36C26320Q0256-0001000.pdf

5. PROJECT NUMBER (if applicable)

CODE 7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO. 1. CONTRACT ID CODE

FACILITY CODE CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30 PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code)

(If other than Item 6)

(Specify type of modification and authority)

(such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 3

0001 02-26-2020 None

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

Angela Stewart, 605-336-3230 Ext. 9-7804

Angela.Stewart438@va.gov

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

To all Offerors/Bidders 36C26320Q0256

02-19-2020 X

X X

MARCH 9, 2020, 11:59 PM ET

X one (1)

The purpose of this Amendment is to respond to Solicitation Questions.

The due date IS EXTENDED to March 9, 2020, 11:59 PM Eastern Time.

See Attachment for list of questions and the Government's response.

John Becker

Contracting Officer

VA-VHA-2019-95FFC7A6

CONTINUATION PAGE

SOLICITATION QUESTIONS AND GOVERNMENT RESPONSE

1. I see the project is set aside 100% Service-Disabled Veteran-Owned Small Business. Since we are not that, are we required to work with a service-disabled veteran? Can we bid this project direct?

Government Response: The requirement is set-aside 100% Service-Disabled Veteran

Owned Small Business (SDVOSB). As such, offerors shall be classified as a SDVOSB firm in the System for Award Management (SAM) and in the U.S. Department of Veterans Affairs

(VA), Vendor Information Pages (VIP) databases at the time of submission of offer and prior to contract award. Offers from other than SDVOSB firms will identified as unresponsive and not considered.

2. If I need to bid through a service-disabled veteran, could you please provide me with a list of these contractors that would qualify (local contractors would be preferred).

Government Response: Selection of SDVOSB firms for meeting the SDVOSB set-aside requirement is at the discretion of the offeror. A listing of SDVOSB firms is available through the U.S. Department of Veterans Affairs (VA), Vendor Information Pages (VIP) database at https://www.vetbiz.gov/.

3. The VA mentioned that there was a report detailing all the deficiencies and recommended repairs. Could you provide this report?

Government Response: BCI report was provided in the solicitation.

4. The BMS for the burner is to be replaced. What brand of boiler management systems were they proposing?

Government Response: The boiler management system brand is completely up to contractor to decide. The BMS and all components will need to meet the current VHA safety device testing manual (provided in solicitation).

5. On page 4 of the solicitation, you are calling out pricing for two separate scopes of work?

Will item 0001 have all items covered under scope of work in section B (Labeled “Boiler

Corrections”)?

Government Response: Both 0001 and 0002 are requirements per the SOW. The pricing for each should be included per item number broken out (price for 0001 and price for 0002).

6. Do we break out pricing for items 1 and 2 under section B?

Government Response: Yes

7. Do we price section B. 2 separate from item 0001? This covers both the boiler, and multiple other items in the steam plant. Are these to be bid together or separately?

https://www.vetbiz.gov/

Government Response: Separately per line item.

8. Section C (pages 10 and 11) covers just the boiler, boiler management systems, and controls. Is this the section that we are bidding under item 0001?

Government Response: Yes, sections A,B and C that involve correcting the deficiencies to bring boiler #1 to current VHA boiler and associated plant safety device testing. Line item

0002 deals with identifying the deficiencies with the burner unit and provide solutions

(please see page 4 of solicitation).

9. Clarify what sections (B or C) is to be bid under item 0001 and 0002. And if the additional items to the plant will be included on the base bid.

Government Response: Please see the scope of work and page 4. All items that are required to meet the current safety device testing are line item 1 whereas the line item 2 deals solely with deficiencies with the burner (see answer to question 6).

10. Item 19 refers to the low atomizing differential pressure switch had failed it test. Can this switch be eliminated since there is no crossover?

Government Response: As long as the solution is in compliance with the current safety device testing manual.

11. Item 20, fuel oil pressure switch: are we required to replace switch, if we cannot adjust to proper setting?

Government Response: If adjustable the solution should meet the current safety device testing (see attached VHA safety device testing and BCI report.

See attached document: Boiler Testing Results.

September 5, 2019 Date

Nebraska-Western Iowa VA Health Care System

Grand Island VA Medical Center

2201 No. Broadwell Avenue

From: Eric Ritz

Mark VII Enterprises, Inc.

4028 Hamilton Street

Omaha, NE 68131

Transmittal No._001_ Resubmittal of Previous Transmittal(s) ____

To: Angela Stewart-Downham Forward To: on:

Delivery via: E-mail

Copies Format Section Description Manufacturer Action

Contractor’s submission of shop drawings, product data, samples and other submittals implies their adherence to requirements of the Contract Documents, including but not limited to paragraphs 3.12 and

4.2.7 of General Conditions of the Contract for Construction and associated Supplementary Conditions.

CSI

Division.

Description of Equipment

Manufacturer

Drawing or

Data No.

Action

Taken

23 5200 Boiler – Testing Results Boiler #1

___Mark VII Enterprises_________________________

Contractor

___4028 Hamilton St. Omaha, NE 68131____________

Mailing Address

The United States Department of Veterans Affairs

VHA Boiler and Associated Plant Safety Device Testing Manual

Fifth Edition

By Thomas Burch David F. Dyer

Glennon Maples

BEI, LLC

P.O. Box 2255 Auburn, Alabama 36831-2255

December 2018

PURPOSE

This document was prepared for use in training and conducting safety reviews for the United States Department of Veterans Affairs.

