BOILER PREFUNCTIONAL CHECKLIST PC-02_____

Prefunctional Checklist
Project ____________________________________

PC-02____ BOILER #s________________________

Associated checklists: HW Pumps

!u"#ittal $ A%%ro&als

Submittal. The above equipment and systems integral to them are complete and ready for functional testing. The checklist items are complete and have been checked off only by parties having direct knowledge of the event, as marked below, respective to each responsible contractor. This prefunctional checklist is submitted for approval, subject to an attached list of outstanding items yet to be completed. A Statement of Correction will be submitted upon completion of any outstanding areas. one of the outstanding items preclude safe and reliable functional tests being performed. !!! "ist attached. !!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!
#echanical Contractor $ate

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Controls Contractor $ate

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%lectrical Contractor TA& Contractor $ate $ate

!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!
Sheet #etal Contractor 'eneral Contractor $ate $ate

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(refunctional checklist items are to be completed as part of startup ) initial checkout, preparatory to functional testing. This checklist does not take the place of the manufacturer*s recommended checkout and startup procedures or report. This checklist does not comprehensively address fire and life safety or basic equipment safety controls. +tems that do not apply shall be noted with the reasons on this form , -A . not applicable, &/ . by others0. +f this form is not used for documenting, one of similar rigor shall be used. Contractors assigned responsibility for sections of the checklist shall be responsible to see that checklist items by their subcontractors are completed and checked off. 1Contr.2 column or abbreviations in brackets to the right of an item refer to the contractor responsible to verify completion of this item. A-% . architect-engineer, All . all contractors, CA . commissioning agent, CC . controls contractor, %C . electrical contractor, 'C . general contractor, #C . mechanical contractor, SC . sheet metal contractor, TA& . test and balance contractor, !!!! . !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!.

Approvals. This filled3out checklist has been reviewed. +ts completion is approved with the e4ceptions noted below.

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Commissioning Agent $ate

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/wner*s 5epresentative $ate

Notes

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&

BOILER PREFUNCTIONAL CHECKLIST PC-02_____

'ocu#entation on site or at (acilities )*his section to "e co#%leted "+ CA ,

Check if /kay. %nter comment or note number if deficient.
Check E-ui% *a.--/

2+0u3+cturers su4m!tt+"s* !0c( per3orm+0ce )+t+ I0st+""+t!o0 +0) st+rtup m+0u+" St+rtup )ocume0t+t!o0 O52 m+0u+"s

Documentation complete as per contract documents.................................___ YES ___ NO

1odel &erification )*his section to "e co#%leted "+ CA ,

& 6 +s spec!3!e)* # 6 +s su4m!tte)* 7 6 +s !0st+""e)( C8ec9 !3 O9+:( E0ter 0ote 0um4er !3 )e3!c!e0t( E;u!p T+1<<<=
& # 7 & 2o)e" # 7 Ser!+" # 7 & Fue" # Source 7 & T:pe* # HW* ste+m 7 Output & C+p+c!t:* # 2Btu-8r 7 & I0put* # 2Btu-8r 7 Com4ust!o0 & E33!c!e0c:* # A>A ?1+s@ 7 & # st+1es or # mo)u"+t!01 7 Tur0)oA0 & R+t!o # ?m+B-m!0 3!re@ 7 Wor9!01 & Pressure* # ps!1 7 I0te1r+" & W+ter # He+terC 7

203ctr(

The equipment installed matches the specifications...................................___ YES ___ NO

