Professional Documents
Culture Documents
PREFUNCTIONALCHECKLISTS
PREFUNCTIONALCHECKLISTS
PREFUNCTIONAL CHECKLISTS
PART 1 GENERAL
1.1
1.2
DESCRIPTION
A.
This section contains sample Prefunctional Checklists. Most checklists contain items for
several contractors. Contractor is to assign responsibility for each line item using the
responsibility column.
B.
Those executing the checklists shall perform only items that apply to the specific
application at hand. These checklists do not take the place of the manufacturers
recommended checkout and start-up procedures or report. Coordinate with Section 01810
Fundamental Commissioning Requirements to utilize these checklists.
C.
Items that do not apply should be noted along with the reasons on the form. Contractor
shall ensure that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor
responsible to verify completion of this item.
PREFUNCTIONAL CHECKLISTS
A.
B.
Contractor shall develop prefunctional checklists with the start-up plans. Electronic copies
of these checklists are available upon request.
C.
Sample forms of similar rigor will be provided to the Contractor by the CA upon request for
other equipment (e.g. VAV terminal units).
01813-1
________________________ _________
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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor, MC =
mechanical contractor, SC = sheet metal contractor, TAB = test and balance contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent Date
________________________ _________
Owners Representative
Date
01813-2
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
Cabinet and General Installation
Contr.
01813-3
Check
Equip Tag
Filter pressure differential measuring device installed and
functional (magnahelic, inclined manometer, etc.)
Contr.
01813-4
Check
Equip Tag
Safeties installed and safe operating ranges are established
Contr.
____No
01813-5
3. Operational Checks (These augment manufacturers list. This is not a functional performance test)
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
Contr.
Supply fan rotation correct
Return / exhaust fan rotation correct
No unusual noise or vibration in supply and exhaust fans
Condenser fan rotation correct (air cooled)
Condenser fan acceptable noise and vibration (air cooled)
Measure line to line voltage imbalance for 1/3 of the
compressors:
Compressor 1 Phase: (%Imbalance = 100 x (avg. lowest) / avg.)
Record in cell, all three phase voltages. Imbalance less than
2%?
Compressor 2 Phase:
(%Imbalance = 100 x (avg. lowest)
/
avg.)
Record in cell, all three phase voltages. Imbalance less than
2%?
Record full load running amps for each compressor.
_____rated FL amps x ______srvc factor = _______ (Max
amps). Running less than max?
Record full load running amps for each condenser fan.
_____rated FL amps x ______srvc factor = _______ (Max
amps). Running less than max?
Fans > 5 hp Phase Checks:
(% imbalance = 100 x (avg. - lowest) / avg.)
List fan & record all 3 voltages in cell. Imbalance less than
2%?
Record full load running amps for each fan. _____rated FL
amps x ______srvc factor = _______ (Max amps).
Running less than max?
Inlet vanes aligned in housing, actuator spanned, modulate
smoothly and proportional to input signal and EMS readout.
All dampers (OSA, RA, EA, etc.) stroke fully without binding
and spans calibrated and BAS reading site verified (follow
procedure in Calibration and Leak-by Test Procedures). List
dampers
checked:
_________________________________________________
____
Valves stroke fully and easily and spanning is calibrated
(follow procedure in Calibration and Leak-by Test
Procedures). List each actuated valve here when spanned:
_________________________________________________
____
Valves verified to not be leaking through coils when closed
at normal operating pressure (follow procedure in Calibration
and Leak-by Test Procedures).
The HOA switch properly activates and deactivates the unit
CITYWIDE PUBLIC SAFETY BOND PROGRAM
PREFUNCTIONAL CHECKLISTS
RAMPART REPLACEMENT STATION
01813-6
Check
Equip Tag
Safeties installed and safe operating ranges for this
equipment provided to the commissioning agent
Contr.
___No
Gage reading = reading of the permanent gage on the equipment. BAS = building automation system.