Fifth Edition, 2018 revision Copyright 2018.

Thomas Burch, David Dyer, and Glennon Maples Published by: BEI, LLC P.O. Box 2255 Auburn, Alabama 36831-2255

1.3.2 REQUIRED CERTIFICATIONS FOR EACH SAFETY DEVICE TEST REPORT

A VA compliant test report will contain the following certification on the first page following the cover page of the report.

I certify that I have properly tested all applicable safety devices listed in this report for boiler #______and its associated equipment and I certify that all of these tests confirm that every device tested “passed” as defined by the following question: Did the device fail or pass the 3 question criteria?

PRINTED NAME SIGNATURE DATE

Position Title Company

OR

I certify that I have properly tested all applicable safety devices listed in this report for boiler #______ and its associated equipment and I certify that some of these tests failed as defined by the following question: Did the device fail or pass the 3 question criteria? More details of these failures are given in Appendix F (Comments on each individual test)

PRINTED NAME SIGNATURE DATE

Position Title Company

1.3.3 Confirming That All Devices Actually Function for Intended Purpose In testing any safety device, it is paramount that the testing procedure verifies compliance with the three requirements listed above.

1.3.4 Lockable Valve Requirements

In order to facilitate testing of some types of safety devices, it is sometimes necessary to temporarily isolate the safety device and provide test ports by means of manual valves. However, these modifications cannot be allowed to increase risk by locking out a safety device during normal operation and must clearly indicate test and normal position. Any such manual valve that could isolate a safety device from its normal

Mike Ferro ____________

SIGNATURE

21Aug2019

Boiler Technician Boiler Chiller Services

Table A.3.1 Basic Information

SITE INFORMATION

VISN

VA Medical Center Location Contact Information Phone Email Evaluators Date

BOILER DESCRIPTION

Boiler # Manufacturer Model and Capacity Serial #:National Board # Typical Operating Pressure Design Pressure Date of Manufacture

BOILER CONTROL DESCRIPTION

Manufacturer Model Date of Manufacture

BURNER DESCRIPTION

Manufacturer Model # Fuels Date of Manufacture

Appendix A.4. REQUIRED CERTIFICATION A VA compliant test report must contain the completed certification shown in section 1.3.2 on the first page following the cover page of the test report.

VHA Grand Island George Burgess

Mike Ferro

(308) 382 - 3660 x 2369 George.Burgess2@VA.gov

21Aug2019

Boiler # 1 Superior 7-5-1000 200hp

17472 NE24058

80psi 200psi Preferred Instruments Burnermate

Preferred Utilities

API200

NG and FO#2

Checklist for Outside Air Damper Alarm (OADA)

The required outside air opening area (ft2) = 10 x boiler HP/250 Note:

1. Boiler HP is total capacity served by opening

The equation is valid up to 1000 ft of elevation. Add 3% to opening area for each additional 1000 ft of elevation.

Any moveable damper used to supply outside air to a boiler requires an OADA.

Measure the opening area used to supply air to boilers (either fixed or damper operated)

Result Boiler HP Served

Required outside air Opening area, ft2

(see above formula)

Fixed Opening Area, ft2

Damper Operated Opening Area, ft2

If OADA exists, close outside air damper and prove that alarm activates with damper more than 80% open

Result Y/N Is there adequate opening to supply combustion air for all boilers?

Is there an OADA on all moveable dampers used to supply outside air to boilers?

If OADA exists, did it work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

200 hp 8 sqft 0 sqft 6.25 sqft

NO

NO

NA

FAIL - Not enough opening and no OADA installed. MF

Checklist for Low Water Alarm and Cutoffs on Boiler

(LWA/LWCO/ALWCO)

(For Steam Boiler System only) Item Make Float / Probe

LWA

LWCO

ALWCO

*An Independent shunt (bypass) switch is required to be installed for each LWCO *The VA requires one float and one probe low water cutoff. No automatic re-start after a low water cut out is allowed by the VA.

*Visible separation of water level in sight glass between all alarms is required. Water level in sight glass is required to be visible for all alarms and cutouts.

LWCO

FLOAT

FLOAT

SHUNT

LWCO

PROBE

SHUNT

PROBE

IN PERFORMING TEST NEVER LET WATER LEVEL LEAVE SIGHT GLASS!!!

Drain sight glass without draining alarm column. Quickly close drain valve. Water level should quickly rise in sight glass indicating good communication with boiler.

If poor communication, clean lines and begin with the step above.

With boiler in manual at low fire, close the feedwater valve to generate a slow drain. You may “crack” the blowdown valve but do not exceed a drain rate of 1 inch per minute. Use water level in sight glass to observe alarm point. The alarm should sound first.

Continue to drain until the primary cutoff activates.

If shunt (bypass switch) exists, verify that it ONLY isolates the LWCO.

Shunt (use bypass switch) the primary cutoff, restart the boiler, and set up drain as described above until the secondary cutoff activates..

Result Y/N Water Level Correct installation including shunts?

Did the LWA work correctly? Record Level.

Did the Primary cutoff work correctly? Record Level.

