ATTACHMENT 34 - Miami Main Boiler Semi Annual Safety Device Testing Documentation.pdf

Year:_____

Miami VAMC Boiler Plant

Semi Annual Safety Device Testing

Documentation

Semi-Annual Ancillary

Equipment Safety Device Testing

Documentation

Year:

Y

Semi Annual Ancillary Plant Device Safety Testing Summary Sheet:

Month/Year: ______________

I certify that I have properly tested all safety devices listed below. I certify that I have performed all of these tests per the listed SOP and documented per the SOP documentation. I certify (by marking pass) that all tests were completely performed and that no failures as defined by the 3 question criteria in the Safety Device Testing Manual 7th edition exist on any of the devices listed below.

Ancillary Plant Devices Semi-Annual Tests

Procedure # Test Name Pass Fail

SD6MSOP 00 Plant Reliability

SD6MSOP 01 High Water Alarm on Condensate Tank

SD6MSOP 02 Low Water Alarm Condensate Tank

SD6MSOP 03 High Water Alarm Deaerator Tank

SD6MSOP 04 Low Water Alarm Deaerator Tank

SD6MSOP 05 Deaerator Overflow Drain System

SD6MSOP 06 Deaerator Safety Valve

SD6MSOP 07 Deaerator Steam Temperature / Pressure Test

SD6MSOP 08 Steam Safety Valve Following PRV DA Tank

SD6MSOP 09 Steam Safety Valve Following PRV Other (N/A)

SD6MSOP 10 Liquid Relief Valve Oil Pump Set

SD6MSOP 11 Carbon Monoxide and Combustible Gas Alarms

SD6MSOP 12 Outside Air Damper Alarm

SD6MSOP 13 Emergency Stop / Panic Button

SD6MSOP 14 High Fuel Pressure Alarms

Signature: ____________________ Date: ________________________

SD6MSOP 14_D

Checklist for General Plant Safety & Reliability

Date: ___________________ Tested By: ___________________________

Procedure Created: January 1, 2024 Procedure Expires: December 31, 2028

Testing Frequency: Semi-Annual VHA Directive: 1810

Location and Plumbing

Is there a deaerator tank bypass? Yes Fail

Is there a condensate tank bypass Yes Fail

Is there a softener bypass Yes Fail

Is there auxiliary makeup to deaerator? Yes Fail

Is there an adequate supply of emergency water available for boilers? Yes Fail

Is there a high oil alarm of oil tanks? Yes Fail

Is there a high gas pressure cutout on main gas line entering the boiler plant? Yes Fail

Is there an emergency kill switch (oil, propane and natural gas) in office and all points of egress? Did all emergency kill switches function properly?

Yes Fail

Were all questions answered as “YES” Yes Fail

If required - Were repairs made to all items marked fail? Repaired Not Repaired

EXPLAIN:

SD6MSOP 01_D

Checklist for High Water Alarm on Condensate Tank (HWACT)

*VA required device is a probe that is independent of water level control

Does the gauge glass communicate with the tank? Yes Fail

Is the alarm a probe type alarm? Yes Fail

Is the alarm independent of water level controller? Yes Fail

Are the LOO valves correctly in place? Yes Fail

Switch Setpoint & Mechanics

*Alarm set point must be below 2/3 tank height & at least 4” below the overflow.

Alarm Activation Point = Inches

Tank Diameter = Inches

Required Alarm Point (from bottom of sight glass) = Inches or less

Level of overflow from bottom of sight glass = Inches

Probe Brand =

Is switch trip point at or below the required setpoint? Yes Fail

Was the alarm point at least 4” below the overflow point? Yes Fail

Was the water level always within the sight glass? Yes Fail

Was the condensate tank overflow adequate? Yes Fail

Check the Logic Did the alarm sound throughout the boiler plant? Yes Fail

Does the alarm give operators adequate time to respond? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 02_D

Checklist for Low Water Alarm on Condensate Tank (LWACT)

*VA required device is a probe or float that is independent of water level control.

Does the gauge glass communicate with the tank? Yes Fail

Is the alarm device a probe or a float? Yes Fail

*Alarm set point must be above 1/3 tank height.