Notes

F!"e #$%&$&'$%()oc* Re"e+se &($* ,-./ Bu!")!01 N+me

BOILER PREFUNCTIONAL CHECKLIST PC-02_____

Installation Checks

T8!s sect!o0 !s to 4e comp"ete) 4: t8e Comm!ss!o0!01 A1e0t ?CA@* 2ec8+0!c+" Co0tr+ctor ?2C@* or Co0tro" Co0tr+ctor ?CC@* +s 0ote) !0 3!0+" co"um0( Perso0 c8ec9!01 o33 e+c8 !tem s8+"" !0!t!+" !0 3!0+" co"um0( C8ec9 !3 O9+:( E0ter comme0t or 0ote 0um4er !3 )e3!c!e0t(
Check 3eneral Installation >e0er+" +ppe+r+0ce 1oo)* 0o +pp+re0t )+m+1e Test +0) 4+"+0ce report HW 3"oAs m+tc8 )es!10 &$D Bo!"er +0) +ccessor: e0E!ro0me0t c"e+0 A)e;u+te 4o!"er 5 +ccessor: +ccess 3or m+!0te0+0ce 5 tu4e pu""!01 No E!s!4"e A+ter or ste+m "e+9s Pressure 1+u1es 5 t8ermometers !0st+""e) per )es!10 E;u!pme0t "+4e"s +33!Be) per spec Re;u!re) se!sm!c restr+!0ts !0 p"+ce F"ue comp"ete": !0st+""e) +0) s"ope) proper": Com4ust!o0 +!r supp": comp"ete S:stem 3!""e) P-T p"u1s !0st+""e) per )es!10 CACACACACACACACACACACACAE-ui% *a.-/ Contr $ Initials

Pi%in. ?!0 E!c!0!t: o3 4o!"ers@ >+s p!p!01 !0st+""e) +0) teste) 5 supp": !s +t proper pressure H:)ro0!c p!p!01 comp"ete +0) teste)* !0c"u)!01 4"oA)oA0 s:stem* m+9eup A+ter p!p!01* +0) s+3et: re"!e3s P!p!01 co03!1ur+t!o0 per )es!10 5 per m03ctrs re;u!reme0ts P!p!01 !0su"+t!o0 !0 1oo) co0)!t!o0 A8ere E!s!4"e C8ec9 E+"Ees 5 3"oA sA!tc8es !0st+""e) !0 proper )!rect!o0( P!p!01 0ot supporte) o0 4o!"er or E+"Ees H:)ro0!c s:stem 3"us8!01 comp"ete +0) str+!0ers c"e+0e) Iso"+t!o0 E+"Ees +0) 4+"+0c!01 E+"Ees !0st+""e) per )es!10 Autom+t!c E+"Ees stro9e 3ree": 5 c"ose t!18t": ?see sect!o0 / proce)uresF 8e+t!01 co!" E+"Ees coEere) A!t8 AHUs@ P!pe 3!tt!01s +0) +ccessor!es comp"ete per )es!10 Pressure re"!e3 E+"Ee !0st+""e) +0) p!pe) to )r+!0F p!pe 0ot supporte) o0 E+"Ee Pressure re"!e3 E+"Ee sett!01 !s per m03ctrs re;u!reme0t P!p!01 t:pe +0) 3"oA )!rect!o0 "+4e"e) o0 p!p!01 W+ter tre+tme0t s:stem or p"+0 !0st+""e) EBp+0s!o0 t+09s* +!r e"!m!0+tor* etc( !0st+""e) per )es!10 5 oper+t!o0+" A!r Ee0ts +0) 4"ee)s +t 8!18 po!0ts o3 s:stems 3u0ct!o0+" 2C2CCACACACA2CCACACACA2CCA2CCACA-

Notes

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BOILER PREFUNCTIONAL CHECKLIST PC-02_____

Check Ste+m tr+ps !0st+""e) per )es!10* +0) oper+t!o0+" Co0)e0s+te pumps !0st+""e) per )es!10* +0) oper+t!o0+" E-ui% *a.-/ Contr $ Initials CACA-