Did the secondary cutoff work correctly? Record Level Was the alarm point above the primary and secondary cutoff point?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Warrick Probe Warrick Probe McDonnel Miller Float

YES 2 "

YES 1.5"

Yes .75"

YES

MF

Checklist for High Water Alarm on Boiler (HWAB) (For Steam Boiler System only)

Item Make Float / Probe

HWA

*Sight glass water level is required to be 1” or more below top of sight glass at alarm.

LWCO

FLOAT

FLOAT

SHUNT

LWCO

PROBE

SHUNT

PROBE

Drain sight glass without draining alarm column and quickly close drain valve. Water level should quickly rise in sight glass indicating good communication with boiler.

If poor communication, clean lines and begin with the step above.

With boiler off, open the bypass feedwater valve to fill the boiler. Use water level in sight glass to observe alarm point. The alarm should sound before water level leaves sight glass.

DO NOT ALLOW WATER LEVEL TO LEAVE SIGHT GLASS

Close the bypass on feedwater line

Result Y/N Water Level Correct Installation?

Did the high water alarm work correctly? Record Level.

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

HWAB

ALARM

Warrick Probe

Yes

YES 5"

PASS - Works properly MF

Checklist for Recycle and Non-Recycle Boiler Steam Pressure Limit Switches

(RBSPLS & NRBSPLS)

(For Steam Boiler System only) Item Make Range

(psig) Switch

Setpoint Normal Steam

Pressure (psig)

Lowest

SVB

Setpoint (psig)

RBSPLS

NRBSPLS

Pressure Gage *RBSPLS setpoint is required to be 10 psig or more above normal steam pressure.

*NRBSPLS setpoint is required to be 5 psig or more above the RBSPLS pressure setpoint & 5 psig or more less than the lowest SVB setpoint.

RBSPLS TEST

Never exceed the boiler MAWP during this test.

Place boiler in minimum fire and manually close the steam supply valves from the boiler.

Raise the steam pressure slowly by firing the boiler.

Raise until RBSPLS activates – record activation pressure in table below.

NRBSPLS TEST

Jumper the recycle switch out of the circuit.

Fire boiler and raise the steam pressure slowly.

Raise until NRSBPLS activates – record activation pressure in table below.

Result Y/N Trip Pressure Is the RBSPLS setpoint 10 psig or more above normal steam pressure.?

Record Pressure.

Is the NRSBPLS setpoint 5 psig or more above the RBSPLS pressure setpoint & 5 psig or more less than the lowest SVB setpoint? Record Pressure.

Did both switches work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Honeywell 150 PSI 120 PSI Honeywell 150 PSI

Ashcroft 300 PSI

106 PSI 145 PSI

YES 120PSI

YES

YES

PASS - Both switches work properly Switch Body proof pressure is above MAWP of Boiler MF

130PSI

130 PSI

Checklist for Steam Safety Valves on Boiler (SVB) (For Steam Boiler System only)

Item Make Capacity (lb/hr)

Range SVB Setpoint

Normal Steam

Pressure

SVB 1

SVB 2

SVB 3

Pressure Gage

*SVB1 is required to be set 5 psig higher than NRBSPLS & 10 psig below boiler MAWP.

*SVB2 is required to be set 5 psig or higher than SVB1 & 5 psig or more below boiler MAWP.

*Each SVB is required to be directly vented to outside.

*Vent lines are required not to contact drip pan ells when hot.

Item MAWP (psig) Capacity (lb/hr) Boiler

DrainDrain

Vent Vent

Roof

SVB SVB

NEVER ALLOW BOILER PRESSURE TO EXCEED MAWP

With boiler off, jumper recycle and non-recycle steam pressure switches.

Close the steam supply valves from the boiler and test the drains on the safety valve drip pan ells by pouring water into them and noting that water flows freely. Unstop drains before proceeding.

Raise the steam pressure slowly by firing the boiler at low fire.

Note the pressure that the first & subsequent safety valves opened. (may require increasing firing rate).

Place boiler in high fire and determine if steam pressure rises with both SVB open (Accumulation Test).

Shut boiler off and note the pressures that the safety valves close.

Kunkle 4109 lbs/hr 145 PSI Kunkle 4238 lbs/hr 150 PSI

NA

Ashcroft 300 PSI

106 PSI

200 PSI 6900 lbs / hr

Checklist for Steam Safety Valves on Boiler (SVB) (Continued)

Result Y/N Lift (P) Reseat (P) Is the Lift & Reseat Pressure correct for #1 SVB? Record Pressures. (See info below for correct values) Is the Lift & Reseat Pressure correct for #2 SVB? Record Pressures. (See info below for correct values) Is the Lift & Reseat Pressure correct #3 SVB? Record Pressures.

(See info below for correct values Did accumulation test meet requirement listed below? Maximum pressure during accumulation test?

Is SVB vent plumbing adequate?

*Max lift pressure of 3% higher than rated lift pressure. Difference between the lift and reseat pressure should be more than the greater of 2 psig or 2% of the set pressure, and shall not exceed 6% of set pressure.

*Maximum accumulation pressure seen with all SVB’s open and boiler in high fire should not exceed 110% of highest SVB setpoint and never exceed boiler rated pressure.

