**APPENDIX A**

**SAMPLE FORMS AND CHECKLISTS**

> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air-Conditioning Unit, Computer Room

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filters Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Installation is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Accessories are Provided
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolator Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Cooling Btu\'s @ Voltage
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

EER (Btuh/Watt)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Heating Btu\'s @ Voltage
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

COP @ 47°F Outside/EER
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE TEST

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air-Conditioning Unit, Computer Room

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Adj. Controls Functions
Oper.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Normal Controls Oper.
Modes\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Lead/Lag Compressor
Oper.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolator Adj.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Cooling Btu\'s @ Voltage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Heating Btu\'s @ Voltage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Filter Housing (Bag-In/Bag-Out)

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Door Latches Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Door Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Frames Sealed to Housing
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Free from Damage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Clamping Mechanism Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Clean and Rust Free
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Correct Quantity of Bags
Provided\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Correct New Filters Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

D\'ffrntl Gage Kit
Inst\'lld/Oper.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filter Bank Tested & Approved
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pre-filter Clean Pr\'ssr Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Final Filter Clean Pr\'ssr Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

T\'tl F\'ltr & F\'ltr H\'sg Pr\'ssr Drop

(in. w.g.) \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Filter Housing (Bag-In/Bag-Out)

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clamping Mechanism
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify D\'ffrntl Gauge Kit
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pre-Filter Clean Pr\'ssr Drop

(in. w.g.) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Final F\'ltr Clean Pr\'ssr Drop

(in. w.g.) \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify T\'tl F\'ltr & F\'ltr H\'sg Pr\'ssr Drop

(in. w.g.) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Cooling Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Air Pressure Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL TEST CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Cooling Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Air Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> 3.RESULTS
>
> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Tension
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Alignment with Ductwork
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Drive Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Keyway and Setscrew Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Proper No. of Belts Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Motorrpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan cfm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan rpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan/Motor Noise Level
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Filter

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filters Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

D\'ffrnt/Gage Kit Inst\'ld/Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Filter

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify D\'ffrnt/Gage
Kit/Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Heating Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Air Pressure Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Handling Unit, Heating Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Air Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Shower, Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Tension
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Drive Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Keyway and Setscrew Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Proper No. of Belts Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Shower, Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Motor rpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan cfm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan rpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan/Motor Noise Level
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Terminal Unit - Shut-Off Type

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Alignment with Ductwork
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Connection Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Connections Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Installed/Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Damper is in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Damper Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

OPERATING DATA (designed/installed)

Minimum Inlet Pressure (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Unit Pressure Drop (in. w.g.)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Terminal Unit - Shut-Off Type

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Damper Operation
Correct\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Minimum Inlet Press. (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Unit Press. Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Terminal Unit - Shut-Off Type,
Heating Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Air Pressure Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Air Terminal Unit - Shut-Off Type,
Heating Coil

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Air Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Chiller, Centrifugal Water

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

No Shipping Damage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Sh\'ppng Hold Down Plates are
Removed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Features Match Specifications
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation is Level
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Adequate Oper. & Service Area
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Connections are
Tight\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Adequate Unit Grounding
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Correct Fuses and Fuse Size
Inst\'lld\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Elec. Service Matches Unit
Nameplate\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fld. W\'rng Matches Unit Elec.
Diag.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flow Switches Correctly
Installed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Rupture Disc Piped to Bldg.
Exterior\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belly Heater is Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Ea. Refrig. Cir. is Fully
Charged\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Crankcase Oil Level is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Liq. Refrig. Drier is Installed

in Ea. Refrig. Cir.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Liq. Line Solen\'d Valve is Inst\'lld

in Ea. Refrig. Cir.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Exp\'nsn Valve Bulb is Correctly

Inst\'lld and Insulated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

All Serv. and Liq. Line Valves

are Open \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Req. 24 Hr. C\'mprssr Cr\'nkcs H\'tr

Oper. Prior to Startup
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Condenser W\'tr Sys. is Sized and

Installed per the Drawings
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Condenser W\'tr Sys. is Connected and

Functional \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chilled W\'tr Sys. is Sized and

Installed per the Drawings
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chilled W\'tr Sys. is Connected and

Functional \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Level of Oil in Sight Glass is at

