (mm) (tick relevan column)
1. Main pipes

2. Communication pipes
Type Nos Size (mm)
3. Sluice valves
4. Butterfly valves
5. Air valves
6. Scour valves
7. Hydrants
8. Valve chambers
9. Pipe markers
10. Pressure reducing valves
11. Sampling points
12. Zone meters
13. Over crossing with/ without
supports/ spike guards
14. Constant Flow Valve
(calibrated)
15. Pipes laid within public road reserve or pipeline reserve
16. Other items :
Satisfactory Unsatisfactory
B) Individual Meter Stand Details Comments
(tick relevan column)
1. Material type
2. Meter size ( mm )
3. Minimum height (mm). 450mm (± 50mm) between mid-
centre of meter to ground.
4. Un-obstructive position for meter reading and meter maintenance.
5. Meter short piece length: 5D =
3D =
 Form QT6(a)
FINAL JOINT INSPECTION REPORT (EXTERNAL PIPELINE) Page 2 of 3
(Valid for six (6) months prior taking over date)

Project Reference No. :

Date of Inspection :

Satisfactory Unsatisfactory
C) Multimeter Stand Details Comments
(tick relevan column)
1. Material type
2. Meter size ( mm )
3. Minimum height (mm)*
Between mid-centre of specials to floor slab.
4. Un-obstructive position for meter reading and meter maintenance.
5. Minimum dist. between meter (mm)
Between mid-centre of meters.*
6. Meter short piece length: 5D =
3D =
Satisfactory Unsatisfactory
D) Domestic Bulk Meter Stand Details Comments
(tick relevan column)
1. Material type
2. Meter size ( mm )
3. Minimum height (mm)*
Between mid-centre of specials to floor slab.
4. Un-obstructive position for meter reading and meter maintenance.
5. Minimum dist. between meter (mm)
Between mid-centre of meters.*
6. Meter short piece length: 6D =
3D =
7. Concrete slab
Satisfactory Unsatisfactory
E) Bulk Meter Stand for Hydrant Details Comments
(tick relevan column)
1. Material
2. Meter size ( mm )
3. Minimum height (mm)*
Between mid-centre of specials to floor slab.
4. Un-obstructive position for meter reading and meter maintenance.
5. Minimum dist. between meter (mm)
Between mid-centre of meters.*
6D =
6. Meter short piece length (mm)
3D =
7. Concrete slab
Satisfactory Unsatisfactory
F) Others (Specify) Details Comments
(tick relevan column)
1.
*Shall refer to appproved standard drawings

Form QT6(a)
 Page 3 of 3
FINAL JOINT INSPECTION REPORT (EXTERNAL PIPELINE)
(Valid for six (6) months prior taking over date)

Project Reference No. :

Checked By

Name :
Firm :
CP Registration No :
NRIC. No. :
Signature of Competent Person
Date :

1. Witnessed By

Name :
Staff No :
Signature of AIR SELANGOR;
Regional Development Unit
Date :

2. Witnessed By

Name :
Staff No :
Signature of SYABAS;
(<50,000LPD) Head, Regional Development Unit/
(≥50,000LPD) Head, of Take Over Unit (HQ)
Date :