NO 135 PSI 130 PSI

UNK UNK UNK

NA

UNK

NO

Relief valves function but do not meet VHA Guidlines. Reccomend replace retest of SV 1 and SV 2 as soon as

MF

FAIL - Inadequate Venting. Could not finish test. MF

Checklist for Low Fuel Gas Pressure Cutoff Switch (LFGPCS) Item Make Range

(inwc/psig) Switch

Setpoint (inwc/ psig)

Regulated Pressure

(inwc/psig)

LFGPCS

Pressure Gage

*LFGPCS is required to be downstream of PRV and upstream of AFGSOV with a setpoint of 80% or higher than regulated pressure. The use of snubbers or dampeners on LFGPCS is prohibited.

Connect a line containing a test pressure gage followed by a manual needle or globe bleed valve to the test port. The manual valve should be closed.

Open test port valve.

With boiler in low fire close lockable manual valve isolating the LFGPCS.

Slowly open manual bleed valve to reduce pressure until boiler trips offline.

Result Y/N Pressure Correct location?

Did the switch work correctly? Record trip pressure.

Is switch trip point 80% or more of regulated pressure?

Are snubbers or dampeners not used?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Ashcroft 15 PSI 8 PSI Ashcroft 10 PSI 10 PSI

NO

YES 4 PSI

NO

FAIL - Not plumbed for testing. Not at correct setpoint. MF

Checklist for High Fuel Gas Pressure Cutoff Switch (HFGPCS) Item Make Range

(inwc/psig) Switch

Setpoint (inwc/ psig)

Regulated Pressure

(inwc/psig)

HFGPCS

Pressure Gage

*HFGPCS is required to be downstream of PRV & upstream of flow control with setpoint less than 120% of regulated pressure.

Connect a line containing a test pressure gage followed by a manual needle or globe bleed valve to the test port.

Open test port valve and manual valve in the line connected to test port.

With boiler in low fire close lockable manual valve isolating the HFGPCS.

Use a hand air pump to slowly raise the pressure on the HFGPCS but NO HIGHER

THAN 120% OF REGULATED PRESSURE.

Result Y/N Switch Trip Point Correct location?

Did switch work correctly? Record Pressure Is switch trip point 120% or less of regulated pressure?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Ashcroft 15 PSI 13 PSI None Installed 10 PSI

NO

YES 13 PSI

NO

FAIL - Not plumbed for testing with guage. Switch did trip. MF

Checklist for Automatic Fuel Gas Shutoff Valves and Solenoid Vent Valve Seat Leakage (AFGSOV & AFGSVV) – Main Gas Line

Item Make Range (inwc/psig)

AFGSOV

AFGSVV

Pressure Gage

*Maximum allowable leak rate is zero bubbles in 2 minutes.

Vent Valve Leak Test Connect flexible tubing (approximately ¼ inch diameter and approximately 3 feet long) to the test port in the vent line. Place the open end of the flexible tubing approximately ¼ inch deep in a cup of water.

With the boiler running in low fire, close the manual lockable valve in the vent line and open the test port valve. If no bubbles appear in the water within a two-minute time period, the vent valve passes.

Upstream AFGSOV Leak Test Connect a pressure gage to the test port downstream of the two AFGSOV’s and open the test port valve. With the boiler running in low fire, close the manual lockable valve in the vent line and then quickly close the manual valve in the main gas line downstream of the two AFGSOV’s. Observe the pressure gage to make sure the manual valve does not leak.

Bleed the pressure by briefly opening and then re-closing both the manual vent valve and the manual main gas line valves.

Connect flexible tubing to the test port located between the AFGSOV’s and place the open end of the tubing approximately ¼ inch deep in a cup of water.

Open the test port valve and observe for bubbles in the water. If there are no bubbles in a two-minute time period, the upstream AFGSOV passes the leak test.

With the boiler off line, close the manual lockable valve on the vent line and the manual valve in the main gas line downstream of the second AFGSOV.

Maxon Maxon Ashcroft 10 PSI

Checklist for Automatic Fuel Gas Shutoff Valves and Solenoid Vent Valve Seat Leakage (AFGSOV & AFGSVV) – Main Gas Line

(Continued) Downstream AFGSOV Leak Test

Connect flexible tubing to the test port on the main gas line downstream of the second AFGSOV and place the open end of the tubing approximately ¼ inch deep in a cup of water.

Pressurize the space between the two AFGSOV’s to approximately the normal gas pressure by using an air pump with pressure gage connected to the test port between the two AFGSOV’s.

Open the test port valve and observe for bubbles in the water. If there are no bubbles in two minutes, the downstream AFGSOV passes the leak test.

Result Y/N Correct Installation?

Did upstream AFGSOV leak?

Did downstream AFGSOV leak?

Did AFGSVV leak?

Did AFGSVV open with boiler off

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

NO

NO Zero Bubbles NO Zero Bubbles NO Zero Bubbles

FAIL - Not plumbed for testing. Valves did not leak. MF

Checklist for Automatic Pilot Fuel Gas Shutoff Valves and Automatic Pilot Fuel Gas Solenoid Vent Valve Seat Leakage (APFGSOV & APFGSVV) – Pilot

Line Item Make Range (inwc/PSIG)

APFGSOV

APFGSVV

Pressure Gage

*Maximum allowable leak rate is zero bubbles in 2 minutes.

