Inspection Release Certificate Template

INSPECTION RELEASE CERTIFICATE (IRC) This is to certify that the equipment / material mentioned hereunder has been released for shipment, subject to satisfactory  compliance with PACKIN, !A"KIN AN# #$C%!&NTI$N 'P(!(#() IN*T"%CTI$N*(

IRC DETAILS IRC No.: Project No.: Purchase order No.: Name o" Supp%ier: Location: Date: !dd-mmm-##$ ) Re%eased b# this IRC:

Inspection Report No.: Project Name: Sub-rder No. !i" an#$: Name "or Sub-Supp%ier: Shipment No: Inspected & 'ai(ed: ) Re%eased to Date:

If Inspection has been wai+ed, the *upplier is still responsible for ensurin that the correct material is supplied and is fully compliant  with the Purchase $rder requirements( A copy of all rele+ant material / test certificates shall be shipped with the supplied items(

P Item No.

Ta* No.

+uantit# Pre(ious%# Re%eased

P +uantit#

Description

+uantit# This Re%ease

Supp%ier to comp%ete the "o%%o,in* items prior to shipment.

Carr# (er 'or - I" app%icab%e inc%ude item detai%s or attach Carr# (er ,or %ist as detai%ed be%o,.

Read# "or Shipment eri"ication. Identify all openings such as pipe flanges, nozzles, hatches, manholes, vessel manways/skirts and ducting.

Checed

N&A

+uantit# o" penin*s

IRC ATTAC/0ENTS The following documents have been checked and are attached to the IRC where indicated. !/" # !ot "pplicable$ "pplicable$ Documents %acking &ist hard copy from supplier$ Certificate of Compliance.

Checed

Attached

N&A

Comments

C of C shall include the following statement+ 'upplier certifies that the euipment inclusive of temporaries and packing$ does not contain hazardous materials where prohibited by "ustralian Customs as detailed in the "ustralian Customs -order %r otection 'ervice website for %rohibited and Restricted Imports www.customs.go www.customs.gov.au/site/page v.au/site/page 01.asp 01.asp$. $. 2or e3ample, asbestos+containing materials including Compressed  "sbestos 4askets C"2$, mercury, lead or or lead+based paints, and %C-*s.

'upplier to provide C of C for materials used to cover openings identified during (Ready for shipment )erification* inspection$.

5aterial test Certificates Carry 6ver 7ork &ist 5anufacturing 8ata Record 58R$ 6ther  SI1NAT2RES Print Name Project Inspection representati(e

Si*nature

Date

Supp%ier +A&+C representati(e

Print Name

Si*nature

Date

3AT (eri"ied to P re4uirements b# Paca*e En*ineer  No outstandin* CR 5 NCR (eri"ied b# +C Coordinator  This certificate is issued without prejudice and does not relie+e the abo+e mentioned *upplier from the uarantees and obliations set forth in the Purchase $rder, subsequent Chane $rders and attachments(