Information

  • Work order No.

  • Chiller No.

  • Site name

  • Site Location
  • Client name

  • Conducted on

  • Prepared by (engineer name)

please select what generation site

  • select one of the following

Chiller details

Chiller Details

  • Chiller location

  • Chiller manufacturer

  • Chiller model

  • Chiller serial

  • Manufacturers nameplate picture - Must take picture for reference

Water Pumps

  • No of pumps

  • condition of pump

  • add picture

  • Make

  • take picture of pump plate

  • take picture of motor plate

  • Model

  • Serial

  • Model

  • serial

  • Volt

  • Amps

  • Leak inspection

  • take pic

System running checks

    System running checks

Chiller - common readings

  • Chiller supply voltage

  • Control voltage

  • All terminals checked for tightness

  • Condenser clean

  • Ambient temperature (C)

  • Condenser on temperature (C)

  • Condenser off temperature (C)

  • Condenser TD (C)

  • Evaporator on temperature (C)

  • Evaporator off temperature (C)

  • Evaporator TD (C)

  • Evaporator on pressure (Bar)

  • Evaporator off pressure (Bar)

  • Evaporator PD (Bar)

Circuit - specific readings

    Circuit
  • No of compressors

  • Circuit run hours

  • Discharge pressure (Bar)

  • Suction pressure (Bar)

  • Oil pressure (Bar)

  • Discharge temperature (C)

  • Suction temperature (C)

  • Suction superheat temperature (C)

  • Liquid line temperature (C)

  • Liquid line sub-cooling temperature (C)

  • Liquid line sight glass clear?

Electrical checks

    Electrical checks Compressor
  • Volts each phase

  • Amps

  • Amps

  • Amps

  • Condenser fan
  • Volts each phase

  • Amps

  • Amps

  • Amps

Component checks

    Component checks
  • Check all HP, LP and oil lines

  • picture

  • Check rota-locks and or any other mechanical connections

  • picture

  • Condenser visual inspection

  • Condenser inspection notes

  • Water pipe visual inspection check for leaks and lagging damage

  • Water pipe inspection notes

  • HP switch
  • Auto or manual reset

  • Cut out pressure (Bar)

  • Cut in pressure (Bar)

  • LP switch
  • Auto or manual reset

  • Cut out pressure (Bar)

  • Cut in pressure (Bar)

  • Low temperature cutout switch
  • Auto or manual reset

  • Cut out temperature (C)

  • Cut in emperature (C)

  • Flow switch
  • Chilled water operational

  • Condenser water operational

  • Heaters

  • Heaters
  • Crank case heater operational

  • amps

  • Evaporator heater operational

  • Control panel fan operational

  • fan motor details for replacement

Pressurisation unit inspection

  • log water usage

  • visual inspection for damage or leaks

  • Picture of any damage or leaks

Water temp checks

  • Return Temp

  • Flow Temp

F-Gas compliance

F-Gas compliance Leakage inspection

  • Leakage inspection

    Systems shall be checked for leakage dependent on refrigerant charge:

    3kg charge and above - check at least once every 12 months.
    30kg charge and above - check at least once every 6 months.
    300kg charge and above - check at least once every 3 months.
    Hermetically sealed systems, which are labelled as such and contain less than 6kg, are exempt.

    Operators of equipment containing 300kg or more must install an automatic leakage detection system. These must be checked at least once every twelve months to ensure they are functioning properly.

    Checked for leakage means that the system is systematically checked for leakage using direct or indirect methods, focusing on those parts of the system most likely to leak. The cause of any leak will need to be recorded in the log book.

    A detailed definition of what constitutes a leak check will be part of legislation attached to F-Gas.

  • Refrigerant type

  • If other make a note here

  • Amount of refrigerant (kg)/circuit
  • Refrigerant (kg)

  • Leak test carried

  • Leak test result<br>Safe = No leak found At Risk = Leak present, make notes and take pictures

  • Refrigerant leak detection installed

  • Refrigerant leak detection operating correctly

Additional information / Notes

Additional information / Notes

Sign off

Sign off

  • Work complete

  • Client - Print and sign

  • Select date

  • Engineer - Print and sign

  • Select date

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.