Required Alarm Point from the bottom of sight glass or higher. = Inches

Low Water Alarm Brand

Is switch trip point at or above the required setpoint? Yes Fail

Does the alarm give operators adequate time to respond? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 03_D

Checklist for High Water Alarm on Deaerator Tank (HWADT)

*VA required device is a probe that is independent of water level control

Does the sight glass communicate with the tank? Yes Fail

Is the alarm a probe type alarm? Yes Fail

*Alarm set point must be below 2/3 tank height & at least 4” below the overflow.

Required Alarm Point (from bottom of sight glass) = Inches

Level of overflow (above bottom of sight glass) = Inches

Probe Brand

Is switch trip point at or below the required setpoint? Yes Fail

Was the alarm point at least 4” below the overflow point? Yes Fail

Does the alarm give operators adequate time to respond? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 04_D

Checklist for Low Water Alarm on Deaerator Tank (LWADT)

*VA required device is a float or a probe that is independent of water level control.

Does the gauge glass communicate with the tank? Yes Fail

Is the alarm device a probe or a float? Yes Fail

*Alarm set point must be above 1/3 tank height.

Required Alarm Point (from bottom of sight glass) = Inches

Low Water Alarm (Probe) Brand

Does the alarm give operators adequate time to respond? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 05_D

Checklist for Deaerator Overflow Drain System (DAODS) – 2 person

*The VA required device is a probe that is independent of water level control and activates a fail open electronic actuated dump valve.

Does the sight glass communicate with the tank? Yes Fail

Is the device a probe? Yes Fail

Is the device independent of water level controller? Yes Fail

Are all valves that can isolate the overflow piping modified LOO? Yes Fail

Is the DA overflow an electronic valve? Yes Fail

*Overflow must occur at least 4 inches below tank top and maintain water visible in sight glass at maximum water input.

Water Level at Overflow Activation Point = Inches

Required Alarm Point = Inches

Water level maintained at Inches

Probe Brand

Did the overflow activate at or below the required set point? Yes Fail

Was the water level in the sight glass at all times? Yes Fail

SD6MSOP 06_D

Checklist for Deaerator Safety Valve (DASV)

*The VA required device is steam safety valve attached to steam space in deaerator and properly vented to the outside with a vacuum breaker on deaerator

Deaerator Make Tray

Deaerator NDT Date

Deaerator Operating Pressure psig

Deaerator Max Working Pressure psig

Safety Valve Manufacturer

Safety Valve Capacity lbs/hr

Safety Valve Set Point psig

Pressure Gage Make & Range /psig

Is there an individual vent line? Yes Fail

Is the range of the gage satisfactory? Yes Fail

Is there a proper vacuum breaker installed on deaerator? Yes Fail

*Stamped set point pressure of 5-10 psig higher than deaerator pressure; Lift pressure no higher than set point pressure + 2 psig and reseat pressure no lower than 94% of stamped set point pressure

What was the safety valve lift pressure? psig

What was the safety valve reseat pressure? psig

Did the safety valve lift at no more than 2 psig above stamped set point? Yes Fail

Did the safety valve reseat at no less than 94% of stamped set point? Yes Fail

SD6MSOP 06_D

Is the NDT date less than 6 years old? Yes Fail

Did the drain operate satisfactorily? Yes Fail

Is the stamped safety valve lift pressure 5-10 psig above DA pressure? Yes Fail

Did the roof vent properly relieve the discharging steam? Yes Fail

SD6MSOP 07_D

Checklist for Comparing DA Steam Pressure & Temperature

Steam Pressure in Miami, in (PSIG) Saturated Steam Temperature (F)

3 222

4 224

5 227

6 230

7 232

8 233

9 237

10 239

11 242

Is there a calibrated steam pressure and temperature gauge installed? Yes Fail

The pressure in the deaerator is? psig

The temperature of the deaerator is? F

The saturated steam temperature for the deaerator pressure from table above F

Is the DA temperature within 2 F of the saturated steam temperature? Yes Fail

SD6MSOP 08_D

Checklist for Safety Valve Following PRV (SVFPRV) –

PRV STATION - DA TANK

*This test applies to all required safety valves following a PRV. The checklist is written for the safety valve following the PRV serving the deaerator. The VA required device is a steam safety valve downstream from PRV and before deaerator properly vented to the outside. There must be a manual isolation valve downstream of safety valve as shown in figure.