Vent Valve Leak Test Connect flexible tubing (approximately ¼ inch diameter and approximately 3 feet long) to the test port in the vent line. Place the open end of the flexible tubing approximately ¼ inch deep in a cup of water.

With the boiler running in low fire, close the manual lockable valve in the vent line and open the test port valve. If no bubbles appear in the water within a two-minute time period, the vent valve passes.

Upstream APFGSOV Leak Test Connect a pressure gage to the test port downstream of the two APFGSOV’s and open the test port valve. With the boiler running in low fire, close the manual lockable valve in the vent line and then quickly close the manual valve in the main gas line downstream of the two APFGSOV’s. Observe the pressure gage to make sure the manual valve does not leak. Bleed the pressure by briefly opening and then re-closing both the manual vent valve and the manual main gas line valves.

Connect flexible tubing to the test port located between the APFGSOV’s and place the open end of the tubing approximately ¼ inch deep in a cup of water.

Open the test port valve and observe for bubbles in the water. If there are no bubbles in a two-minute time period, the upstream APFGSOV passes the leak test.

Downstream APFGSOV Leak Test Connect flexible tubing to the test port on the main gas line downstream of the second APFGSOV and place the open end of the tubing approximately ¼ inch deep in a cup of water.

ASCO

ASCO

Ashcroft 60"

Checklist for Automatic Pilot Fuel Gas Shutoff Valves and Automatic Pilot Fuel Gas Solenoid Vent Valve Seat Leakage (APFGSOV &

APFGSVV) – Pilot Line (Continued)

Pressurize the space between the two APFGSOV’s to approximately the normal gas pressure by using an air pump with pressure gage connected to the test port between the two APFGSOV’s.

Open the test port valve and observe for bubbles in the water. If there are no bubbles in two minutes, the downstream APFGSOV passes the leak test.

Result Y/N Correct Installation?

Did upstream APFGSOV leak?

Did downstream APFGSOV leak?

Did APFGSVV leak?

Did APFGSVV open with boiler off

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

NO

NO Zero Bubbles NO Zero Bubbles NO Zero Bubbles

FAIL - Not plumbed for testing. Valves did not leak. MF

Checklist for Proof of Closure on Automatic Fuel Shutoff Valves (POC- AFGSOV) – Natural Gas

Item Make

POC-AFGSOV

*Switch is required to open with a very slight opening of the valve (no indicated pressure).

*Switches is required to be wired in series.

Close manual fuel valve downstream of AFGSOV. Perform the following test on each AFGSOV separately.

Remove cover on both automatic shut off valves to provide access to two wires connected across proof of closure switch. Can also access wires in appropriate junction box.

Disconnect both leads from switch going to control circuit.

Temporarily connect the two wires that were disconnected from the POC switch in order to electrically bypass the switch.

Start boiler and verify that switch opens before the AFGSOV opens to the point of allowing flow by measuring resistance across switch. Verifying that switch opens before the AFGSOV opens can be done by measuring pressure downstream of switch. Infinite resistance across the switch should occur before pressure is measured.

Shut boiler down and disconnect two wires going to control circuit. Try to start boiler and verify that the boiler does not allow ignition sequence to begin.

Repeat procedure for switch on 2nd valve.

Result Y/N Is POC present in both valves wired in series?

Did either POC being open prevent the boiler from firing?

Did switch on each AFGSOV open before the AFGSOV opened (no indicated pressure)?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Maxon

NO

YES

NO

FAIL - POC is Present in both valves, but not wired in series. Each is a separate input to controller.

Controller is not compliant with VHA 1810 Directive for Boiler Construction.

Both POC Function to disable boiler from firing. MF

Checklist for Flame Scanner-for main flame out (FSMFO)

Item Make Model Flame Scanner

*Maximum allowable timing is 4 sec.

*Only a UV– Self checking scanner is VA compliant.

*The scanner is required to not be rebuilt.

HFGPCS

C

NO

LO

RT

FL

WO

LOCK OPEN

Burner

HFGPCS

TP

MV

FUEL FLOW

CONTROL

Operate boiler in low fire.

Close the lockable manual valve between the fuel line and the HFGPCS.

Quickly close the manual valve in fuel line before burner.

Observe the time required for the flame scanner to close the automatic fuel gas shutoff valves. (Valves should close within 3 to 4 seconds from the time the flame goes out in the firebox).

Result Y/N Time (seconds) Is scanner UV, self-checking and not rebuilt?

Did the scanner work correctly?

Time to close fuel valves?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Burnermate W4T20mA

YES

YES

4 seconds

FAIL - Flame Scanner is self check, but burner flame safeguard is not a separate component from Boiler Controller in accordance with VHA 1810. MF

Checklist for Flame Scanner Not Sensing Igniter Spark (FSNSIS)

Item Make Model Programmer

*The scanner is required to not indicate a voltage for duration igniter spark is on, Voltage indicates that scanner senses spark.

*Only a UV– Self checking scanner is VA compliant.

*The scanner is required to not be rebuilt.

Close manual valve in main fuel line after the second (AFGSOV) and before the HFGPCS and the manual valve in the pilot gas line downstream of the second APFGSOV.

Attempt to start boiler. The boiler should go through pilot trial for ignition.

Determine if the scanner output indicates a voltage during pilot trial for ignition.

Result Y/N Is scanner UV, self-checking and not rebuilt?

