Bell Hole Report

Pipeline exposed and directly examined — the dig, the pipe, and what the coating and CP were doing.

HOT PASS QA/QC Document Control
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Project

Job No.

Client

Sheet ____ of ____

Report No.

Date Excavated

Dig / Excavation No.

One-Call Ticket No.

Pipeline / Line

Segment / System

Product

MAOP

Station / Chainage

Milepost

Latitude

Longitude

County / State

Reason for the Dig

ILI feature verificationLeak / repairCorrosion assessmentECDA / direct assessmentCIS / CP investigationTie-in or fittingCasing investigationThird-party damageDepth of coverOther

In-Line Inspection Feature — what the tool said before anyone dug

Feature / Anomaly ID

Tool Run Date

Predicted Feature Type

Predicted Depth (% WT)

Predicted Length

Distance from U/S Girth Weld

Predicted O’Clock

Joint / Spool No.

Excavation

Length

Width

Depth

Depth of Cover at Pipe

Casing Present

YesNo

Casing Vent / Shorted

Foreign Lines Crossing

Nearest Test Station

Soil Type / Description

Soil Resistivity

Groundwater Present

YesNo

Shoring / Sloping / Benching

Pipe Data — as found, not as recorded

Nominal OD

Nominal Wall Thickness

Grade / SMYS

Seam Type

Manufacturer / Year

Operating Pressure at Exam

Pipe Temperature

Pipe Marking / Stencil

Coating & Cathodic Protection — readings taken before the coating is disturbed

Coating Type

FBECoal tar enamelAsphaltTape wrapShrink sleeveLiquid epoxyWaxBare

Coating Condition

GoodFairPoorDisbondedHolidaysWrinkled / tentedWater under coatingSoil stress damage

P/S Potential — ON

P/S Potential — Instant OFF

Reference Electrode

Test Lead / Anode Installed

HP-BH-01 | Rev 0 | Side 1 of 2 Free blank form from HOT PASS QA/QC — hotpassqc.com

Bell Hole Report

Direct examination, wall thickness readings, assessment, disposition and backfill.

HOT PASS QA/QC Document Control
hotpassqc.com

Project

Job No.

Client

Report No.

Condition Found on the Pipe Surface

No defect foundGeneral corrosionPittingInternal corrosionGougeDentCrackArc burnLaminationSeam anomalyGirth weld anomalyMechanical damage

Grid Datum — 0 in. is

Grid Interval

Measurement Method

Instrument / Serial No.

O’clock \ Axial

0″

3″

6″

9″

12″

15″

18″

21″

24″

12:00

1:30

3:00

4:30

6:00

7:30

9:00

10:30

Remaining wall thickness at each point, not pit depth — say which in the datum box if the job works the other way round. Record the deepest reading in the row below whether or not it landed on a grid point.

Max Pit Depth

Min Remaining Wall

Wall Loss (%)

Corroded Length

Corroded Width

Actual O’Clock Position

Actual Distance from U/S Girth Weld

NDE Performed

NDE Technician / Level

Remaining Strength & Disposition

Assessment Method

Predicted Failure Pressure

Safety Factor

Pressure Restriction Applied

Disposition

No repair — recoat onlyGrind and recoatComposite wrapType A sleeveType B sleevePipe replacementDeferred — engineering review

Surface Preparation

Coating Applied

DFT

Holiday Test

Padding / Select Backfill

Rock Shield

Warning Tape

Cover Restored

Date Backfilled

Restoration / Reclamation

Photos Taken (nos.)

Excavation Left Open Overnight

Yes — barricadedNo

Notes & Observations

Examined by / Date

NDE technician / Level / Date

Integrity / engineering review / Date

HP-BH-01 | Rev 0 | Side 2 of 2 Free blank form from HOT PASS QA/QC — hotpassqc.com