Safety Valve Manufacturer

Safety Valve Capacity lbs/hr

Safety Valve Stamped Set Point psig

Pressure upstream of PRV psig

Pressure downstream of PRV psig

Pressure gage calibration Date

Pressure gage range psig

Largest PRV Make and Size / inch

Bypass valve type and size / inch

PRV maximum steam flow capacity lbs/hr

Bypass maximum steam flow capacity lbs/hr

Is there a manual valve to isolate downstream of safety valve? Yes Fail

Is there adequate space between drip pan and bottom vent pipe? Yes Fail

Is there an adequate, individual vent line to outside? Yes Fail

Is the pressure gage calibrated and the proper range for the test? Yes Fail

SD6MSOP 08_D

*Stamped set point pressure of approximately 5 psig higher than PRV regulated pressure;

Capacity must relieve largest wide open flow capacity: PRV or bypass valve; Lift pressure no higher than stamped set point pressure + 2 psig; and reseat pressure no lower than 94% of stamped set point pressure.

What was the safety valve lift pressure? psig

What was the safety valve reseat pressure? psig

Maximum pressure observed during accumulation test psig

Did the safety valve lift at no more than 2 psig above stamped set point? Yes Fail

Was the accumulation pressure 2 psig or less than the stamped set point? Yes Fail

Did the safety valve reseat within 6% of stamped set point pressure? Yes Fail

Did the drain operate satisfactorily? Yes Fail

Was steam vent adequate? Yes Fail

SD6MSOP 10_D

Checklist for Liquid Relief Valve Oil Pump Set (LRVOPS)

Liquid Relief Valve Make

Liquid Relief Valve Capacity GPM

Liquid Relief Valve Stamped set point psig

Oil Supply Pressure psig

Is view port in place to see relief valve discharge? Yes Fail

Is a manual valve installed downstream of gage for testing? Yes Fail

Is the discharge pipe free of any potential obstructions (a valve)? Yes Fail

Is the relief valve acting as a relief valve only and not a regulator? Yes Fail

*The stamped set point pressure must be less than the max allowable pump pressure and less than 10 psig above normal regulated oil supply pressure.

What was relief valve 1 lift point psig

What was relief valve 2 lift point psig

Was the relief valve lift pressure <10 psig above the Supply P? Yes Fail

Did the relief valves operate satisfactorily? Yes Fail

SD6MSOP 11_D

Checklist for Carbon Monoxide and Combustible Gas Alarms in Boiler Plant

Location and Plumbing *The VA requires a number of CO and combustible sensors at several locations to be in compliance with the VA directive. CO is typically located at breathing height in control rooms and bathrooms with vents and within 50’ of anywhere operators typically work. For LEL sensors, a minimum of two LEL sensors located high in the plant (at ceiling level).

Make of Combustible Alarm

Number of Combustible Alarms

Set Point of Combustible Alarms

Make of CO Alarm

Number of CO Alarms

Set Point of CO Alarms

Switch Setpoint & Mechanics *CO alarm set point must be equal to or less than 50 ppm; Combustible alarm set point should be equal to or less than 10% LEL; Test gas for CO alarm must be 50 ppm or less; Test gas for combustible alarm must be 10% LEL or less.

What was the concentration of CO test gas? ppm

What was the concentration of combustible test gas? % LEL

What was the alarm activation point of the CO sensors? ppm

What was the alarm activation point of the LEL alarms? % LEL

Were the CO activation points 50 ppm or below? Yes Fail

Were the LEL activation at points 10% or below? Yes Fail

Check the Logic Were 50 ppm CO test gas and 10% LEL test gas used for the testing? Yes Fail

Were all alarms audible throughout the boiler plant? Yes Fail

Are all the alarms located in a VA compliant manner? Yes Fail

SD6MSOP 12_D

Checklist for Outside Air Damper Alarm on (OADA)

Location and Plumbing *The VA requires a fixed opening into the boiler or an outside air damper alarm. A fixed opening must be locked or in a permanently fixed position.

Type of Outside Air Provision into Boiler Plant

*The VA requires that the outside air opening into boiler room be at least ten times the boiler horsepower / 250 provided by a fixed opening or moveable damper opening with alarm.

Approximate area of required air opening= ft^2 = 10 x boiler HP/250= ft^2

Elevation <1000 feet – Therefore no correction necessary.