Least 1/3 and No More Than 1/2

with the C\'mprssrs Running
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pre-Operational Check List
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chilled/Condenser Water Pumps

Pre-Operational Check Lists are

Completed and Submitted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cooling Tower Pre-Operational

Check is Complete and
Submitted\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Pre-Operational Check List

is Complete and Submitted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Test and Balance Report is
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

and Submitted

Chemical Treatment Pre-Operational

Check List is Complete &
Submitted\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

OPERATING DATA (designed/installed)

Condenser W\'tr Temp. In (°F)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Condenser W\'tr Temp. Out (°F)
\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

C\'ndnsr W\'tr Pr\'ssr Drop (ft.
w\'tr)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Chilled W\'tr Temp. In (°F)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Chilled W\'tr Temp. Out (°F)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Ch\'lld W\'tr Pr\'ssr Drop (ft.
w\'tr)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE TEST

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Chiller, Centrifugal Water

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Time-of-Day Program
Oper.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Soft-Start Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Chiller Shut Down Open
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Chiller Re-Start Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Full-Load Condenser W\'tr Temp.

In (oF) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Full-Load Condenser W\'tr Temp.

Out (oF) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify W\'tr Pr\'ssr Drop (ft.
w\'tr)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Full-Load Chilled W\'tr Temp.

In (oF) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Full-Load Chilled W\'tr Temp.

Out (oF) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Ch\'lld W\'tr Pr\'ssr Drop (ft.
w\'tr)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify RLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Coil, Cooling

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs.
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs. in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Air Pressure Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Coil, Cooling

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Air Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Coil, Heating

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometer Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Pressure Drop (in. w.g.)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Coil, Heating

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Controls

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Instrument Air Meets
Specifications\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Instrument Air Connections
Tight\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Pr\'ssr Gages Inst\'lld/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrls Properly
Inst\'lld/Operating\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vent Valves Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Equip. No. Tag
Inst\'lld\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Spring/Throttle Ranges
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Set Point at Design Conditions
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. Bee Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Controls

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Adequate Supply Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Air Pr\'ssr Gauges
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Spring/Throttle Ranges
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Components
Operations\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control System
Operations\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Controls, Space Pressurization

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Instrument Air Meets
Specifications\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Instrument Air Connections
Tight\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Pr\'ssr Gages
Inst\'lld/Operating\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrls Properly
Inst\'lld/Operating\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vent Valves Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Controls Equip. No. Tag
Inst\'lld\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Spring/Throttle Ranges
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Set Point at Design Conditions
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK LIST

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Controls, Space Pressurization

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Adequate Supply Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Air Pr\'ssr Gauges
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Spring/Throttle Ranges
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Components
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control System
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Cooling Tower

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Level \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Corrosion Protection Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fan (Axial) Pitch Angle
Correct\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Tension
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Drive Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Keyway and Setscrew Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Proper No. of Belts Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Clearance Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fill Clean/Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Louver Clean/Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chemical Treatment Pre-Operational

Check List is Complete and
Submitted\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tower Water Pumps Pre-Operational

Check List is Complete and
Submitted\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Sump Control System Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Make-up Water Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Sump Heater Operable

Vibration Switch Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Water Distribution System Water

Level Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE TEST

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Cooling Tower

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Motor RPM
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan cfm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan rpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan/Motor Noise Level
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Correct Sump Control System

Operation \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Correct Make-Up Water System

Operation \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Correct Sump Heater
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Dampers

INSPECTED BY :

CONDITION EVALUATED: OPERABLE NORM. POS. CURR. POS.

EQUIPMENT NO.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Dampers

INSPECTED BY :

CONDITION EVALUATED: VERIFY CURRENT OPERATION

EQUIPMENT NO.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Dehumidifier

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Desiccant Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Installation is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Piping Connections Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Alignment Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Connection Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Accessories are Provided
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolator Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE TEST

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Dehumidifier

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Desiccant Wheel
Rotation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Adj. Functions Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Normal Oper. Modes
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolator Adj.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Air-Conditioning

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Test Ports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Doors/Cleanouts Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Term. Devices Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dampers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire/Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Joints Sealed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flex. Conn. Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cleaned \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Correctly Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Air-Conditioning

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN

Verify Leak Test
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Exhaust

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Test Ports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Doors/Cleanouts Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dampers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire/Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Joints Sealed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flex. Conn. Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cleaned \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Correctly Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Exhaust

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Leak Test \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Welded Galvanized

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Test Ports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Doors/Cleanouts Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dampers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire/Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Joints Sealed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flex. Conn. Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cleaned \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Correctly Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.

