Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Untitled Page
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Project
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Date
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Chiller Tag
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Building
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Location
Chiller Information
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Make
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Model Number
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Serial Number
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Capacity
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GPM
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Volts/Phase
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Refrigerant
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Charge
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Comments
Associated Checklists
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- Condenser Water Pump
- Chilled Water Pump
- BAS
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- Condenser Water Piping
- Chilled Water Piping
- Cooling Tower
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Comments:
Requested documentation submitted
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Manufacturer's cut sheets
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Comments
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Performance data (pump curves, coil data, etc.)
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Comments
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Installation and startup manual and plan
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Comments
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O&M manuals
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Comments
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Factory test results
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Comments
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Sequences and control strategies
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Comments
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Warranty Certificate
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Comments
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Comments:
Installation Checks
General
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General appearance good, no apparent damage
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Comments
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Proper vibration isolators installed and adjusted
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Comments
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Seismic restraints in place
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Comments
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Oil filter clean
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Comments
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No leaking apparent
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Comments
Piping
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Piping supported independently of the chiller
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Comments
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Piping type and flow direction labeled on piping
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Comments
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Isolation valves, balancing valves and piping specialties installed
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Comments
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Unnecessary U-turning pipe clearance
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Comments
Electrical and Controls
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Power disconnects located within site of the unit it controls and labeled
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Comments
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All electric connections tight
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Comments
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Safeties installed and operational
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Comments
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Starter overload breakers installed
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Comments
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All control devices and wiring complete
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Comments
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Control system interlocks connected and functional
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Comments
Sensors and Gages
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Temperature, pressure and flow gages and sensors installed
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Comments
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Piping gages, BAS and associated panel temperature and pressure readouts match
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Comments
Untitled Page
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LEED CxA
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Date
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Owner's Representative
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Date