Electrical and Controls E"ectr!c+" co00ect!o0s t!18t PoAer )!sco00ects !0st+""e) 5 "+4e"e) Co0tro" s:stem !0ter"oc9s 8oo9e) up +0) 3u0ct!o0+" A"" co0tro" )eE!ces* p0eum+t!c tu4!01 +0) A!r!01 comp"ete Bo!"er 1+teA+: or !0ter3+ce to co0tro" s:stem !0st+""e) 5 3u0ct!o0+" CACACCCCCC-

The checklist items of Part 4 are all successfully completed.....................___ YES ___ NO

O%erational Checks ?T8ese +u1me0t m3rs "!st( T8!s !s 0ot t8e 3u0ct!o0+" per3orm+0ce test!01(@

T8!s sect!o0 !s to 4e comp"ete) 4: t8e Comm!ss!o0!01 A1e0t ?CA@* 2ec8+0!c+" Co0tr+ctor ?2C@* or Co0tro" Co0tr+ctor ?CC@* +s 0ote) !0 3!0+" co"um0( Perso0 c8ec9!01 o33 e+c8 !tem s8+"" !0!t!+" !0 3!0+" co"um0( C8ec9 !3 O9+: or e0ter )+t+ +s re;ueste)( E0ter comme0t or 0ote 0um4er !3 )e3!c!e0t(
Check Bo!"er s+3et!es e0er1!Ge) +0) teste) St+rtup report !0c"u)es opt!m+" +0) +ctu+" perce0t CO #* CO* O#* st+c9 temper+tureF com4ust!o0 e33!c!e0c:( ?For eB!st!01 4u!")!01s* +tt+c8 F+c!"!t!es com4ust!o0 test resu"ts !3 +E+!"+4"e(@ No u0usu+" 0o!se or E!4r+t!o0 Pr!m+r: 8e+t!01 A+ter setpo!0t( Accept+0ce # F )e1 3rom )es!10 E-ui% *a. ---/ Contr $ Initials 2CCA-

CACA-

The checklist items of Part

are all successfully completed.....................___ YES ___ NO

Notes

F!"e #$%&$&'$%()oc* Re"e+se &($* ,-./ Bu!")!01 N+me

BOILER PREFUNCTIONAL CHECKLIST PC-02_____

!ensor Cali"ration Check )to "e 6itnessed or co#%leted "+ CA

Instructions: A"" test !0strume0ts s8+"" 8+Ee 8+) + cert!3!e) c+"!4r+t!o0 A!t8!0 t8e "+st &# mo0t8s I-N______( A"" co0tro" po!0ts "!ste) u0)er e+c8 4o!"er re3er to se0sors +0) st+ts t8+t +re )e)!c+te) to t8+t 4o!"er s:stem* +0) 3or t8e most p+rt p8:s!c+"": "oc+te) c"ose to or !0 t8e 4o!"er* 0ot 1"o4+" ?4u!")!01<"eEe"@ po!0ts( I3 se0sor "oc+t!o0 !s !mproper* eBp"+!0 !0 comme0ts( E0ter ot8er 4o!"er co0tro" po!0ts t8+t +re cr!t!c+" to t8e co0tro" se;ue0ce !0 t8e 4"+09 sp+ces 3or e+c8 4o!"er* +s +ppropr!+te( It !s 0ot 0ecess+r: to repe+t +0: c+"!4r+t!o0 t8+t A+s )ocume0te) !0 t8e St+0)+r) Comm!ss!o0!01 Proce)ure 3or E0er1: 2+0+1eme0t S:stems* 4ut re3er to t8+t )ocume0t A8ere re"eE+0t( Criteria for Acce%tance: W+ter temper+ture se0sors << E2S +0) 4o!"er p+0e" E+"ues #($ F )e1rees 3rom me+sure) E+"ues( Outs!)e +!r temper+ture se0sors << E2S +0) 4o!"er p+0e" E+"ues &(% F )e1rees 3rom me+sure) E+"ues(
CONTROL TIPE Out)oor +!r temp(* 1"o4+" ?E2S@ Boiler-____: W+ter temp( !0 W+ter temp( out SENSOR - STAT LOCATION LOCATION OKC &st E2S-PANEL JALUES 2EASUREK JALUE F!0+" E2S-PANEL JALUES PASS I-NC