Instr. = testing instrument. Visual = actual observation. The Contractors own sensor check-out sheets
may be used in lieu of the above, if the same recording fields are included and the referenced
procedures are followed.
All sensors are calibrated within required tolerances
____Yes
____No
-- END OF CHECKLIST --
01813-7
________________________ _________
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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor, MC =
mechanical contractor, SC = sheet metal contractor, TAB = test and balance contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-8
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
Cabinet and General Installation
Contr.
____No
3. Operational Checks (These augment mfrs list. This is not a functional performance test)
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
Fan rotation correct
Contr.
____No
-- END OF CHECKLIST --
01813-9
________________________ _________
Controls Contractor
Date
________________________ _________
Electrical Contractor
Date
________________________ _________
Plumbing 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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor, MC =
mechanical contractor, SC = sheet metal contractor, TAB = test and balance contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-10
5. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
General Installation
Label permanently affixed
Pumps installed in place and properly grouted, bases filled
Vibration isolation devices installed and functional
Factory alignment checked and appears correct
Field alignment, if required, completed
Seismic anchoring installed
Temperature and pressure gauges and sensors installed
Pump and motor lubricated
Piping (immediately around pump, see full piping checklist)
Pipe fittings completed and piping properly supported
No leaks in pipe fittings and accessories at pump?
Piping and pump properly insulated
Strainers in place and cleaned out
Piping system properly flushed
Valves properly tagged
Electrical and Controls
Contr.
01813-11
Check
Equip Tag
balancing to be completed following specified NEBB or
AABC procedures and contract documents
Final
Startup report completed with this checklist attached
Contr.
____No
6. Operational Checks (These augment mfrs list. This is not a functional performance test)
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag
The HOA switch properly activates and deactivates the unit
under manual and automatic control.
Pump rotation verified correct
No unusual noise or vibration
No leaking apparent around fittings
Measure line to line voltage phase imbalance for each
pump:
(%lmbalance = 100 x (avg. - lowest) / avg.) Record
imbalance of each pump in cell. Imbalance less than 2%?
Record full load running amps for each pump. FL amps x
factor (Max amps). Running less than max?
Specified sequences of operation and operating schedules
have been implemented with variations documented
Specified point-to-point checks have been completed and
documentation record submitted for this system
Checklist items of Part 3 are all successfully completed for given trade ___Yes
Contr.
____No
Gage reading = reading of the permanent gage on the equipment. Instr. = testing instrument. Visual =
actual observation.
Sensors are calibrated within required tolerances
____Yes
____No
END OF CHECKLIST
01813-12
________________________ _________
General Contractor
Date
________________________ _________
Electrical Contractor
Date
________________________ _________
Mechanical Contractor
Date
Prefunctional checklist items must be completed as part of startup & initial checkout, preparatory to
functional testing.
This checklist does not take the place of the manufacturers recommended startup procedures or
reports.
Note items that do not apply with the reasons on this form (N/A = not applicable, BO = by others).
If this form is not used for documenting prefunctional testing, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, GC = general
contractor, PC = plumbing contractor, MC = mechanical contractor, CC = controls contractor, SM =
sheet metal contractor, TAB = test and balance contractor, EC = electrical contractor, CA =
commissioning agent.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-13
3. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag->
Contr.
