03c_Reference 1_CG_5519.pdf

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Boiler Inspections for USCG TRACEN PETALUMA
Solicitation number
61200PR260031567
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This is a U.S. Coast Guard inspection form (CG-5519) for boilers and pressure vessels. The form is a template used to document comprehensive inspections of boiler and pressure vessel equipment, primarily for maritime vessels and installations.

The inspection template captures critical equipment specifications including manufacturer details, installation date, horsepower rating, and safe working pressure parameters. Inspectors document the condition of internal and external components, including presence of grease, scale, pitting, and corrosion. The form requires detailed measurements of hydrostatic pressure testing, tube conditions and quantity, safety valve specifications and settings, pressure gauge accuracy, and fusible plug status. Inspectors must identify necessary repairs or additions, document steam leak repairs, and note any variations between pressure gauges. The form concludes with separate sections for inspector remarks and recommendations, and local officer remarks and recommendations, both requiring enumeration of deficiencies that must be corrected for safe operation at the allowed working pressure. Both the inspector and Officer in Charge must sign and date the completed form, with the Officer in Charge providing certification of inspection completion.

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1. Inspection conducted by: 2. Date: 3. OPFAC number or ship name:

4. Manufactured by: 5. Manufacturer's number:

6. Type: 7. Plant number:

8. Date installed: 9. Manufacturer's rating (Hp.):

10. Safe working pressure designated by manufacturer: 11. State service (lighting, pumping, sawmill, etc.):

12. Does boiler contain grease or scale? 13. If so, is the quantity of same considered serious?

14. Was pitting or corrosion apparent? 15. If so, to what extent?

16. What hydrostatic pressure was applied? 17. Were signs of weakness apparent under this pressure?

18. If so, where and to what extent: 19. State maximum safe working pressure (lbs.):

20. State present working pressure (lbs.): 21. State number, length, and size of tubes in boiler:

22. State condition: 23. Are all tubes tight?

24. State number and size of safety valves: 25. State conditions of safety valves:

26. Safety valves set to open at pressure of (lbs.):

27. What variation in pressure existed between pressure gauge and inspector's test gauge at working pressure?

28. Was Gauge Corrected?

29. Were Fusible Plugs Renewed?

30. What is the general condition of the boiler or pressure vessel (internally) (externally)?

31. What is the general condition of the mountings, attachments, settings, etc.?

32. What additions or repairs are considered necessary? 33. Were steam leaks repaired?

34. Memoranda:

DEPARTMENT OF HOMELAND SECURITY

U.S. COAST GUARD

INSPECTION OF BROILER OR PRESSURE VESSEL

CG-5519 (02/20) Page 1 of 2

35. Remarks and recommendations by inspector (Enumerate deficiencies to be corrected in order that the boiler or pressure vessel may be operated with safety at the working pressure allowed.).

Signature of inspector: Official title of inspector:

36. Remarks and recommendations by the local officer (Enumerate deficiencies to be corrected in order that the boiler or pressure vessel maybe operated with safety at the working pressure allowed.).

I certify that the above inspection was completed on (date):

Signature of Officer in Charge: Official title of Officer in Charge:

Page 2 of 2CG-5519 (02/20)

CG-5519

USCG

Inspection of Boiler or Pressure Vessel 6.3.0.20170316.1.928536

1. Inspection conducted by:

2. Date:

3. OPFAC number or ship name:

4. Manufactured by:

5. Manufacturer's number:

6. Type:

7. Plant number:

8. Date installed:

9. Manufacturer's rating (Hp.):

10. Safe working pressure designated by manufacturer:

11. State service (lighting, pumping, sawmill, etc.):

12. Does boiler contain grease or scale?

13. If so, is the quantity of same considered serious?

14. Was pitting or corrosion apparent?

15. If so, to what extent?

16. What hydrostatic pressure was applied?

17. Were signs of weakness apparent under this pressure?

18. If so, where and to what extent:

19. State maximum safe working pressure (lbs.):

20. State present working pressure (lbs.):

21. State number, length, and size of tubes in boiler:

22. State condition:

23. Are all tubes tight?

24. State number and size of safety valves:

25. State conditions of safety valves:

26. Safety valves set to open at pressure of (lbs.):

27. What variation in pressure existed between pressure gauge and inspector's test gauge at working pressure?

28. Was Gauge Corrected?

29. Were Fusible Plugs Renewed?

30. What is the general condition of the boiler or pressure vessel (internally) (externally)?

31. What is the general condition of the mountings, attachments, settings, etc.?

32. What additions or repairs are considered necessary?

33. Were steam leaks repaired?

34. Memoranda:

DEPARTMENT OF HOMELAND SECURITY

U.S. COAST GUARD

INSPECTION OF BROILER OR PRESSURE VESSEL

CG-5519 (02/20)

35. Remarks and recommendations by inspector (Enumerate deficiencies to be corrected in order that the boiler or pressure vessel may be operated with safety at the working pressure allowed.).

Signature of inspector:

Official title of inspector:

36. Remarks and recommendations by the local officer (Enumerate deficiencies to be corrected in order that the boiler or pressure vessel maybe operated with safety at the working pressure allowed.).

I certify that the above inspection was completed on (date):

Signature of Officer in Charge:

Official title of Officer in Charge:

CG-5519 (02/20)

I certify that the above inspection was completed on. Date. Enter 2 digit month, 2 digit day and 4 digit year.:
1. Inspection conducted by.:
4. Manufactured by.:
7. Plant number.:
10. Safe working pressure designated by manufacturer.:
12. Does boiler contain grease or scale?:
14. Was pitting or corrosion apparent?:
19. State maximum safe working pressure (pounds).:
15. If so, to what extent?:
31. What is the general condition of the mountings, attachments, settings, etc.?:
26. Safety valves set to open at pressure of (pounds).:
9. Manufacturer's rating (H p.).:
11. State service (lighting, pumping, sawmill, etc.).:
13. If so, is the quantity of same considered serious?:
17. Were signs of weakness apparent under this pressure?:
23. Are all tubes tight?:
27. What variation in pressure existed between pressure gauge and inspector's test gauge at working pressure?:
32. What additions or repairs are considered necessary?:
34. Memoranda.:
33. Were steam leaks repaired?:
28. Was Gauge Corrected?:
29. Were Fusible Plugs Renewed?:
6. Type.:
5. Manufacturer's number.:
3. O P F A. C number or ship name.:
8. Date installed. Enter 2 digit month, 2 digit day and 4 digit year.:
Reset:
36. Remarks and recommendations by the local officer (Enumerate deficiencies to be corrected in order that the boiler or pressure vessel maybe operated with safety at the working pressure allowed.).:
Official title of Officer in Charge.:
Signature of inspector. This is a digital signature field.:

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