Boiler-____: W+ter temp( !0 W+ter temp( out

Boiler-____: W+ter temp( !0 W+ter temp( out

Boiler-____: W+ter temp( !0 W+ter temp( out

Boiler-____: W+ter temp( !0 W+ter temp( out

!ll sensors are cali"rated #ithin required tolerances.................................___ YES ___ NO

1isc Procedures

Notes

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BOILER PREFUNCTIONAL CHECKLIST PC-02_____

7 1 !ensor Cali"ration 1ethods A"" Se0sors( Jer!3: t8+t +"" se0sor "oc+t!o0s +re +ppropr!+te +0) +A+: 3rom c+uses o3 err+t!c oper+t!o0( Jer!3: t8+t se0sors A!t8 s8!e")e) c+4"e* +re 1rou0)e) o0": +t o0e e0)( For se0sor p+!rs t8+t +re use) to )eterm!0e + temper+ture or pressure )!33ere0ce* m+9e sure t8e: +re re+)!01 A!t8!0 $(#LF o3 e+c8 ot8er 3or temper+ture +0) A!t8!0 + to"er+0ce e;u+" to #D o3 t8e re+)!01* o3 e+c8 ot8er* 3or pressure( To"er+0ces 3or cr!t!c+" +pp"!c+t!o0s m+: 4e t!18ter( Se0sors W!t8out Tr+0sm!tters<<St+0)+r) App"!c+t!o0( 2+9e + re+)!01 A!t8 + c+"!4r+te) test !0strume0t A!t8!0 ' !0c8es o3 t8e s!te se0sor( Jer!3: t8+t t8e se0sor re+)!01 ?E!+ t8e perm+0e0t t8ermost+t* 1+1e or 4u!")!01 +utom+t!o0 s:stem ?BAS@@ !s A!t8!0 t8e to"er+0ces !0 t8e t+4"e 4e"oA o3 t8e !0strume0t<me+sure) E+"ue( I3 0ot* !0st+"" o33set !0 BAS* c+"!4r+te or rep"+ce se0sor( 7 2 8al&e Leak Check( Comm+0) E+"Ee to c"ose( ?For 7<A+: E+"Ees* test A!t8 4ot8 t8e NO 5 NC "e1s c"ose)* o0e +t + t!me(@ W!t8 pump ru00!01* +3ter &$ m!0utes o4serEe A+ter )e"t+ T +cross co!"( I3 !t !s 1re+ter t8+0 #LF* "e+9+1e !s pro4+4": occurr!01( Reset E+"Ee stro9e to c"ose t!18ter( Repe+t test u0t!" comp"!+0ce( 7 0 8al&e !troke Check For +"" E+"Ee +0) +ctu+tor pos!t!o0s c8ec9e)* Eer!3: t8e +ctu+" pos!t!o0 +1+!0st t8e BAS re+)out( Set pumps to 0orm+" oper+t!01 mo)e( Comm+0) E+"Ee c"ose)* Eer!3: t8+t E+"Ee !s c"ose) +0) +)just output Gero s!10+" +s re;u!re)( Comm+0) E+"Ee ope0* Eer!3: pos!t!o0 !s 3u"" ope0 +0) +)just output s!10+" +s re;u!re)( Comm+0) E+"Ee to + 3eA !0terme)!+te pos!t!o0s( I3 +ctu+" E+"Ee pos!t!o0 )oes0t re+so0+4": correspo0)* rep"+ce +ctu+tor or +)) p!"ot pos!t!o0er ?3or p0eum+t!cs@(

-- E9' O( C:EC;LI!* --

Notes

F!"e #$%&$&'$%()oc* Re"e+se &($* ,-./ Bu!")!01 N+me

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