Title Page

  • Site conducted

  • Operator Name

  • Which Ipad Are You Using?

  • Shift

  • Date & Time

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

    I4434.png
  • Take Photos of Leaks and Make Sure To Add In The Red Book

    Capture.PNG

Mezzanine

Hot Water Pump #2

  • Status

  • Suction

  • Discharge

  • Supply Temperature

Hot Water Pump #1

  • Status

  • Suction

  • Discharge

  • Supply Temperature

Medium Chilled Water Pump #1

  • Status

  • Suction

  • Discharge

Medium Chilled Water Pump #2

  • Status

  • Suction

  • Discharge

Medium Chilled Water Heat Exchange #1

  • Chilled Water PSI In

  • Chilled Water PSI Out

  • Chilled Water Temperature In Chilled Water Temperature Out
  • Medium Chilled Water PSI In

  • Medium Chilled Water PSI Out

  • Medium Chilled Water Temperature In Medium Chilled Water Temperature Out

Medium Chilled Water Heat Exchange #2

  • Chilled Water PSI In

  • Chilled Water PSI Out

  • Chilled Water Temperature In Chilled Water Temperature Out
  • Medium Chilled Water PSI In

  • Medium Chilled Water PSI Out

  • Medium Chilled Water Temperature In Medium Chilled Water Temperature Out

Humidifier HF-01-01 ( Services AH#2)

  • Steam draining?

  • Steam Condensate PSI

AHU #2 **UNIT IS CRITICAL**

  • Status

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returend to Normal Operation

  • Call Controls or Foreman

Basement

Lab Air Compressor

Power EX Control Panel

  • Alarm

  • Dryer #1

  • Dryer #2

  • Which dryer is running?

  • PSI Gauge - Measures Air is Reserve Tank

Dryer #1 & #2

  • Dryer Gauge #1

  • Dryer Gauge #2

LCD Screen

  • Alarm

  • Status

  • PSI

  • Look at pump number order

    image.jpg
  • Pump #3

  • Pump #2

  • Pump #1

  • Pump #6

  • Pump #5

  • Pump #4

Air Tech Vacuum Pump

  • LCD Screen

  • Alarms

Vacuum Reading

  • Tank mmHg

  • LCD Screen Reading

Pump #1

  • Status

  • % Percentage Running

  • Hours running

Pump #2

  • Status

  • % Percentage Running

  • Hours running

Pump #3

  • Status

  • % Percentage Running

  • Hours running

Condenser Water Return Pump (Red light on top vfd)

  • Alarm

  • Water Level

House Pumps Domestic

  • Alarms

  • PSI In

  • PSI Out

RO Water

  • Alarms

  • Alarm Type

RO Tank

  • 1850 gallons is max full - 600 is low water

  • Is The Tank Below 600 gallons

  • How Many RO Pumps Turned On

  • Did Pump 3 & 4 Turn Off - VFD should read 0

  • Water Level

Control Panel (Right Side)

  • VFD : RO Pump labeled 1&2 / also number 3&4. Please Refer to the VFD using Rop#1 & ROP#2

  • Repress Pump Select

  • Pump P - 3

  • Pump P - 4

Control Panel (Left Side- LCD Screen)

  • RO 1

  • TAKE PHOTO OF SIGHT GLASS x3 & THE 2 PRESSURE GAUGES

  • RO 2

  • TAKE PHOTO OF SIGHT GLASS x3 & THE 2 PRESSURE GAUGES

  • Conductivity = Units of milliSiemens/cm (mS/cm)

  • RO Conductivity

  • Permeate Level

  • 15 gpm Minimum 20 is Maximum

  • Loop Flow (gpm)

VFD Screen Status - Bottom Right Corner Screen

  • P3

  • P4

Condenser Water Pump #1

  • Status

  • Suction

  • Discharge

Condenser Water Pump #2

  • Status

  • Suction

  • Discharge

Condenser Water Pump #3

  • Status

  • Suction

  • Discharge

AHU #1

  • Status

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returend to Normal Operation

  • Call Controls or Foreman

Heat Recovery Chiller

  • 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

  • Multi- Stack

  • HRC Chilled Water Pump #2

  • Chilled Water PSI In

  • Chilled Water PSI Out

  • Chilled Water Temperature In Chilled Water Temperature Out
  • HRC Heating Hot Water Pump #1

  • Hot Water PSI In

  • Hot Water Psi Out

  • Hot Water Temperature In Hot Water Temperature Out

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 Temperature In Condenser Water Temperature Out
  • Chilled Water Press In

  • Chilled Water Press Out

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

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 Temperature In Condenser Water Temperature Out
  • Chilled Water Press In

  • Chilled Water Press Out

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

Primary Chilled Water Pump #1

  • Status

  • Suction

  • Discharge

Primary Chilled Water Pump #2

  • Status

  • Suction

  • Discharge

Chilled Water Pump #1

  • Status

  • Suction

  • Discharge

Chilled Water Pump #2

  • Status

  • Suction

  • Discharge

Chilled Water Pump #3

  • Status

  • Suction

  • Discharge

Condenser Unit Return

  • Visual Inspection

Penthouse

Heat Trace

  • Alarms

Domestic Water Heaters #1-4

  • Status

  • Temperature

AHU #8

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

  • Status

AHU #7

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

  • Status

AHU #6

  • Status

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

Lab Exhaust Fan 1A

  • Status

Lab Exhaust Fan 1B

  • Status

Lab Exhaust Fan 1C

  • Status

Lab Exhaust Fan 1D

  • Status

AHU #5

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

  • Status

Lab Exhaust Fan 2A

  • Status

Lab Exhaust Fan 2B

  • Status

Kitchen Exhaust Fan

  • Status

AHU #4

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

  • Status

AHU #3

  • Alarm

  • Time of Alarm

  • Cause of Alarm

  • Was Unit Able to Be Returned to Normal Operation

  • Call Controls or Foreman

  • Status

Boilers

DA Gauges

    Temperature
  • Water PSI

  • Steam PSI

Steam Boiler *Control Panel*

  • Boiler #1

  • Boiler #2

  • Alarms

Pump Selection * Control Panel*

  • Pump Number Selected On

  • Pump #1 Status

  • Switch Control

  • Are boilers being serviced?

  • Pump #2 Status

  • Switch Control

  • Are boilers being serviced?

Boiler #1

  • 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 Foreman or Mechanic

  • Status

  • PSI

  • Sight Glass

Boiler #2

  • 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 Foreman or Mechanic

  • Status

  • PSI

  • Sight Glass

Deaerator

  • Water Level

  • Contact Foreman or Mechanic

  • Is there an increased amount of water going to drain

Roof

Cooling Towers

Cooling Tower #1

  • Status

Cooling Tower #2

  • Status

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.