DEPARTMENT OF VETERANS AFFAIRS
BOILER SAFETY DEVICES - OPERATION CHECK LIST
HOSPITAL______PROJECT NO. ______DATE______BOILER NO. ______
BOILER MAKE AND MODEL ______
BURNER MAKE AND MODEL ______
TECHNICIAN AND COMPANY ______
VA REPRESENTATIVE ______
Not
Item OK OK Set Point - Remarks
Low Water Cutoff [ ] [ ] ______
Aux. Low Water Cutoff [ ] [ ] ______
High Water Alarm [ ] [ ] ______
Low Water Alarm [ ] [ ] ______
Low Water Cutoff Shunt Switch [ ] [ ] ______
Aux. Low Water Cutoff Shunt Switch [ ] [ ] ______
High Steam Press. Cutout - Recycle [ ] [ ] ______
High Steam Press. Cutout - Non-Recycle [ ] [ ] ______
Steam Safety Valve No. 1 - Pop [ ] [ ] ______
Blowdown [ ] [ ] ______
Steam Safety Valve No. 2 - Pop [ ] [ ] ______
Blowdown [ ] [ ] ______
Steam Safety Valve No. 3 - Pop [ ] [ ] ______
Blowdown [ ] [ ] ______
Steam Safety Valve No. 4 - Pop [ ] [ ] ______
Blowdown [ ] [ ] ______
Main Gas
High Pressure Cutoff [ ] [ ] ______
Low Pressure Cutoff [ ] [ ] ______
Safety Shut-Off Valves Proof of Closure [ ] [ ] ______
Leak Test Safety Shut-Off Valves [ ] [ ] ______
Oil
High Pressure Cutoff [ ] [ ] ______
Low Pressure Cutoff [ ] [ ] ______
High Temperature Cutoff (Heated Oil) [ ] [ ] ______
Low Temperature Cutoff (Heated Oil) [ ] [ ] ______
Low Atomizing Pressure [ ] [ ] ______
Low Atomizing/Oil Differential Pressure [ ] [ ] ______
Oil Burner Position Switch [ ] [ ] ______
Safety Shut-Off Valves Proof of Closure [ ] [ ] ______
Leak Test Safety Shut-Off Valves [ ] [ ] ______
Cold Start/Steam Atomizing Burners [ ] [ ] ______
LP Gas Ignitor Operation [ ] [ ] ______
Ignitor (Pilot)
Low Gas Pressure [ ] [ ] ______
Leak Test Safety Shut-Off Valves [ ] [ ] ______
Forced Draft Motor Interlock [ ] [ ] ______
F. D. Damper Open Wide for Purge [ ] [ ] ______
Outlet Damper Open Wide for Purge [ ] [ ] ______
Purge Air Flow Interlock [ ] [ ] ______
Purge Timing [ ] [ ] ______
Ignition Timing [ ] [ ] ______
Low Fire Position Interlock [ ] [ ] ______
Combustion Air Flow Interlock [ ] [ ] ______
Main Flame Out - Time to Close Valves [ ] [ ] ______
Ignition Flame Out - Time to Close Valves [ ] [ ] ______
Minimum Ignitor Flame Test [ ] [ ] ______
Scanner Not Sensing Ignition Spark [ ] [ ] ______
Control Air Pressure Interlock [ ] [ ] ______
Sound Level - High Fire [ ] [ ] ______
Fan Motor Amps [ ] [ ] ______
Low Oxygen Alarm [ ] [ ] ______
Boiler Soot Blower Operation and Alignment [ ] [ ] ______
Economizer Soot Blower Operation [ ] [ ] ______
Flue Gas Recirculation Damper Set for Prepurge [ ] [ ] ______
______[ ] [ ] ______
VACO 183A
2/7/00