Approximate area of (actual) air openings= ft^2

Is the approximate area of fixed openings greater than the total area required? Yes Fail

If required - Were repairs made to all items marked fail? Repaired Not

Repaired

SD6MSOP 13_D

Checklist for Emergency Stop/Panic Buttons (ESPB)

Location and Plumbing *An Emergency Stop Panic Button is required at each egress point from the boiler plant and in the control room. ESPBs must be identified with signage. The ESPB is required to be protected from accidental activation.

Make of Main Natural Gas Shutoff Valve?

Are ESPBs located at each point of egress? Yes Fail

Are all ESPBs labeled with signage to identify their purpose? Yes Fail

Are all ESPBs protected from accidental activation? Yes Fail

*The Main Natural Gas Shutoff Valve must close within 3 seconds from activation of the button. The Fuel Oil Pumps must stop running within 3 seconds from activation of the button.

Time for Main Natural Gas Valve to Close? Seconds

Time for Main Propane Valve to Close? Seconds

Time for Fuel Oil Pumps to Stop? Seconds

Did the Main Natural Gas Shutoff Valve Close with 3 seconds for all ESPBs? Yes Fail

Did the Propane Shutoff Valve Close with 3 seconds for all ESPBs? Yes Fail

Did the Fuel Oil Pumps Stop within 3 seconds for all ESPBs? Yes Fail

Did all ESPBs shutoff the Main Natural Gas, Propane and Fuel Oil Pumps? Yes Fail

Checklist for High Fuel Pressure Alarms

* The VA required HFGPANG and HFGPALP are pressure switches on the Main feeds into the Boiler Plant. Each switch must have a Lockable Only in the Open Position Isolation Valve and Valved Test Port.

High Fuel Gas Pressure Alarm on Natural Gas Line (HFGPANG)

HFGPANG Make

HFGPANG Range

Does the HFGPANG have the required Valve and Test Port? Yes Fail

* The VA requires that the switch activation point be less than 120% of the regulated pressure.

Regulated gas pressure entering Plant

HFGPANG activation point

Required cutout Point=1.2 x regulated pressure =

Is the range of the switch and test gage satisfactory? Yes Fail

Did the HFGPANG activate at or less than 120% of regulated pressure? Yes Fail

Is there an Audible Alarm and Annunciation Message? Yes Fail

Is the LOO valve open and locked? Yes Fail

High Fuel Gas Pressure Alarm on Propane Line (HFGPALP)

HFGPALP Make

HFGPALP Range

Does the HFGPALP have the required Valve and Test Port? Yes Fail

* The VA requires that the switch activation point be less than 120% of the regulated pressure.

Regulated Propane pressure entering Plant

HFGPALP activation point

Did the HFGPALP activate at or less than 120% of regulated pressure? Yes Fail

Is there an Audible Alarm and Annunciation Message? Yes Fail

Is the LOO valve open and locked? Yes Fail

Semi-Annual Boiler Safety

Device Testing Documentation

Semi Annual Boiler Safety Testing Summary Sheet:

Month/Year: ______________

I certify that I have properly tested all safety devices listed below. I certify that I have performed all of these tests per the listed SOP and documented per the SOP documentation. I certify (by marking pass) that all tests were completely performed and that no failures as defined by the 3 question criteria in the Safety Device Testing Manual 7th edition exist on any of the devices listed below.

Boiler 1 Semi-Annual Tests

Procedure # Test Name Pass Fail

SD6MSOP 15 Recycle/ Non-Recycle Steam Limit Switches

SD6MSOP 16 Steam Safety Valves on Boiler

SD6MSOP 17 Low Fuel Gas Pressure Cutoff Switch

SD6MSOP 18 High Fuel Gas Pressure Cutoff Switch

SD6MSOP 19 Auto Main Fuel Gas Valve/ Vent Valve Leak Test

SD6MSOP 20 Auto Pilot Fuel Gas Valve / Vent Valve Leak test

SD6MSOP 21 Main Gas Valve Proof of Closure

SD6MSOP 22 Low Pilot Gas Pressure Cutoff Switch

SD6MSOP 23 Flame Scanner not Sensing Ignitor Spark

SD6MSOP 24 Boiler Ignitor Timing

SD6MSOP 25 Boiler Main Flame Ignition Timing

SD6MSOP 26 Boiler Pre Purge and Post Purge Timing

SD6MSOP 27 Low Fire Proving Switch

SD6MSOP 28 Forced Draft Damper Wide Open Proving Switch

SD6MSOP 29 Combustion Air Pressure Switch

SD6MSOP 30 Purge Airflow Proving Switch

SD6MSOP 31 Forced Draft Motor Interlock Switches (Current Relays)

