MAD-Pre Fill Checklist

PRE FILL CHECKLIST

• Job Name:

• Foreman Name:

• System Type:

  Select Domestic Cold Water Domestic Hot Water HVAC Chilled Water HVAC Hot Water Med Gas Sprinkler Steam-High Pressure Steam-Low Pressure

  • Domestic Cold Water
  • Domestic Hot Water
  • HVAC Chilled Water
  • HVAC Hot Water
  • Med Gas
  • Sprinkler
  • Steam-High Pressure
  • Steam-Low Pressure

• Floor:

  Select Basement 1 2 3 4 5 6

  • Basement
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Section:

• Pre-Task Plan Completed and Reviewed By:

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SYSTEM INTEGRITY

• System Walked and QC'd By:

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• STOP. Correct situation before proceeding with test.

• Are valves and /or stops in proper position?

  Yes

  No

• STOP. Correct situation before proceeding with test.

• Are drain or vent valves closed and capped or plugged?

  Yes

  No

• STOP. Correct situation before proceeding with test.

• Are end caps equipped with a way to drain (tap or valve)?

  Yes

  No

• STOP. Correct situation before proceeding with test.

• Is the system complete (joints, caps, plugs, test tees)?

  Yes

  No

• STOP. Correct situation before proceeding with test.

EMERGENCY RESPONSE

• Are emergency response carts in place?

  Yes

  No

• Do all carts contain the following?

• Wet Vac

• Squeegee

• Pump

• Hose

• STOP. Correct situation before proceeding with test.

• Radios are working and batteries charged?

  Yes

  No

• STOP. Correct situation before proceeding with test.

• Radios on channel #:

AIR FILLING

• Will system be pre-filled with air?

  Yes

  No

• How many PSI?

• For how many minutes?

• Air Test Witness:

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• Has air test been drained down?

  Yes

  No

• Drained down by:

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• Select date

  Date

• Pressure remaining:

EMPLOYEE SIGNATURES

• Add signature

  Sign

• Add signature

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• Add signature

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• Add signature

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• Add signature

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