General Installation
General appearance good, no apparent damage
Site clean and ready for testing
Equipment labels and tags affixed
Tube pull and access door space adequate
Required seismic restraints in place
Flue installed completely and sloped properly
Combustion air supply provided
System filled with water and treatment chemicals
Pressure gages installed
Thermometers installed
Flue
Flue installed completely and sloped properly
Flue is installed away from combustible materials
Proper flue connection with draft diverter
Proper flue termination, vent cap, and flashing
Proper type flue double wall penetration
Piping
EMS instruments installed
PIT plugs installed as per drawings
Boiler interlocks and controls completed
Piping Immediately at unit. Also see Hydronic and Domestic
Piping)
Gas piping installed and tested (supply is at proper pressure)
Hydronic piping complete, including makeup water piping and
safety relief valves
Hydronic system flushing complete, strainers clean and treatment
installed
Isolation valves and balancing valves installed with extensions to
clear insulation
Pipe fittings and accessories installed with extensions for insulation
Test ports installed near control sensors and per spec
Flow switches installed as required
Flow meters installed as required
Flow directions labeled on piping insulation
Chemical treatment pot installed in proper direction
ASME pressure vessel data sheet or certification tag posted and
inspection complete for each expansion tank
Expansion tanks verified not waterlogged and system is completely
full of water.
Air vents and bleeds at high points of systems functional
Electrical and Controls
Power to disconnect switch and unit installed
Electrical components grounded
Sensors calibrated (see below)
Control system interlocks hooked up and functional
CITYWIDE PUBLIC SAFETY BOND PROGRAM
PREFUNCTIONAL CHECKLISTS
RAMPART REPLACEMENT STATION
01813-14
Check
Equip Tag->
Contr.
____No
Gage reading = reading of the permanent gage on the equipment. Instr. = testing instrument. Visual =
actual observation.
Sensors are calibrated within required tolerances
____Yes
____No
-- END OF CHECKLIST --
01813-15
________________________ _________
General Contractor
Date
________________________ _________
Electrical Contractor
Date
________________________ _________
Prefunctional checklist items must be completed as part of startup & initial checkout, preparatory to
functional testing.
This checklist does not take the place of the manufacturers recommended startup procedures or
reports.
Note items that do not apply with the reasons on this form (N/A = not applicable, BO = by others).
If this form is not used for documenting prefunctional testing, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, GC = general
contractor, PC = plumbing contractor, MC = mechanical contractor, CC = controls contractor, SM =
sheet metal contractor, TAB = test and balance contractor, EC = electrical contractor, CA =
commissioning agent.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-16
6. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag->
Contr.
General Installation
General appearance good, no apparent damage
Site clean and ready for testing
Equipment labels and tags affixed
Required seismic restraints in place
Insulating blanket installed (if necessary)
Adequate combustion air supply provided (air supply is sized and
located properly)
Unit is protected from weather
Unit is accessible and has manufacturer recommended clearances
Flue
Flue installed completely and sloped properly
Flue is installed away from combustible materials
Proper flue connection with draft diverter
Proper flue termination, vent cap, and flashing
Proper type flue double wall penetration
Piping immediately at unit. (Also see Hydronic and Domestic
Piping))
Gas piping installed and tested (supply is at proper pressure)
Piping complete, including safety relief valves.
System flushed and sterilized. Strainers clean and installed
Shutoff valves installed properly
Heat Trap properly installed
Dielectric connections installed correctly
Drain pipe is properly terminated
Smitty pan is properly installed (if required)
Air vents and bleeds at high points of systems functional
Electrical and Controls
Electrical components grounded
Sensors calibrated (see below)
Control devices and wiring complete
Shutoff devices and controls installed (if necessary)
Flow switches installed as required (if necessary)
Checklist items of Part 2 are all successfully completed for given trade ___Yes
____No
01813-17
Gage reading = reading of the permanent gage on the equipment. Instr. = testing instrument. Visual =
actual observation.
Sensors are calibrated within required tolerances
____Yes
____No
-- END OF CHECKLIST --
01813-18
________________________ _________
General Contractor
Date
________________________ _________
Electrical Contractor
Date
________________________ _________
Mechanical Contractor
Date
Prefunctional checklist items must be completed as part of startup & initial checkout, preparatory to
functional testing.
This checklist does not take the place of the manufacturers recommended startup procedures or
reports.
Note items that do not apply with the reasons on this form (N/A = not applicable, BO = by others).
