PREFUNCTIONAL TEST CHECKLIST
BRIDGE TENDER STATION (BT STA) - _________
Specification Section 15_____
Project: __________________________________ Project No: __________
Components included:
___ Control Valves (V-1, V-2), ___Flow meters, ___ Sensors and Transmitters,
___ Control Panel
Associated Checklists:
___CHW Piping, ___ CHW Pump ____,
___Other_______________________
1. Submittal / Approvals
Submittal. The above equipment and systems integral to them are complete and ready
for functional testing. The checklist items are complete and have been checked off only
by parties having direct knowledge of the event, as marked below, respective to each
responsible contractor. This prefunctional checklist is submitted for approval, subject to
an attached list of outstanding items yet to be completed. A Statement of Correction will
be submitted upon completion of any outstanding areas. None of the outstanding items
preclude safe and reliable functional tests being performed. ___ List attached.
_____________________ __________ _____________________ __________
Mechanical Contractor Date Controls Contractor Date
_____________________ __________ _____________________ __________
Electrical Contractor Date Sheet Metal Contractor Date
_____________________ __________ _____________________ __________
TAB Contractor Date General Contractor Date
Prefunctional checklist items are to be completed as part of startup & initial checkout,
preparatory to functional testing.
This checklist does not take the place of the manufacturer’s recommended
checkout and startup procedures or report.
Contractors assigned responsibility for sections of the checklist shall be
responsible to see that checklist items by their subcontractors are completed and
checked off.
Approvals. This filled-out checklist has been reviewed. Its completion is approved.
_____________________ __________ ____________________ __________
Commissioning Authority/Agent Date Owner’s Representative Date
2. Requested documentation submitted
a. Manufacturer’s cut sheets/piping and instrumentation diagrams:
Yes / No - date to be submitted _______
a. Performance data (control valve Cvs, etc.):
Yes / No - date to be submitted _______
a. Installation and startup manual and plan:
Yes / No - date to be submitted _______
a. Sequences and control strategies: Yes / No - date to be submitted
_______
b. O & M Manuals: Yes / No - date to be submitted _______
c. Data base sheets: Yes / No - date to be submitted _______
3. Model Verification
Item Specified Submitted Installed
Manufacturer
Model
Serial Number
Full Flow no by-pass (GPM)
Primary Pipe Size (in)
Secondary Pipe Size (in)
Design Press/Temp (psig/F)
4. Installation Checks
d. Unit and General Installation
i. Permanent labels affixed: Yes / No
ii. Panel condition good – no dents, door shuts and locks: Yes / No
iii. Thermometers readable without special equipement: Yes / No
iv. Flow meters readable without special equipment: Yes / No
v. Maintenance access to valves, flow meters and panel
acceptable: Yes / No
vi. Instrumentation installed correctly per specifications (thermowells,
thermometers, pressure gages, flow meters, transmitters,
sensors):
Yes / No
vii. Equipment clean: Yes / No
b. Flow Meters, Valves and Piping
vii. Pipe fittings complete and pipes properly supported: Yes / No
viii. Pipe pressure test compete and acceptable: Yes / No
ix. Pipes properly insulated: Yes / No
x. Pipes properly labeled: Yes / No
xi. Piping system properly flushed: Yes / No
xii. Water quality testing complete per CHW piping checklist: Yes /
No
xiii. Water quality testing results approved by MDAD
Maintenance: Yes / No
xiv. Piping system charged: Yes / No
xv. No leaking evident around fittings or components: Yes / No
xvi. Flow meters installed correctly per piping and instrumentation
drawings (including minimum straight runs): Yes / No
xvii. Valves installed properly: Yes / No
xviii. Valves open and close: Yes / No
b. Electrical and Controls
vii. Panel power source identified: Yes / No
viii. Panel labeled with permanent label: Yes / No
ix. Power disconnect in place and labeled: Yes / No
x. Low voltage wiring in separate conduit as 120 vac: N/A / Yes /
No
xi. 120 vac lightning protection installed: N/A / Yes / No
xii. Low voltage lightning protection installed (underground only): N/A
/ Yes / No
xiii. Pneumatic devices separated from controller and electronics: Yes
/ No
xiv. E-O-L devices labeled and wiring tagged per drawings: Yes / No
xv. Panel devices labeled and wiring tagged per drawings: Yes / No
xvi. I/O devices labeled and wiring tagged per drawings: Yes / No
xvii. Digital inputs and outputs operational: Yes / No
xviii. E-PROM images on LAN for each controller: Yes / No
xix. Controller drawing and point summary log in panel: Yes / No
xx. All electric connections tight: Yes / No
xxi. Proper grounding installed for components and unit: Yes / No
xxii. Safeties in place and operable: Yes / No
xxiii. Sensors calibrated (see below) : Yes / No
xxiv. Control system interlocks hooked up and functional: Yes / No
xxv. Secondary Supply Temperature as setpoint/control: Yes / No
xxvi. Primary Return Temperature as setpoint/control: Yes / No
xxvii. All control devices, pneumatic tubing and wiring complete: Yes /
No
b. TAB
vii. Installation of required system balancing devices complete: Yes /
No
b. Final
vii. Startup report completed with this checklist attached: Yes / No
viii. Safeties and safe operating ranges for this equipment have been
reviewed and accepted: Yes / No
ix. Sequence of Operation adequately show all information: Yes /
No
x. Manufacturer piping and instrumentation diagrams attached: Yes
/ No
5. Operational Checks (These augment manufacturer’s list. This is not the
functional performance testing.)
e. V1 valve (PCHWR) modulates: Yes / No
f. V2 valve (bypass) modulates: Yes / No
g. Specified sequences of operation and operating schedules have been
implemented with all variations documented: Yes / No
h. Specified point-to-point checks have been completed and documentation
record submitted for this system: Yes / No
6. Sensor and/or Actuator Calibration
All field-installed temperature, [relative humidity], [CO], [CO 2] and pressure
sensors and gages, and all actuators (dampers and valves) on this piece of
equipment shall be calibrated. Sensors installed in the unit at the factory with
calibration certification provided need not be field calibrated.
All test instruments have had a certified calibration within the last 12 months:
Y/N______.
Sensor/Actuator Verification Table
Sensor or Actuator Location Thermometer or BMS Instrument Pass
OK (Y/N) Gage Value Value Measured (Y/N)
Value
PCHW Supply Temp
PCHW Return Temp
SCHW Supply Temp
SCHW Return Temp
Primary Flow
Secondary Flow
Differential Pressure
across V2 valve
Thermometer/Gage reading = reading of the permanent instrument on the
equipment. BMS = building management system. Instrument = testing
instrument.
All sensors are calibrated within required tolerances ___ YES ___ NO
-- END OF CHECKLIST--