FUNCTIONAL PERFORMANCE CHECK

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Welded Galvanized

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Leak Test \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Welded Stainless Steel

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Test Ports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Access Doors/Cleanouts Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dampers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fire/Smoke Dampers Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Joints Sealed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flex. Conn. Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cleaned \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Correctly Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Ductwork, Welded Stainless Steel

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Leak Test \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Tension
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fan Alignment with Ductwork
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Drive Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Keyway and Setscrew Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Belt Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Proper No. of Belts Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE TEST

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Fan and Motor

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Safeties Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Motor RPM
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan cfm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan rpm
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan/Motor Noise Level
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Fume Hood

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Piping Connxs. Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs Correctly Piped
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Connx. Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Services in the Correct
Location\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Accessories Provided
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Provided
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Maximum Air Flow Rate (cfm)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Minimum Air Flow Rate (cfm)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL TEST CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Fume Hood

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Correct Remove Baffle
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Correct Sash Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Man. Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Light Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Heat Exchanger

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Minimal Air Leakage
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Pressure Drop (in. w.g.)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Heat Exchanger

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Clean Pressure Drop (in.
w.g.)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Humidifiers, Steam

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Supply Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Humidifiers, Steam

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Verify Supply Pressure (psig)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Laminar Flow Benches/Fume Hood

INSPECTED BY :

EQUIPMENT NO:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Piping Connxs. Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs Correctly Piped
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Duct Connx. Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Grounding Connx.
Tight\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power is Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filter Frames Sealed Correctly to
Housing\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Correct Filters Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

D\'ffrnt Pr\'ssr Gauge Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Control Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Air Flow Gauge Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Services in Correct Location
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Installation is Correct and
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Unit Accessories are Provided
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Maintenance Access Adequate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolator Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Snubbers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Total Filter Clean Pressure Drop (in.
w.g.)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Laminar Flow Benches/Fume Hood

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fan Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify D\'frntl Gauge Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Air Flow Control Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Air Flow Gauge Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Man. Valve Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Light Oper.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Chilled Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pump Discharge Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component

to be checked.

> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Chilled Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gages Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Return Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Compressed Gases

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Installed/Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Operating Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Compressor Discharge Pressure
(psig)\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Compressed Gases

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify PRVs Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Compressor Discharge Pr\'ssr
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Deionized Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Skid Mounted Equipment
Completely\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Connected

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Cleaned and Sterilized
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, (With Deionized
Water)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Connected to Vendor-Installed

Equipment \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vendor Equipment Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pump Discharge Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Deionized Water

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_

Verify Vendor Equipment
Operation\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Unit Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Unit Return Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Fuel Oil

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Clean Sediment Bowl/Primary
Filter\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fill Storage Tank with Correct
Fuel\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Unit Discharge Pressure (psig)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Fuel Oil

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Unit Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Hot Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pump Discharge Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Hot Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Return Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Test\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Natural Gas

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Meter Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Installed/Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Operating Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Natural Gas

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Meter Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify PRVs Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Steam and Condensate

INSPECTED BY :

INSPECTION ITEM: STEAM CONDENSATE

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pipe Sloped Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Installed/Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PRVs Operating Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Traps Installed/Accessible
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Traps Operating Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Supply Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Steam and Condensate

INSPECTED BY :

INSPECTION ITEM: STEAM CONDENSATE

Verify PRVs Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Traps Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs

Operating Correctly \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Supply Pr\'ssr (psig) \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Tower Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pump Discharge Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Piping, Tower Water

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operating
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Return Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Plumbing

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed, Refilled, Vented
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Insulation Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Pump Discharge Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Plumbing

INSPECTED BY :

INSPECTION ITEM: SUPPLY RETURN \_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Return Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Pump and Motor

INSPECTED BY :

EQUIPMENT NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pump/Motor Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Coupling Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Snubbers Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pipe Vibration Isolation
Inst\'lld\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Flow (gpm)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Discharge (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Return, (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Pump and Motor

INSPECTED BY :

EQUIPMENT NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Motor RPM
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauge Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge (psig)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Return (psig)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Pump and Motor, Sewage/Sump