If this form is not used for documenting prefunctional testing, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, GC = general
contractor, PC = plumbing contractor, MC = mechanical contractor, CC = controls contractor, SM =
sheet metal contractor, TAB = test and balance contractor, EC = electrical contractor, CA =
commissioning agent.
A significant part of the BAS functional testing requirements is the successful completion of the
functional tests of equipment the BAS controls or interlocks with. Uncompleted equipment functional
tests or outstanding deficiencies in those tests lend the required BAS functional testing incomplete.
Integral or stand-alone controls are functionally tested with the equipment they are attached to,
including any interlocks with other equipment or systems and thus are not covered under the BAS
testing requirements, except for any integrated functions or interlocks listed below. In addition to the
controlled equipment testing, the following tests are required for the BAS, where features have been
specified. The following testing requirements are in addition to and do not replace any testing
requirements elsewhere in the specifications.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-19
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Equip Tag->
Contr.
01813-20
3.
Contr. = [
The following procedures are required to be performed and documented for each and every point in the
control system. The following procedures are minimum requirements. The control contractor is
encouraged to identify better and more comprehensive checkout procedures in their submitted plan.
These procedures are not a substitute for the manufacturers recommended start-up and checkout
procedures, but are to be combined with them, as applicable. The documentation may be provided on
the vendors stock form, as long as all the information in the sample table below can be clearly
documented on the form.
Similar checkout and calibration requirements are found on the equipment prefunctional checklists.
Redundant documentation is not required. Cross reference, by name and form number, to other forms
that contain documentation left blank on the current form.
Procedures:
a.
b.
[Actu] If the device is or has an actuator, verify full free movement through its full range.
c.
d.
[Load] For devices with a controller, verify that current software program with proper setpoints has
been downloaded.
e.
[DevCal] Device stroke/range calibration. This applies to all controlled valves, dampers, fans,
pumps, actuators, etc. Simulate maximum and minimum transmitter signal values and verify
minimum and maximum controller output values and positively verify each and every control
device minimum and maximum stroke and capacity range.
f.
[SensLoc] Verify that all sensor locations are appropriate and away from causes of erratic
operation.
g.
[SensCal] Sensor calibration. Calibrate or verify calibration of all sensors and thermostats,
including temperature, pressure, flow, current, kW, rpm, Hertz, etc. Verify that the sensor readings
in the control system are within the sensor accuracies specified in this section, using hand-held or
other external measuring instruments.
h.
[OperCk] For controlled devices (dampers, valves, actuators, VAV boxes, etc.), after mechanical
equipment control becomes operational, perform an operational test of each control loop. Follow
procedure 6.2 below. Operational checks are preparatory to the later functional testing.
i.
Other Abbreviations: [BAS] Building automation system or gage-read value; [Instru] Instrument
(calibrated) read value; [Ofset] Offset programmed into the point to correct the calibration.
Items of Parts 2 and 3 are all successfully completed for given trade ___Yes
____No
[Contr. = ______ ]
01813-21
Field-installed temperature, CO 2, CO, and pressure sensors and gages on this piece of equipment are
calibrated. Test instruments NIST certified for calibration within the last 12 months: Y/N______.
Sensors installed in the unit at the factory with NIST calibration certificates provided need not be field
calibrated.
SAMPLE FORM: Controls Checkout Documentation Table
Poin
t
Obje
ct
Field
Devic
e
Hardware Checks
Wire
Actu
Addr
Senscal
Load
Dev
Sens
Final Check
BA
S
Instru
Offse
t
Ope
r
____Yes
____No
-- END OF CHECKLIST --
01813-22
________________________ _________
General Contractor
Date
The TAB Plan checklist does not take the place of the recommended formats or procedures in
standards referenced in the specifications, but it is intended to augment them.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
Approvals. This filled-out checklist and the TAB Plan have been reviewed. Their completion is approved
with the exceptions noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
Chilled
Water
Heating
Water
TAB contractor has reviewed drawings, walked through the site and verified
that there are sufficient balancing dampers, valves, isolation dampers and
valves and test ports installed to perform TAB per spec. Deficiencies in
design or installation that will adversely affect or preclude proper TAB have
been reported.
