Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Project

  • Date

  • Pump Tag

  • Building

  • Location

Untitled Page

Pump 1 Information

  • Make

  • Model Number

  • Serial Number

  • GPM

  • Head

  • Volts/Phase

  • Function

  • Service Area

  • Motor HP

  • Motor Eff

  • RPM

  • Comments

Pump 2 Information

  • Make

  • Model Number

  • Serial Number

  • GPM

  • Head

  • Volts/Phase

  • Fuction

  • Service Area

  • Motor HP

  • Motor Eff

  • RPM

  • Comments

Pump 3 Information

  • Make

  • Model Number

  • Serial Number

  • GPM

  • Head

  • Volts/Phase

  • Function

  • Service Area

  • Motor HP

  • Motor Eff

  • RPM

  • Comments

Associated Checklists

  • Comments

Installation Checks

General

  • Installation is per manufacturer’s instructions

  • Comments

  • Manufacturer’s recommended spare parts are provided

  • Comments

  • Equipment label permanently affixed

  • Comments

  • Pump lubricated

  • undefined

  • Pump drive properly aligned

  • Comments

  • Drive guard or shield is properly installed

  • Comments

  • Pump foundation is level

  • Comments

  • Pumps in place and properly anchored

  • Comments

  • Pipes are supported independently of the pump

  • Comments

  • Vibration isolation devices installed and functional

  • Comments

  • Seismic anchoring installed and functional where applicable

  • Comments

  • Isolation valves and piping specialties installed

  • Comments

  • Shaft seal is leak free

  • Comments

  • Pump detail checked against the drawings and all devices gages and appurtenances are in place

  • Comments

  • Insulation installed per requirements; insulated to avoid condensation yet allow for service

  • Comments

Electrical and Controls

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

  • Comments

  • All electric connections tight

  • Comments

  • Grounding installed for components and unit

  • Comments

  • Safeties installed and operational

  • Comments

  • Starter overload breakers installed and correct size

  • Comments

  • All control devices and wiring complete

  • Comments

  • Control system interlocks connected and functional

  • Comments

  • Rotates in the correct direction (for VFD, check inverter and Bypass modes)

  • Comments

VFD

  • Drive location not subject to excessive moisture or dirt

  • Comments

  • Drive location not subject to excessive temperatures

  • Comments

  • Appropriate Volts vs. Hz curve is being used

  • Comments

  • Drive size matches motor size

  • Comments

  • Drive mounted on housekeeping pad (if applicable)

  • Comments

  • Cooling air flow path clean and unobstructed

  • Comments

  • Permanent label affixed

  • Comments

  • VFD interlocked to control system

  • Comments

  • Unit is programmed with full written programming record on site

  • Comments

  • Minimum and maximum speed set

  • Comments

  • Where applicable, ensure safeties are active in all modes

  • Comments

  • Coordinated with BAS for all interface ranges and signal isolation

  • Comments

  • Restart on Power Failure parameter set to auto

  • Comments

  • VFD powered (wired to controlled equipment)

  • Comments

  • Grounding installed for components and unit

  • Comments

  • Drive min and max speed set to ___ Hz min and 60 Hz max

  • Comments

  • Security settings set per owner direction and password documented for owner

  • Comments

  • Upper frequency limit set at 100%, unless explained otherwise

  • 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

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  • LEED CxA

  • Date

  • Owner's Representative

  • Date

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