SD6MSOP 32 Low Flue Gas Oxygen Interlock

SD6MSOP 33 Low Fuel Oil Pressure Cutoff Switch

SD6MSOP 34 High Fuel Oil Pressure Cutoff Switch

SD6MSOP 35 Low Atomizing Media Pressure Switch

SD6MSOP 36 Automatic Oil Valve Leak Test

SD6MSOP 37 Oil Valve Proof of Closure

SD6MSOP 38 Oil Burner Position Switch

SD6MSOP 39 Secondary High Fuel Oil Pressure Cutoff Switch

SD6MSOP 40 Control Air Pressure Interlock

SD6MSOP 41 Furnace Pressure Interlock

SD6MSOP 42 Secondary Low Atomizing Media Pressure Switch

SD6MSOP 43 Spare

Signature: ____________________ Date: ________________________

Boiler 2 Semi-Annual Tests

Procedure # Test Name Pass Fail

SD6MSOP 15 Recycle/ Non-Recycle Steam Limit Switches

SD6MSOP 16 Steam Safety Valves on Boiler

SD6MSOP 17 Low Fuel Gas Pressure Cutoff Switch

SD6MSOP 18 High Fuel Gas Pressure Cutoff Switch

SD6MSOP 19 Auto Main Fuel Gas Valve/ Vent Valve Leak Test

SD6MSOP 20 Auto Pilot Fuel Gas Valve / Vent Valve Leak test

SD6MSOP 21 Main Gas Valve Proof of Closure

SD6MSOP 22 Low Pilot Gas Pressure Cutoff Switch

SD6MSOP 23 Flame Scanner not Sensing Ignitor Spark

SD6MSOP 24 Boiler Ignitor Timing

SD6MSOP 25 Boiler Main Flame Ignition Timing

SD6MSOP 26 Boiler Pre Purge and Post Purge Timing

SD6MSOP 27 Low Fire Proving Switch

SD6MSOP 28 Forced Draft Damper Wide Open Proving Switch

SD6MSOP 29 Combustion Air Pressure Switch

SD6MSOP 30 Purge Airflow Proving Switch

SD6MSOP 31 Forced Draft Motor Interlock Switches (Current Relays)

SD6MSOP 32 Low Flue Gas Oxygen Interlock

SD6MSOP 33 Low Fuel Oil Pressure Cutoff Switch

SD6MSOP 34 High Fuel Oil Pressure Cutoff Switch

SD6MSOP 35 Low Atomizing Media Pressure Switch

SD6MSOP 36 Automatic Oil Valve Leak Test

SD6MSOP 37 Oil Valve Proof of Closure

SD6MSOP 38 Oil Burner Position Switch

SD6MSOP 39 Secondary High Fuel Oil Pressure Cutoff Switch

SD6MSOP 40 Control Air Pressure Interlock

SD6MSOP 41 Furnace Pressure Interlock

SD6MSOP 42 Secondary Low Atomizing Media Pressure Switch

SD6MSOP 43 Spare

Signature: ____________________

Date: ________________________

Boiler #1

SD6MSOP 15_D

Checklist for High and High-High Boiler Steam Pressure Limit Switches

Boiler#_________ (HBSPLS & HHBSPLS)

*This test involves two switches. Manual Reset is required after the activation of either Steam

Pressure Switch.

Make & Range of HBSPLS psig

Setpoint of HBSPLS psig

Make & Range of HHBSPLS psig

Setpoint of HHBSPLS psig

Normal Steam Pressure psig

Lowest Boiler Steam Safety Valve Set Point psig

Pressure Gage Calibration Date

Do both switches require a Manual Reset? Yes Fail

Are the ranges of the switches and gage satisfactory? Yes Fail

*The VA requires that the RBSPLS set point should be 10 psig or more higher than the normal steam pressure and the NRBSPLS set point should be 5 psig or more above the

RBSPLS set point & 5 psig or more below the lowest boiler steam safety valve set point