Did the scanner work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Burnermate

YES

YES

FAIL - Flame Scanner did work, but the installation does not meet VHA 1810. MF

Preferred Instruments

Checklist for Igniter Timing (IT)

Item Make Model Programmer

* Maximum allowable duration is 10 sec.

Close manual valve in main fuel line after the second (AFGSOV) and before the HFGPCS and the manual valve in the pilot gas line downstream of the second APFGSOV.

Attempt to Start boiler.

View igniter by means of furnace front or back view port and time the ignition spark. (You can hear the igniter click on and off so that it may not be necessary to view the spark if not easily visible).

Observe the duration of the ignition spark with a stop watch.

Result Y/N Time (seconds) Did the scanner work correctly?

Igniter timing?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Preferred Instruments Burnermate

YES

10 sec

FAIL - Timing was good, but installation does not meet

VHA 1810. MF

Checklist for Main Flame Ignition Timing (MFIT)

Item Make Model Programmer

* Maximum timing is required to be 14 seconds from attempt to start boiler until AFGSOVs close.

HFGPCS

C

NO

LO

RT

FL

WO

LOCK OPEN

Burner

HFGPCS

TP

MV

FUEL FLOW

CONTROL

Close the lockable manual valve in the fuel line after the second (AFGSOV) and before the

HFGPCS .

Close manual valves in main fuel line.

Attempt to start boiler.

Time the AFGSOV from the time they begin to open until they close with a stopwatch.

Result Y/N Time (seconds) Did the programmer work correctly?

Time to AFGSOVs?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Preferred Instruments Burnermate

YES

13 Seconds

FAIL - Programmer functioned correctly but the installation does not meet VHA 1810. MF

Checklist for Pre-Purge and Post-Purge Timing (PPT)

Item Make Model Purge Timer

Boiler make Fire Tube / Water tube Boiler Fireside Volume (ft3)

* Eight air changes are required for a water tube boiler and 4 air changes for a fire tube boiler.

The method to calculate required purge time is:

Let Vfireside = volume of boiler fireside measured in cubic feet. (Obtain from boiler manufacturer) = _______________cubic feet

Let m = maximum boiler capacity in lb/hr of steam = __________ lb/hr

Let AC = required air changes (4 for a fire tube boiler and 8 for a water tube boiler) =

Then required minimum purge time = (AC x Vfireside x 270) / m = ______ sec

Start up boiler and record the pre-purge time in the table below.

Repeat this step for post purge cycle.

Result Time (sec) Y/N Adjustable Timing?

Low fire to high fire?

Time in high fire?

High fire to low fire?

Time in post purge?

Equivalent High Purge Time?

Is purge adequate?

*Equivalent pre-purge is all time spent at high fire plus half of the time spent in getting to high fire and returning to low fire.

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Preferred Instruments Burnermate

Superior Fire Tube 60 cuft

4 AC

90 cuft

YES

15 seconds 45 seconds 20 seconds 20 secoonds 62 seconds

FAIL - Purge Timing is adjustable in controller. Controller does not meet VHA 1810. MF

Checklist for Low-Fire Proving Switch (LFPS)

Item Make Model LFPS of gas valve position LFPS on oil valve position LFPS on forced draft damper *The LFPS is required not to be made above 10% of the load range for the actuator monitored by LFPS and to be separate from control system modulating firing rate.

*For single point positioning control systems, only one LFPS is required to determine the position of the fuel flow control valves and air damper. (To use one LFPS for this situation, all linkages to the oil valve and air damper are required to be drilled and pinned. Also if the LFPS is mounted in the drive motor or linkages connecting the drive motor to the LFPS, the linkage to the gas valve must be drilled and pinned.). For parallel positioning systems (with no mechanical connection between the fuel flow control valves and the inlet air damper) a LFPS is required on the gas flow control valve, the oil flow control valve, and the inlet air damper (three switches in all, directly activated by the actuator that is monitored by the LFPS).

*For the case of VFD fan control, this test is valid only if the damper controls air flow at low fire. If this is not the case, an appropriate alternate procedure must be developed and reviewed with CFM/OCAMES prior to operation to ensure an equivalent level of safety.

Perform the following test for each of the required LFPS.

Start the boiler and disconnect one electrical lead from switch.

Measure the ohms across the switch as boiler load is increased. (The switch should be closed at low fire (Less than 2 ohms) and should open with less than a 10% point increase in load for all LFPS).

Turn boiler off and try to restart boiler with electrical lead disconnected. Boiler should not start. If the boiler does start, the switch is not working correctly.

Result Y/N Switch Trip point Correct switch for all required valve/damper positions?

Did all the required switches work correctly?

What was the switch trip point for gas valve position?

What was the switch trip point for oil valve position?

What was the switch trip point for the forced draft damper position?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Preferred Instruments Burnermate Preferred Instruments Burnermate Preferred Instruments Burnermate

NO

YES

Low Fire

Low Fire

Low Fire

FAIL - System uses feed back potentiometer for Low Fire. Motor not pinned to shaft. MF

Checklist for Forced Draft Damper Wide-Open Pre-Purge Proving Switch

(FDDWOPS)

Item Make Model

FDDWOPS

* Is required to be open at positions with damper vanes less than 90% wide open.

