Plumbing Commmisioning Check List

5/4/22, 12:49 PM Plumbing Commissioning Checklist - SafetyCulture
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Plumbing Commissioning Checklist
General
Is the work area clean, orderly, no leftover material or debris?
Yes No N/A
Are Safety Hazards addressed: sharp edges, low head clearance, missing equipment
guards, etc.?
Yes No N/A
Are Maximo Tag, Nameplate, and Serial Number attached to equipment?
Yes No N/A
Hi there 👋
Do you
Is instrument gauges/meters labeling correct and operating inneed some help
the normal finding the
range?
right form?
Yes No N/A
Yes, I'd like some help.
I want to import my own form.

Are valves labeled according to standard?
No, I'm good. Thanks!
Yes No N/A
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Are equipment and components labeled according to labeling standard?
Yes No N/A
Are wall and ceiling penetrations repaired, painted, or replaced with equivalent material?
Yes No N/A
Has penetrations through fire rated construction been sealed with fire caulk and pillows?
Yes No N/A
Does the installation meet code compliance requirements?
Yes No N/A
Do isolation devices (valves, disconnects, etc.) have provisions for lock-out devices?
Yes No N/A
Has material been disposed or recycled in the proper containers (Ex: Wood, Metal,
General Trash, Cardboard)?
Hi there 👋
Yes No N/A
Do you need some help finding the
right form?
Yes, I'd like

Has abandoned, unused, or decommissioned equipment been wrecked out some help.
or removed
from service (Note: Apply Red Tag, if applicable)?
Yes No N/A
Are manufacturer installation, operation, and start-up documents complete and verified?
Yes No N/A
Does equipment meet requirements for workspace clearance (Ex. Electrical panels,
thermostats, etc.)?
Yes No N/A
Documentation
Are equipment operation manuals and specifications submitted to the System Owner?
Yes No N/A
Are as-built documentation, such as red line drawings, are submitted to the System
Owner?
Yes No N/A
Have LOTO procedures been documented for nonstandard or special electrical,

mechanical, and chemical systems which will be needed for future use?
Hi there 👋
Yes No N/A
right form?
Plumbing Yes, I'd like some help.
Are all new piping tie-ins to existing plumbing mains and submains coordinated with
system owner for capacity and compatibility?
Yes No N/A
Are pipes labeled in compliance to the current Standard, including direction of flow and
content?
Yes No N/A
Are dielectric unions on dissimilar metals installed where applicable?
Yes No N/A
Is chilled water piping, both supply and return, insulated per design?
Yes No N/A
Are rains sized properly, in proper location, and traps installed per design?
Yes No N/A
Is all gravity drain piping sloped a minimum of 1/8" drop per linear ft or greater as
required by system capacity and building code?
Yes No N/A
Hi there 👋
Are plumbing fixtures vented to correct location with properly sized vent line as required?

Yes No N/A right form?
Does the supply water piping include the properly sized water arrestor?
Yes No N/A
Are new chilled water piping systems chemically passivated per current Standards
Yes No N/A
Are all pipe weldments made with sil-fos, unless otherwise approved by system owner?
Yes No N/A
Does the system meet performance design criteria for operation and control
(temperature, end of line pressure, flow rates, test and balance, etc.)?
Yes No N/A
Is the pipe properly supported?
Yes No N/A
Are Aerators/Strainers in place and clean?
Yes No N/A
Are faucet/flush handles secured and properly aligned?

Hi there 👋
Yes No N/A
right form?

Are joints between fixtures and walls, floors, and counters sealed?
Yes No N/A I want to import my own form.
Are fixtures installed consistent with ADA and Code requirements?
Yes No N/A
Are any additional commissioning checklist(s) complete, if applicable?
Yes No N/A
Completion
Additional Comments
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right form?

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5/4/22, 12:49 PM Plumbing Commissioning Checklist - SafetyCulture

Convert your paper

Plumbing Commissioning Checklist

Is the work area clean, orderly, no leftover material or debris?

Are Maximo Tag, Nameplate, and Serial Number attached to equipment?

I want to import my own form.

Are equipment and components labeled according to labeling standard?

Does the installation meet code compliance requirements?

Yes, I'd like

Have LOTO procedures been documented for nonstandard or special electrical,

Plumbing Yes, I'd like some help.

I want to import my own form.

Are dielectric unions on dissimilar metals installed where applicable?

Do you need some help finding the

Yes, I'd like some help.

Is the pipe properly supported?

Are Aerators/Strainers in place and clean?

Are faucet/flush handles secured and properly aligned?

Yes, I'd like some help.

Yes No N/A I want to import my own form.

No, I'm good. Thanks!

Are fixtures installed consistent with ADA and Code requirements?

Are any additional commissioning checklist(s) complete, if applicable?

Yes, I'd like some help.

I want to import my own form.

No, I'm good. Thanks!

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