What pressure did the HBSPLS activate? psig

What pressure did the HHBSPLS activate? psig

Did HBSPLS activate 10 psig or more above the normal steam pressure Yes Fail

Did HHBSPLS activate 5 psig or more above that of the HBSPLS Yes Fail

Did HHBSPLS activate 5 psig or more below the lowest boiler SSRV set point? Yes Fail

Check the Logic Did HBSPLS require a manual reset ? Yes Fail

Did HHBSPLS require a manual reset ? Yes Fail

SD6MSOP 16_D

Checklist for Steam Safety Valves on Boiler (SVB) – Boiler#________

*This test is written for the normal setup of two steam safety valves per boiler. The VA required device is a minimum of two steam safety valves vented to the outside with individual adequate vent lines. The total capacity of all safety valves has to be more than the maximum capacity of the boiler. If fitted with multiple safety valves the relief capacity of each safety valve must be so that the boiler can lift all valves with steam pressure.

Boiler maximum capacity lbs/hr

Boiler maximum allowable working pressure (MAWP) psig

Setpoint of HHBSPLS psig

Safety Valve # 1 (SVB1) Make

Safety Valve # 1 (SVB1) Setpoint psig

Safety Valve #1 (SVB1) Capacity lbs/hr

Safety Valve # 2 (SVB2) Make

Safety Valve # 2 (SVB2) Setpoint psig

Safety Valve #2 (SVB2) Capacity lbs/hr

Normal Operating Pressure of boiler psig

Are there at least two safety valves? Yes Fail

Is there a satisfactory individual vent line? Yes Fail

Is the range of the gage satisfactory? Yes Fail

Is the capacity of all safety valves combined more than the boiler capacity? Yes Fail

Is SVB1 stamped safety valve lift pressure more than 5 psig above the

HHBSPLS set point and more than 10 psig lower than the boiler MAWP?

Yes Fail

Is SVB2 stamped safety valve lift pressure at or more than 5 psig above the SVB1 stamped lift pressure and at or more than 5 psig lower than the boiler MAWP?

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

The VA requires that SVB1 should be set 5 psig higher than HHBSPLS and 10 psig or more below the boiler MAWP. The VA requires that SVB2 should be set 5 psig or higher than

SVB1 & and 5 psig or more below boiler MAWP. The maximum lift pressure of any SVB must not exceed 3% higher than the rated lift pressure. All SVB must re-seat at a pressure higher than the HBSPLS will re-set. The maximum accumulation pressure seen must not exceed

110% of highest SVB setpoint and never exceed boiler MAWP.

What was SVB1 lift pressure? Psig

What was the SVB1 reseat pressure? Psig

What was SVB2 lift pressure? Psig

What was the SVB2 reseat pressure? Psig

Did SVB1 lift at less than 103% of stamped set point? Yes Fail

Did the SVB1 reseat above the HBSPLS Re-Set pressure? Yes Fail

Did SVB2 lift at less than 103% of stamped set point? Yes Fail

Did the SVB2 reseat above the HBSPLS Re-Set pressure? Yes Fail

Was the maximum pressure in accumulation test less than 110% of SVB2 stamped safety valve lift pressure?

Yes Fail

If required – Were repairs made to all items marked fail? Repaired Not Repaired

Explain:_______________________________________________________________________

SD6MSOP 17_D

Checklist for Low Fuel Gas Pressure Cutoff Switch (LFGPCS) Boiler#_____

*The VA required LFGPCS is a pressure switch that is downstream of the pressure regulator and upstream of the fuel gas flow control valve. The LFGPCS must be normally open. The switch must be set up with a lock only open isolation valve and test port as shown in the figure.

Low Gas Pressure Switch Make

Low Gas Pressure Switch Range

Is the LFGPCS downstream of the pressure regulator? Yes Fail

Is the LFGPCS upstream of the flow control valve? Yes Fail

Is there a LOO valve installed for testing? Yes Fail

Is the switch installed without snubbers or dampeners? Yes Fail

* The VA requires that the LFGPCS trip point be greater than 80% of the regulated pressure.

Regulated pressure at low fire

Low Gas Pressure activation point

Required cutout Point=0.8 x LF regulated pressure =

Did the LFGPCS trip the boiler offline and lockout? Yes Fail

Was the annunciation proper? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 18_D

Checklist for High Fuel Gas Pressure Cutoff Switch (HFGPCS) – Boiler#____

* The VA required HFGPCS is a pressure switch that is downstream of the pressure regulator and upstream of the fuel gas flow control valve. The HFGPCS must be normally closed. The

High Gas Pressure Switch Make

High Gas Pressure Switch Range

Is the HFGPCS downstream of the pressure regulator? Yes Fail

Is the HFGPCS upstream of the flow control valve? Yes Fail

* The VA requires that the switch trip point be less than 120% of the regulated pressure.

