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AGENCIES LTD. 

BOILER COMMISSIONING REPORT

1. Form must be filled out completely and signed by the Commissioning Agent. 

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 2. If commissioning agents find pre-commissioning work to be incomplete, the project commissioning will not proceed. Additional visits to the commission will require a Purchase Order or Payment in full, prior to site arrival.

Please complete all fields.

Boiler Commissioning Report

Boilers

SERIAL NUMBERS:

Boiler is: (Please select one)
Natural Gas
Propane

Mechanical Room

Boiler(s) CO2 & O2 within content range specified in Boiler Manual:
YES
NO
NA

*PLEASE SEND A SEPARATE EMAIL WITH ALL PICTURES OF COMBUSTION ANALYSIS WITH JOB NAME TO GLEN@ALTATECH.CA

Is Combustion air free of halogens (solvents, cleaning fluids) and dust (Drywall etc.):
YES
NO
NA
Visual inspection of boiler(s) and equipment installed/mounted correctly?
YES
NO
NA
Boiler is Level:
YES
NO
NA
Gas supply pressure: W.C. Static & W.C. High Fire
YES
NO
NA
Air properly bled from system:
YES
NO
NA
Condensate piped properly installed and vented:
YES
NO
NA
Neutralization System installed:
YES
NO
NA
Any evidence of leaks within Boiler Cabinet
YES
NO
NA

Operation/Controls

Heating pump direction and operation verified:
YES
NO
NA
DHW pump (if equipped) direction and operation verified:
YES
NO
NA
Mixing valve (if equipped) operation verified:
YES
NO
NA
Outdoor air temperature sensor (if equipped) verified:
YES
NO
NA
Supply temperature sensor (if equipped) verified:
YES
NO
NA
DHW temperature sensor (if equipped) verified:
YES
NO
NA
DHW pump (if equipped) direction and operation verified
YES
NO
NA
Boiler pump (if equipped) direction and operation verified:
YES
NO
NA
Isolation valve (if equipped) direction and operation verified:
YES
NO
NA

Safeties

Boiler Pressure Relief Valve:
Boiler pressure relief valve tested:
YES
NO
NA
Boiler flow switch:
YES
NO
NA
Low water cut off tested:
YES
NO
NA
Any evidence of Leaks within boiler cabinet:
YES
NO
NA

Venting

Venting Material:
Venting transition adaptor installed according to installation instructions:
YES
NO
NA
Venting is connected to boiler and secured according to installation instructions:
YES
NO
NA
Ventilation adequate:
YES
NO
NA
Vent damper (if equipped) operation verified:
YES
NO
NA

Connectivity Status

BMS Communication:
Internet Connection:
Apps: Configured with ViGuide (if applicable please provide report)
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