* If the switch is not actuated by damper itself, all connections in linkages must be drilled and pinned.

Measure the voltage across the switch during the purge cycle to determine if the switch is open or closed. Note load that switch closes.

Disconnect one electrical lead from switch. Let boiler go through purge cycle. (Boiler should stay at high purge).

Result Y/N % Load that switch closes.

Is switch actuated by damper itself?

If switch is not actuated by damper itself, are all required connections drilled and pinned?

Did the switch work correctly? Record % Load.

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Preferred Instruments Burnermate

NO

NO

YES High Fire

Checklist for Combustion Air Pressure Switch (CAPS)

THIS TEST IS APPLICABLE ONLY TO A VARIABLE SPEED FORCED

DRAFT FAN SETUP

Item Make Low Pressure Tap Location

High Pressure Tap Location

Switch Range (inwc)

Switch Setpoint (inwc)

CAPS

*CAPS is required to be open if pressure drops to less than 35% of the pressure difference measured at purge. It probably will be necessary to limit the turndown of fan speed to approximately 40 Hertz in order to achieve this requirement.

*Switch taps are required to be across fan with no variable damper between as shown.

Install appropriate flex tubing to a manometer from the test ports closest to CAPS to measure the pressure difference that the switch senses by opening the lockable test ports across the switch.

Start the boiler and record the pressure difference read by manometer during purge.

During purge close the lockable manual valve to isolate high pressure leg of switch or, with boiler running, use a hand pump to pressurize the high pressure leg of switch With boiler running, decrease the pressure in the high pressure leg by slowly opening the test port closest to the fan outlet (high pressure leg) and observe the pressure at which the switch opens and shuts off boiler.

Record value of pressure difference at which switch tripped

Pressure (inwc) Y/N Pressure Difference during purge Switch Trip (Break) Point Is switch installed correctly?

Did switch work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

TP

Inlet

Outlet

Inlet

Vanes Vanes Outlet

Lock TP

TP

CAPS

Open

Dwyer Atmosphere Fan outlet 1 " .4"

10 inches .4 inches

NO

FAIL - Low Fire Fan Speed is 15hz. Too low to allow for an adequate CAPS operation. MF

Checklist for Combustion Air Pressure Switch (CAPS)

THIS TEST IS APPLICABLE ONLY TO A CONSTANT SPEED FORCED

DRAFT FAN SETUP

Item Make Low Pressure

Tap Location High Pressure Tap

Location Switch Range

(inwc) Switch Setpoint

(inwc)

CAPS

*CAPS should open if pressure drops to 80% of minimum pressure difference.

*Switch taps are required to be across fan with no variable damper between as shown.

Install appropriate flex tubing to a manometer from the test ports closest to CAPS to measure the pressure difference that the switch senses by opening the lockable test ports across the switch.

Start the boiler and record the pressure difference read by manometer during purge.

During purge close the lockable manual valve to isolate high pressure leg of switch (this is easiest way to apply adequate pressure across the switch) With boiler running, make the pressure drop in the high pressure leg by slowly opening the test port closest to the fan outlet (high pressure leg) and observe the pressure at which the switch opens and shuts off boiler.

Record value of pressure difference at which switch tripped.

Pressure (inwc) Y/N Minimum Pressure Difference from low to high fire Switch Trip (Break) Point Is switch installed correctly?

Did switch work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

TP

Inlet

Outlet

Inlet

Vanes Vanes Outlet

Lock TP

TP

CAPS

Open

NOT APPLICABLE

Checklist for Purge Airflow Proving Switch (PAPS)

Item Make Low Pressure Tap Location

High Pressure Tap Location

Switch Range (inwc)

Switch Setpoint (inwc)

PAPS

*PAPS is required to make at 80% or more of maximum differential pressure signal at high fire.

* Switch taps are required to be in inlet to combustion chamber after any variable damper and in the boiler stack before any variable damper.

PAPS

OSD

High pressure tap after all variable air flow

Lock

TP

TP

Open

Lock Closed restrictions

Connect a manometer to measure the pressure difference that the switch senses by opening the test ports on either side of the switch and installing appropriate flex tubing to the manometer from the test ports.

Start the boiler and record the pressure difference indicated by manometer from low fire to high fire positions.

With boiler offline disconnect one lead from the PAPS.

Close lock open valve on the high pressure side of the switch and slowly pressurize the high pressure leg with air using a hand pump.

Determine switch trip point using a manometer and measuring electrical resistance across the switch.

With lock open valve on high pressure side of switch open and high pressure leg test port open, attempt to restart boiler. Boiler should hold in purge.

Open lock open valve and close test port. Boiler should light.

Pressure (inwc) Y/N Maximum Pressure Difference from low to high fire Switch Trip (make) Point Is switch installed correctly?

Did switch work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Atunes Furnace at Burner Fan Outlet 4 inches 2 inches

Unknown

Unknown

NO

Unknown

FAIL - Switch not installed correctly. Low pressure tap in wring location. MF

Checklist for Forced Draft Motor Interlock Switches (FDMIS) Item Make Type of Switch: Aux. Contact

Phase Monitor Current Relays

FDMIS

*The FDMIS are required to be current relays (one on each of the three phase legs) that can be unlatched and removed for testing (split-core, hinged, clamp-on).

