Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Untitled Page

  • Project

  • Date

  • Chiller Tag

  • Building

  • Location

Chiller Information

  • Make

  • Model Number

  • Serial Number

  • Capacity

  • GPM

  • Volts/Phase

  • Refrigerant

  • Charge

  • Comments

Associated Checklists

  • undefined

  • undefined

  • Comments:

Requested documentation submitted

  • Manufacturer's cut sheets

  • Comments

  • Performance data (pump curves, coil data, etc.)

  • Comments

  • Installation and startup manual and plan

  • Comments

  • O&M manuals

  • Comments

  • Factory test results

  • Comments

  • Sequences and control strategies

  • Comments

  • Warranty Certificate

  • Comments

  • Comments:

Installation Checks

General

  • General appearance good, no apparent damage

  • Comments

  • Proper vibration isolators installed and adjusted

  • Comments

  • Seismic restraints in place

  • Comments

  • Oil filter clean

  • Comments

  • No leaking apparent

  • Comments

Piping

  • Piping supported independently of the chiller

  • Comments

  • Piping type and flow direction labeled on piping

  • Comments

  • Isolation valves, balancing valves and piping specialties installed

  • Comments

  • Unnecessary U-turning pipe clearance

  • Comments

Electrical and Controls

  • Power disconnects located within site of the unit it controls and labeled

  • Comments

  • All electric connections tight

  • Comments

  • Safeties installed and operational

  • Comments

  • Starter overload breakers installed

  • Comments

  • All control devices and wiring complete

  • Comments

  • Control system interlocks connected and functional

  • Comments

Sensors and Gages

  • Temperature, pressure and flow gages and sensors installed

  • Comments

  • Piping gages, BAS and associated panel temperature and pressure readouts match

  • Comments

Untitled Page

  • LEED CxA

  • Date

  • Owner's Representative

  • Date

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