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START-UP INSPECTION FORM
PRE START-UP
INSPECTION
Addressed To:
Date:
Tbe~mllationof
___________________________
msmlledat __________________________ _
and
identified
by
"H" No.
has
been mspecied
by
me
and the following
poinrs
checked for
completeness:
1.
2.
3.
4.
Voltage
of
_ _
volts
is
connect to boiler
Cl
Tank
vemline installed
0
Fuel
oil
suction line rested
by
inst.al.ler
0
Fuel oil
tank.
filled witb _grade
oil
0
5.
6.
7.
Breechiog connected 10 stack
Warer
connected to boiler
Steam
lines
or warer
lines
connected
0
0
0
The
foregoing
has been checked
by
me this
date of
_ _____________
and
for
this reason me
stan-up
should
be performed.
Signature
of
Agent or Represemaive
------------------------Date.
START-UP FORM FO
R
INDUSTRIAL
EQUIPMENT
Zone
Number-------- -
----
Date-::::----:-------
Unit Model No._-:::::----------------
Serial Number
Type Fuel Used.
_______
Voltage/Frequency/Phase,
_
_ _ _ _ _ _
Installed at
Address
City
Type Pilot
EleCtric·
Gas
&
BTU cu.ft.
Light Oil
- - - - - - -
Installation
Appearance:
Dirty
a
Completed
a
Incomplete
a
Temporary Heat
a
OPERATION CBECK
DATA
·--HIGH
FIRE
DATA-----
CHECK
POINTS
GAS
OIL
I.
Stack
Temperature
fNet
0
F)
2.
Breecbing C02
(%)
3.
Fuel
Oil
Pumo
Pressure
(Lbs)
4.
Nozzle
Air
Pressure
(Lbs)
5.
Nozzle Oil Temoerarure
("F)
6.
Pilot Gas Pressure
(ln.
H20)
7.
Main
Gas
Pressure
(ln.
H20)
8.
Gas Rate
(cu.ftlhr)
9.
Pumo Suction
Vacuum
10.
Wiodowbox Pressure
((ln.
H20)
11.
Nozzle Oil
Bv-oass Pressure
12.
Safety
Sbut-<>ff
TIIDe
TYPE OF
PU.OT
13.
Type
Combustion
Control
Control Test Voltage
Ignition
Timing
14.
Has
Maintenance
Person
been
insrruaed?
a
YES
a
NO
Maintenance
Person's
Signarure
15.
Customer Remarks
CUSTOMER
(Signature)
(Date)
·------LOW
FIRE DATA·--·-··
GAS
OIL
Main Cut
off
Time
START UP AGENCY
(Signature)
(Date)
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