3 Phase Line In

3 Phase Line Out

Current Transformers

Contactor Motor feeding current relays

Be certain to follow NFPA 70E requirements as the forced draft power supply has significant shock and potential arc flash.

With power to fan off, unclamp and remove one current relay from around one power lead feeding the fan. When complete, restore power.

Attempt to start boiler. Boiler should shut down quickly.

Replace the current transformer and repeat above process for each of three power leads to fan.

Result Y/N Correct switch?

Did each switch work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

None Installed VFD output

NO

FAIL - Not approved Device. MF

Checklist for Outlet Stack Damper Position Interlock Switch (OSDPI)

Item Make Modulating Damper Y/N

OSDI

*The OSDPI is required to be open if damper is not at least 80% open. For a modulating damper, the OSDPI is required to interrupt purge if the damper is not at least 80%open. For a non-modulating, operable damper, an open OSDPI is required to interrupt purge during the purge cycle or, if the boiler is firing, is required to shut down the boiler.

*In the case where normal boiler operation does not require a non-modulating damper, no OSDPI is required if the damper is welded in the open position.

*The OSDPI can be actuated by the damper itself or, if all linkages between the switch and damper are drilled and pin, it can be located in the drive motor.

Connect a multi-meter across the switch to measure voltage.

Start the boiler and monitor voltage across the switch. The switch should be open (no voltage) until the damper opens to 80% or greater of wide open position.

Stop boiler and turn off power to controls.

Disconnect one lead from switch. Install jumper with toggle switch in open position. Start boiler. The boiler should not complete purge sequence Using a toggle switch momentarily close the toggle switch. Purge should begin counting.

Then open toggle switch. Purge should be interrupted.

Close toggle switch and let boiler begin firing. Open toggle switch and boiler should shut off.

Result Y/N Trip Position If OSDPI is required, is it present?

If OSDPI is not located on damper itself, are linkages drilled and pinned?

Did the switch work correctly? Record trip position.

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Belimo YES

YES

NO

Unknown

FAIL - Not Pinned to Shaft. Not installed corectly. MF

Checklist for Furnace Pressure Interlock (FPI)

Item Make Low Pressure Tap Location

High Pressure Tap Location

Switch Setpoint (inwc)

FPI

*FPI is only required on boilers with a modulating outlet stack damper *Required trip point is less than the greater of 1 inwc or 120% boiler furnace pressure at high fire.

FPI

Furnace pressure tap downstream of burner

Lock

TP

Open

Connect a manometer using appropriate flex tubing to the high pressure test port with other side of manometer open to atmosphere. Open TP valve.

Start the boiler and record the pressure sensed by the switch over the entire firing rate.

Return the boiler to low fire.

Close manual lockable valve isolating switch from furnace pressure.

Connect flex tubing to TP. Tubing must provide means of using a hand pump to pressurize system and a manometer to read the gage pressure.

Slowly pressurize the switch with the hand air pump.

Note the pressure that the boiler trips off line.

Pressure (inwc) Y/N Maximum Furnace Pressure from low to high fire Switch Trip (Break) Point Is switch installed correctly?

Did switch work correctly?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

Ashcroft Fan outlet Burner Firebox 10 inches

Unknown

Unknown

NO

FAIL - Switch not installed correctly. MF

Checklist for Low Pilot Fuel Gas Pressure Cutoff Switch (LPFGPCS)

Item Make Range (inwc/psig)

Switch Setpoint

Regulated Pressure

LPFGPCS

Pressure Gage *LPFGPCS Switch setpoint is required to be 80% of regulated pressure and switch is required to be after the PRV as shown. No dampeners, snubbers, or other such devices are allowed.

Close the manual valve in the gas line after the fuel control valve and allow the pilot burner to light. Place programmer in check mode while holding in the pilot cycle.

In low fire throttle manual valve upstream of the LPFGPCS slowly until switch trips the boiler offline due to low pilot fuel pressure.

Open the manual valve upstream of the LPFGPCS and again put boiler in check mode with pilot lit. Slowly close manual valve upstream of the LPFGPCS and regulate the pilot gas pressure to a value of less than 10% above trip point pressure.

Open the manual valve in the gas line after the fuel control valve, place the programmer in the “run” mode, and carefully observe that the main burner ignites immediately and smoothly.

Be prepared to stop the burner immediately with E Stop if this does not occur.

Result Y/N Switch Trip point Correct switch location/installation?

Did the boiler light smoothly with low pilot gas pressure?

Did the device fail or pass the 3 Question Criteria (section 1.3.1)? Pass Fail If boiler is to be operated with failed safety device, a properly approved ISM is required.

Describe safety device failure/remedy in Appendix F.

20 PSI 6 inches 16 inches 60 inchesAschcroft

Aschcroft

NO

YES 6 inches

FAIL - Switch actuates and measures low pressure but it is wrong swtich range. MF

Checklist for Flue Gas Recirculation Damper Interlock (FGRDI) Item Make Manufacturer Required FGRDI

Position on Purge

FGRDI

*Open FGRDI switch is required to prevent completion of the pre purge cycle.

*Dampers are required to be at least 80% open on purge if manufacturer requires an open damper on purge or it should be at least 80% closed if the manufacturer requires a closed damper on purge.

*If manufacturer requires an open damper on purge, consult manufacturer to determine if…