TAB contractor has reviewed the construction documents and the systems
with the design engineers and contractors to sufficiently understand the
design intent for each system and outlet.
Prior to plan, TAB contractor met with controls contractor to become familiar
with using the terminal unit programmer for TAB
Field checkout sheets and logs provided as part of plan
Proposed final test report sheets provided as part of plan
Field and final test report sheets list each piece of equipment to be tested,
adjusted and balanced with the data cells to be gathered for each
Discussion of what notations and markings will be made on the duct and
piping drawings.
CITYWIDE PUBLIC SAFETY BOND PROGRAM
PREFUNCTIONAL CHECKLISTS
RAMPART REPLACEMENT STATION
01813-23
Check
Air
Side
Chilled
Water
Heating
Water
N/A
N/A
List of air flows, water flows, sound levels, system capacities and efficiency
measurements to be performed, and a description of specific test
procedures, parameters, formulas and test instrument type to be used for the
measurements have been provided. Sample forms have been included.
Detailed step-by-step procedures for TAB work: Terminal flow calibration (for
each terminal type), diffuser proportioning, branch/sub-main proportioning,
total flow calculations, rechecking, and others. Similar for water side.
Details of how total flow will be determined (Air: Sum of terminal flows via
BAS calibrated readings or via hood read of terminals, supply (SA) and
return air (RA) pitot traverse, SA or RA flow stations. Water: pump curves,
circuit setter, flow station, ultrasonic meter.)
Specific procedures that will ensure (and which can be verified) that both air
side and water side are operating at the lowest possible pressures and
energy consumption.
Outside air ventilation criteria under clearly understood by TAB contractor
Details of if and how minimum outside air cfm will be verified and set and for
what level (total bldg, zone, other.)
Details of how building static and exhaust fan/relief damper capacity will be
checked.
The identification and types of measurement instruments to be used and
their most recent calibration date
Proposed selection points for sound measurements
Details of any TAB work to be done in phases, by floor, or of areas to be built
out later
Details regarding specified deferred or seasonal TAB work
Details of specified false loading of systems to complete TAB work
Details of exhaust fan balancing and capacity verifications, including
required room pressure differentials.
Plan for hand-written field technician logs of discrepancies, deficient or
uncompleted work by others, contract interpretation requests and lists of
completed tests (scope and frequency)
Plan for formal progress reports (scope and frequency)
Plan for formal deficiency reports (scope, frequency and distribution)
Checklist items of Part 2 are successfully completed
____Yes
____No
-- END OF CHECKLIST --
01813-24
________________________ _________
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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-25
2.
Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient (attach notes). Complete
table for each room.
Check
Rooms
Contr.
Lighting fixtures and switches
Light switches are located per plans
Light switches are labeled with proper ID to match drawings
or field changes
Light switch is controlling the fixtures in the area indicated on
design drawings
Fixtures are properly supported for seismic zone
Verify proper lamp type is installed in each fixture to match
fixture schedule and specifications
Lighting controls
Lighting
control
is
installed
per
manufacturer
recommendations (attached recommendations to this
checklist)
Lighting control is calibrated per manufacturer checklist
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient (attach notes). Complete table for
each room.
Check
Rooms
Contr.
01813-26
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient (attach notes). Complete table for
each room.
Check
Lighting fixtures and switches
Rooms
Contr.
Rooms
Contr.
____No
-- END OF CHECKLIST --
01813-27
_____Piping,
_____Dx
coils,
______Condensing
units,
________________________ _________
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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor, MC =
mechanical contractor, SC = sheet metal contractor, TAB = test and balance contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-28
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Piping (line sets)
Contr.