INSPECTED BY :

EQUIPMENT NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-

Motor Type Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pump/Motor Alignment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Coupling Tightness
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Vibration Isolators Adjustment
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Snubbers Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pipe Vibration Isolation
Inst\'lld\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Shaft Guard Installation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Motor Cover Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment Lubricated
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electrical Connections Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Alternator Operates Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Sump/Basin Cover Installed
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Basin Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Connections Tight
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Float Installed/Operable
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Horsepower \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

RPM \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Volts \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Phase \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Flow (gpm)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Pump Discharge (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Pump and Motor, Sewage/Sump

INSPECTED BY :

EQUIPMENT NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-

Verify Pump Rotation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Vibration Isolators
Adj.\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Alternator Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Float Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify MotorRPM
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify FLA
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pump Discharge (psig)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Terminal Unit-Fin Tube Radiator

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Control Valve Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Balancing Valve
Installed/Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gauges Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fins Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Tubes Undamaged
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Fluid Flow Unrestricted
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Clean Pressure Drop (in. w.g.)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Temperature (oF)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Inlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

Outlet Fluid Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

General Contractor:

Mechanical Contractor:

Controls Contractor:

Electrical Contractor:

Commissioning Authority:

SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Terminal Unit-Fin Tube Radiator

INSPECTED BY :

EQUIPMENT
NO.:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Control Valve Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Fluid Flow (gpm)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gauges Operation
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Temperature
(oF)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Inlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Verify Outlet Fluid Pressure
(psig)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Unit Heater, Electric

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Electric Power Correct
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

FLA \_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Unit Heater, Electric

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Unit Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify FLA \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Unit Heater, Hot Water

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Supports Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Seismic Restraints Inst\'lld
Correctly\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Filled and Hydrostatically
Tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C\'ntrl V\'lvs Normal Position
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thermometers Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Pr\'ssr Gages Installed/Visually
Acc\'ssbl\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAMEPLATE DATA (designed/installed)

Supply Pressure (psig)
\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_/\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Unit Heater, Hot Water

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify C\'ntrl V\'lvs Operation \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

Verify Thermometers Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Pr\'ssr Gages Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Supply Pressure (psig) \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Valves

INSPECTED BY :

CONDITION EVALUATED: OPERABLE NORM. POS. CURR. POS.

EQUIPMENT NO.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Valves

INSPECTED BY :

CONDITION EVALUATED: VERIFY CORRECT OPERATION

EQUIPMENT NO.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Water Heater, Electric

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Electric Power Correct \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Relief Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Installation Correct & Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Water Heater, Electric

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Relief Valve Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Thermometer Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.
>
> PRE-OPERATIONAL CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Water Heater, Steam

INSPECTED BY :

INSPECTION ITEM:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Flushed \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Cleaned
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Strainers Installed Correctly
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Relief Valve
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs
Installed/Accessible\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Man. V\'lvs in the Correct
Position\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Equipment No. Tag Installed
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Installation Correct &
Complete\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Submittal Data Complete
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

FUNCTIONAL PERFORMANCE CHECK

1\. PERSONNEL PRESENT FOR THE PERFORMANCE TEST

> General Contractor:
>
> Mechanical Contractor:
>
> Controls Contractor:
>
> Electrical Contractor:
>
> Commissioning Authority:
>
> SNL Representative:

2\. FUNCTIONAL PERFORMANCE

> A. Demonstrate (by the Contractor) operation of the
> system/equipment/component to be checked.
>
> B. See Functional Performance Check List below.
>
> FUNCTIONAL PERFORMANCE CHECK LIST

SYSTEM/EQUIPMENT/COMPONENT CHECKED: Water Heater, Steam

INSPECTED BY :

INSPECTION ITEM: \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Relief Valve Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

Verify Thermostat Operation \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_

3\. RESULTS

> A. Report (by the CA) the results obtained in the Functional
> Performance Test.
>
> B. Report (by the CA) remedial action for system/equipment/component
> which is not verified as meeting its specified performance.
> Re-schedule Functional Performance Test for unverified
> system/equipment/component.

4\. REPORTS

> A. Submit reports on the \"Functional Performance Check\" to the
> Architect/Engineer.