Title Page

  • Site conducted

  • Operator Name

  • Which Ipad Are You Using?

  • Date & Time

  • Shift

  • Berne Brown.JPG
  • Need safety gear? ask your supervisor!

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  • Take Photos of Leaks and Make Sure To Add In The Red Book

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CHWP & CWP

Chilled Water Pump #1

  • Status

  • Suction

  • Discharge

Condenser Water Pump #1

  • Status

  • Suction

  • Discharge

Chilled Water Pump #2

  • Status

  • Suction

  • Discharge

Condenser Water Pump #2

  • Status

  • Suction

  • Discharge

Chilled Water Pump #3

  • Status

  • Suction

  • Discharge

  • Frequency - Hertz

Condenser Water Pump #3

  • Status

  • Suction

  • Discharge

  • Frequency - Hertz

Chilled Water Pump #7

  • Status

  • Suction

  • Discharge

Chilled Water Pump #8

  • Status

  • Suction

  • Discharge

Hot Water Pump

Hot Water Pump #5

  • Status

  • Suction

  • Discharge

Hot Water Pump #6

  • Status

  • Suction

  • Discharge

Hot Water Pump #12

  • Status

  • Suction

  • Discharge

Air Compressor

Quincy Compressor #1

  • Compressor #1

  • Temperature
  • PSI - Air Pressure

Quincy Compressor #2

  • Compressor #2

  • Temperature
  • PSI - Air Pressure

Air Dryer

  • Status

  • Temperature

Air Storage Tank

  • Tank PSI

  • Auto Blow Down functioning and plugged in

Chiller

Chiller #3 SMARDT

  • Alarms

  • What Was The Alarm Type

  • Was The Chiller Able To Be Returned To Normal Operation

  • Was Alarm Cleared / Reset

  • Did Another Chiller Turn On

  • Can You Start Another Unit

  • Did You follow The After Hours Incident Chart

  • Status

Main Page

  • Must be in "External Start"

Common Loop Chilled Water Temperature

    Entering Chilled Water Leaving Chilled Water Chilled Water Set Point
  • Percent System Demand

  • Total Input KWs

  • Percent Full Load AMPs

  • Common Loop Condenser Water Temperature

  • Entering Condenser Water Temperature Leaving Condenser Water Temperature

Compressor #1

  • Status

  • Alarms

  • Active Fault

  • Demand %

  • Interlock

  • Speed (RPM)

  • IGV % Open

  • Suction Press

  • Suction Temperature
  • Discharge Press

  • Discharge Temperature
  • Power Input

  • Desired Power

  • 3 ph Amps

  • Pressure Ratio

  • Surge RPM

  • Choke RPM

  • % Common Ok

Compressor #2

  • Status

  • Alarms

  • Active Fault

  • Demand %

  • Interlock

  • Speed (RPM)

  • IGV % Open

  • Suction Press

  • Suction Temperature
  • Discharge Press

  • Discharge Temperature
  • Power Input

  • Desired Power

  • 3 ph Amps

  • Pressure Ratio

  • Surge RPM

  • Choke RPM

  • % Common Ok

Compressor #3

  • Status

  • Alarms

  • Active Fault

  • Demand %

  • Interlock

  • Speed (RPM)

  • IGV % Open

  • Suction Press

  • Suction Temperature
  • Discharge Press

  • Discharge Temperature
  • Power Input

  • Desired Power

  • 3 ph Amps

  • Pressure Ratio

  • Surge RPM

  • Choke RPM

  • % Common Ok

Chiller #2 TRANE

  • Alarms

  • What Was The Alarm Type

  • Was The Chiller Able To Be Returned To Normal Operation

  • Was Alarm Cleared / Reset

  • Did Another Chiller Turn On

  • Can You Start Another Unit

  • Did You follow The After Hours Incident Chart

  • Status

  • Run Time

  • Starts

  • Amperage

  • Oil Sump Temperature
  • Oil Level

  • Oil Press Gauge

  • Evaporator Press Gauge

  • Condenser Water Gauge

  • Purge - Pump Out Life

  • Condenser Water Press In

  • Condenser Water Press Out

  • Condenser Water Press In Temperature Condenser Water Press Out Temperature
  • Chilled Water Press In

  • Chilled Water Press Out

  • Chilled Water Press In Temperature Chilled Water Press Out Temperature
  • Limit Demand Setting

Chiller #1 TRANE

  • Alarms

  • What Was The Alarm Type

  • Was The Chiller Able To Be Returned To Normal Operation

  • Was Alarm Cleared / Reset

  • Did Another Chiller Turn On

  • Can You Start Another Unit

  • Did You follow The After Hours Incident Chart

  • Status

  • Run Time

  • Starts

  • Amperage

  • Oil Sump Temperature
  • Oil Level

  • Oil Press Gauge

  • Evaporator Press Gauge

  • Condenser Water Gauge

  • Purge - Pump Out Life

  • Condenser Water Press In

  • Condenser Water Press Out

  • Condenser Water Press In Temperature Condenser Water Press Out Temperature
  • Chilled Water Press In

  • Chilled Water Press Out

  • Chilled Water Press In Temperature Chilled Water Press Out Temperature
  • Limit Demand Setting

RO Water

RO Water

  • RO Tank Level

  • Move to next equipment

  • RO Pump On

  • Pump # Running

  • RO Purity Level

SKIP Domestic Water Heater

SKIP

Domestic Water House Pumps

Domestic Water House Pumps

  • Pressure In - PSI

  • Pressure Out - PSI

  • Alarms

Boilers

Benchmark Boiler #1A

  • Alarms

  • Time of Alarm

  • Alarm Type

  • Supply Temperature Before Resetting Alarm Return Temperature Before Resetting Alarm
  • Was Unit Able To Return Back To Normal

  • Did You Contact Mechanic / Controls

  • Status

  • Water Temperature Out

Benchmark Boiler #1B

  • Alarms

  • Time of Alarm

  • Alarm Type

  • Supply Temperature Before Resetting Alarm Return Temperature Before Resetting Alarm
  • Was Unit Able To Return Back To Normal

  • Did You Contact Mechanic / Controls

  • Status

  • Water Temperature Out/Supply

Aerco Boiler # 3A

  • Alarms

  • Time of Alarm

  • Alarm Type

  • Supply Temperature Before Resetting Alarm Return Temperature Before Resetting Alarm
  • Was Unit Able To Return Back To Normal

  • Did You Contact Mechanic / Controls

  • Status

  • Water Temperature Out
  • Pressure

Aerco Boiler # 3B

  • Alarms

  • Time of Alarm

  • Alarm Type

  • Supply Temperature Before Resetting Alarm Return Temperature Before Resetting Alarm
  • Was Unit Able To Return Back To Normal

  • Did You Contact Mechanic / Controls

  • Status

  • Water Temperature Out
  • Pressure

Cooling Towers

Cooling Tower

  • Water Level Checked

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.