____No
-- END OF CHECKLIST --
01813-29
________________________ _________
General Contractor
Date
________________________ _________
Mechanical 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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, GC = general
contractor, PC = plumbing contractor, MC = mechanical contractor, CC = controls contractor, TAB =
test and balance contractor, EC = electrical contractor, CA = commissioning agent.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-30
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Piping
Contr.
Checklist items of Part 2 are all successfully completed for given trade ____Yes
____No
END OF CHECKLIST
01813-31
________________________ _________
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 manufacturers recommended checkout and startup
procedures or report.
Items that do not apply shall be noted with the reasons on this form (N/A = not applicable, BO = by
others).
If this form is not used for documenting, one of similar rigor shall be used.
The Contractors who are assigned responsibility for sections of the checklist shall also be responsible
to see that checklist items by their subcontractors are completed and checked off.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, GC = general
contractor, PC = plumbing contractor, MC = mechanical contractor, CC = controls contractor, TAB =
test and balance contractor, EC = electrical contractor, CA = commissioning agent.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-32
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Piping
Contr.
Pipe fittings complete and pipes properly supported allowing for thermal expansion
and contraction and building expansion joints.
Pipe joints properly installed
Required seismic anchoring installed
Pipes properly labeled
Pipes properly insulated
Piping properly sloped
Proper construction isolation
Strainers in place and clean
Isolation valves and balancing valves installed
Test ports (P/T) installed near all control sensors and as per spec
Piping system properly flushed and cleaned and temporary piping removed (report
attached)
10% of strainers and Owner-selected low-point drains opened and witnessed by
Owner to be clean. (List points checked below).
Piping hydrostatic pressure test completed according to contract documents (report
attached)
No leaking apparent around fittings
ASME pressure vessel data sheet or certification tag posted and inspection complete
for each expansion tank and storage tank
Expansion tanks verified to not be air bound and system completely full of water.
System purged of air.
Air vents and bleeds at high points of systems functional
Water hammer arrestors installed and tested
Backflow preventer proper location
Adequate depth of bury for service piping
Cross connection protection
Valves
Valve tags permanently affixed
Valves installed in proper direction
Pressure reducing valves set at proper pressure
No leaks
Flexible connections at equipment installed
Dielectric fittings for dissimilar metals installed
Vibration Isolation installed
Fire-rated pipe penetrations installed properly
Valves that require a positive shut-off are verified to not be leaking when closed at
normal
operating
pressure.
List:
__________________________________________________
CITYWIDE PUBLIC SAFETY BOND PROGRAM
PREFUNCTIONAL CHECKLISTS
RAMPART REPLACEMENT STATION
01813-33
Check
Contr.
____No
END OF CHECKLIST
01813-34
Prefunctional Checklist
Ductwork
Associated Checklists: Rooftop Packaged Unit
1. Submittals / Approvals
Submittal. The above equipment is 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.
None of the outstanding items preclude safe and reliable functional tests being performed.
___ List attached.
________________________ _________
Mechanical Contractor
Date
________________________ _________
Sheet Metal Contractor
Date
________________________ _________
General Contractor
Date
________________________ _________
Electrical Contractor
Date
Prefunctional checklist items are to be completed as part of startup & initial checkout, preparatory to
functional testing.
Contr. column or abbreviations in brackets to the right of an item refer to the contractor responsible
to verify completion of this item. A/E = architect/engineer, All = all contractors, CA = commissioning
agent, CC = controls contractor, EC = electrical contractor, GC = general contractor, MC =
mechanical contractor, SC = sheet metal contractor, TAB = test and balance contractor.
Approvals. This filled-out checklist has been reviewed. Its completion is approved with the exceptions
noted below.
________________________ _________
Commissioning Agent
Date
________________________ _________
Owners Representative
Date
01813-35
2. Installation Checks
Check if Okay. Enter N/A if not applicable. Enter Note number if deficient.
Check
Run to/from
Ducts
Contr.
____No
END OF CHECKLIST
END OF SECTION
01813-36