Backflow Testing Schedule.pdf

PDF 440 KB Posted

Attached to
J041--SUBJECT* Steam, Plumbing and HVAC Service Contract Bedford VA Medical Center
Solicitation number
36C24126Q0134
Issued by

About this file

This is an inspection checklist or testing log template used to document system inspections across multiple buildings and locations. The document provides a comprehensive record-keeping framework for facility testing activities, with columns for building number, room/location, date, time, duration, pass/fail results, and comments.

The checklist covers inspections across at least 82 buildings and numerous rooms/locations, with a focus on mechanical and utility systems. Notable inspection points include exterior hot boxes, basement areas, hydronic systems, chilled water systems, domestic hot water systems, boiler plants, mechanical rooms, dishwashers, medical air and pump systems, and various other facility components. The document appears designed to track compliance testing or preventive maintenance activities across a large institutional or industrial complex, with blank fields to be completed during actual inspections. The template provides sufficient space for documenting findings across numerous locations, enabling systematic tracking of pass/fail determinations and any associated observations or issues discovered during testing.

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Text version

Bldg # Room/Location Date Time Duration Pass/Fail Comments 80 Exterior Hot box

Avenue R Exterior Hot box Avenue R Exterior Hot box Avenue R Exterior Hot box

1 Basement 2 B06 2 B06 (Hydronic) 2 B06 (Dental) 2 Penthouse 2 Old Hydronic Penthouse 2 226 2 Tunnel Cage 2 263 (Top) 2 263 (Bottom) 3 B28 (high) 3 B24 Chilled water 3 B24 (high) 3 warehouse 3 Kitchen Dishwasher 4 B14E (Med Air) 4 B14E (Med Pump) 4 Cage 4 B21 5 B01 6 B08 6 Penthous (make up water) 7 B19 (Domestic Hot Water) 7 B19 8 B09B 9 B03 9 B06 (High)

10 B01E 10 2nd Floor (STAIR #2) 10 B02A 10 Outside Room SPD 10 Outside Room SPD

12 Basement 13 Basement 14 Basement 15 Basement 16 Basement 17 Basement 17 Basement 20 05A 22 Boiler Plant 22 Boiler Plant 33 Closet 61 B16 (High) 62 B23 62 B23 (High) 70 Basement 70 Basement 78 b2 (Domestic Hot Water) 78 Mech Room 78 Penthouse (SPD Heat X) 78 B2 (Up High) 78 B2

78A B34 78A Above Theatre 80 2 81 110 82 Basement 82 Pool Feed 82 Mech Room 82 Men's Room 82 Mech Room

File details come from the government source that posted it. Updated .