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Loop Check Sheet
Injected against observed at three points, through to the DCS or PLC.
SPARKY QC
Electrical QA/QC
sparkyqc.com
Project
Job No.
Client
Sheet ____ of ____
Loop No.
Instrument Tag
Service
Date
Signal Type
4-20 mA
4-20 mA HART
0-10 V
RTD
Thermocouple
Pulse
Discrete
Fieldbus
DCS / PLC Tag
Tolerance
Injection points
Injected 0%
Observed 0%
Injected 50%
Observed 50%
Injected 100%
Observed 100%
Alarms Tested
Yes
No
N/A
Test Instrument ID
Tested By
Result
Pass
Fail
Retest
Notes
Tested by / Date
Witnessed by / Date
Commissioning Acceptance / Date
SQ-LC-01 | Rev 0
Free blank form from
SPARKY QC
— sparkyqc.com