PPM VISIT RECORD | Monthly

• Conducted on

  Date

• Prepared by

• Location
  Address

Safety

• Plant Room secured on arrival

  Yes

  No

• Are you aware of your escape routes and fire exit locations

  Yes

  No

• Are Fire Extinguishers | First Aid Kits | Eyes Washes on site & in date

  Select Fire Extinguishers Present Fire Extinguishers Not Present/Not in date First Aid Kit Present First Aid Kit Not Present/ Not in date Eye Wash Present Eye Wash Not Present

  • Fire Extinguishers Present
  • Fire Extinguishers Not Present/Not in date
  • First Aid Kit Present
  • First Aid Kit Not Present/ Not in date
  • Eye Wash Present
  • Eye Wash Not Present

Visual Inspection (Damage and Abnormalities)

• Pipework | Valves | Lagging | Fixings

  Select Pipework Pass Pipework Fail Valves Pass Valves Fail Lagging Pass Lagging Fail Fixings Pass Fixing Fail Other Fail

  • Pipework Pass
  • Pipework Fail
  • Valves Pass
  • Valves Fail
  • Lagging Pass
  • Lagging Fail
  • Fixings Pass
  • Fixing Fail
  • Other Fail

• Pumps

  Select PRI LTHW VT Pumps PRI LTHW CT Pumps SEC LTHW VT Pumps SEC LTHW CT Pumps Shunts Pumps SEC HWS Pumps Stratification Pumps Fail

  • PRI LTHW VT Pumps
  • PRI LTHW CT Pumps
  • SEC LTHW VT Pumps
  • SEC LTHW CT Pumps
  • Shunts Pumps
  • SEC HWS Pumps
  • Stratification Pumps
  • Fail

• Are the pumps controlled via External BMS or Local Inverters

  Select External BMS Local Inverter Single Speed

  • External BMS
  • Local Inverter
  • Single Speed

• Do pumps require any maintance works

  Select YES NO Primary Shunt Pumps Secondary LTHW Pumps CT Secondary LTHW Pumps VT Secondary HWS Pumps

  • YES
  • NO
  • Primary Shunt Pumps
  • Secondary LTHW Pumps CT
  • Secondary LTHW Pumps VT
  • Secondary HWS Pumps

• What maintenance works is required

  Select Bearing Replacement Shaft Seal Replacement None

  • Bearing Replacement
  • Shaft Seal Replacement
  • None

• CHP

  Operational

  Non Operational

  None on site

• Boilers

  Operational

  Individual Boiler Fault

• Pressurisation Units | Degassers | Filling Loops

  Select Pressurisation Units Degassers Filling Loops Fail

  • Pressurisation Units
  • Degassers
  • Filling Loops
  • Fail

• Filters

  Pass

  Fail

  Non Present

• Is there a Elysator on site?

  Yes

  No

  N/A

• Is there a X Pot on site?

  X Pot Present

  X Pot Required

  X Pot Not required

• Electrical System including BMS & Programmers

  Pass

  Fail

• Plant Room: Doors | Ventilators | Duct work

  Pass

  Fail

• Is there any mechanical venatilation

  Yes

  No

  N/A

• Is the cooling ventilation adequate ?

  Pass

  Fail

• Is the Plant room clean from excessive dust?

  Pass

  Fail

• PRI System Expansion Vessel

  Select Pass Fail Open Vented System N/A

  • Pass
  • Fail
  • Open Vented System
  • N/A

• SEC System Expansion Vessel

  Select Pass Fail Open Vented System N/A

  • Pass
  • Fail
  • Open Vented System
  • N/A

Testing of Plant

• Tested Pumps Duty

  Pass

  Fail

• Tested Boilers Duty Operation (For Operation only not Gas Safety Checking)

  Pass

  Fail

• Tested Pressurisation Unit

  Select PRI Pressurisation Unit SEC Pressurisation Unit Fail Unable to test function of PRI Unable to test function of SEC

  • PRI Pressurisation Unit
  • SEC Pressurisation Unit
  • Fail
  • Unable to test function of PRI
  • Unable to test function of SEC

• Tested LED Lighting on Control Panel

  Pass

  Fail

  No test function available

• Is the plant floor sealed?

  Yes

  No

  N/A

• Does the Plant room require painting?

  Yes

  No

  N/A

• Is there a commercial kitchen on site?

  Yes

  No

  N/A

• Is there Gas laundry appliances?

  Yes

  No

  N/A

• Is there Emergency Lighting working/present?

  Yes

  No

  N/A

• Is there a cold water tap on site?

  Yes

  No

  N/A

• What key is currently being used for the Plantroom ?

  Select PR2 PR13 R14 FB1 FB4 Gas Triangle Key Lock Fault Non of the above (Please Specify)

  • PR2
  • PR13
  • R14
  • FB1
  • FB4
  • Gas Triangle Key
  • Lock Fault
  • Non of the above (Please Specify)

• What key is currently being used for the Gas Meter?

  Select PR2 PR13 R14 FB1 FB4 Gas Triangle Key Lock Fault Non of the above (Please Specify)

  • PR2
  • PR13
  • R14
  • FB1
  • FB4
  • Gas Triangle Key
  • Lock Fault
  • Non of the above (Please Specify)

• Cleaning of Plant room sweep out and clear rubbish

  Select Cleared Rubbish Waste Removal Team Required

  • Cleared Rubbish
  • Waste Removal Team Required

• X Pot Flushing & Cleaning

  Select Flushed & Cleaned Micron Filtration Bag Required X Pot Not Present

  • Flushed & Cleaned
  • Micron Filtration Bag Required
  • X Pot Not Present

• Flushed Dirt Air Separator

  Yes

  No

  N/A

• Primary Circuit System Pressure (BAR)

• Secondary Circuit if Applicable (BAR)

• Flow Temperature

• Return Temperature

• PPM Visit Completed

  Sign