Regulated gas pressure at low fire

High Gas Pressure activation point

Did the HFGPCS trip at or less than 120% of regulated pressure? Yes Fail

Did BMS annunciate – High Gas Press? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 19_D

Checklist for Automatic Fuel Gas Shutoff Valves and Solenoid Vent Valve

Seat Leakage (AFGSOV & AFGSVV) – Main Gas Line – Boiler#____

This test is leak testing the two AFGSOV’s and the AFGSVV. These valves must be set up for testing as shown in the figure with a test port downstream of each AFGSOV and AFGSVV. In addition, a lock open only valve in the vent line after test port is required.

Main Gas Valve Make

Vent Valve on Main Gas Line Make

Are the valves set up for testing as required by the VA? Yes Fail

Is testing possible and easy to access? Yes Fail

The VA requires that maximum allowable leak rate is zero bubbles in 2 minutes for each valve tested.

Were both AFGSOV without leaks? Yes Fail

Was the AFGSVV without leaks? Yes Fail

Did the AFGSVV open with the boiler off? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 20_D

Checklist for Automatic Pilot Fuel Gas Shutoff Valves and Solenoid Vent

Valve Seat Leakage (APFGSOV & APFGSVV) – Pilot Gas Line – Boiler#____

Pilot Gas Valve Make

Vent Valve on Pilot Gas Line Make

Were both APFGSOV without leaks? Yes Fail

Was the APFGSVV without leaks? Yes Fail

Did the APFGSVV open with the boiler off? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 21_D

Checklist for Proof of Closure on Automatic Fuel Shutoff Valves (POC-

AFGSOV) – Natural Gas – Boiler#_____

The VA requires POC-AFGSOV on both AFGSOV. The two switches must be wired in series.

Make of POC-AFGSOV

The VA requires that the POC-AFGSOV open before gas pressure is sensed downstream of the valve.

Is a POC-AFGSOV present in both valves? Yes Fail

Did upstream POC open (Shows Voltage) before pressure was sensed? Yes Fail

Did downstream POC open (Shows Voltage) before pressure was sensed? Yes Fail

Did the boiler lock out when each POC switch was open? Yes Fail

Did the BMS annunciate properly? Yes Fail

SD6MSOP 22_D

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

Boiler#______

*The VA required LPFGPCS is a normally-open pressure switch that is downstream of the pilot gas pressure regulator and upstream of the first pilot gas solenoid shut off valve. The

LPFGPCS must be wired in the running interlock.

Low Pilot Gas Pressure Switch Make

Low Pilot Gas Pressure Switch Range

Is the LPFGPCS downstream of the pilot pressure regulator? Yes Fail

*The VA requires that the LPFGPCS trip point be greater than 80% of the regulated pressure and that the boiler lights smoothly at a pressure slightly higher than switch trip point.

Regulated pressure during pilot =

Low Pilot Gas Pressure activation point =

Required cutout Point=0.8 x regulated pressure =

Did the boiler shutdown and lockout? Yes Fail

Was the annunciation proper? Yes Fail

SD6MSOP 23_D

Checklist for Flame Scanner Not Sensing Igniter Spark (FSNSIS) – Boiler#__

* The VA requires a UV-self checking scanner

Is the FSMFO a UV-self checking device? Yes Fail

The VA requires that the scanner does not sense the ignition spark

Flame Scanner Brand?

Model of Flame Scanner?

Did the Fireye not show a flame signal (Should be Zero/Nothing)? Yes Fail

UV Self

Checking

Scanner

(Compliant)

IR Scanner

(NOT Compliant)

SD6MSOP 24_D

Checklist for Igniter Timing (IT) – Boiler#_____

*The VA requires a programmer compatible with the UV-self checking scanner

Is the Programmer compatible with a UV-self checking device? Yes Fail

The VA requires a maximum of 10 seconds igniter time.

Make of Programmer?

Model of Programmer?

What was the igniter timing? Seconds

Was the igniter timing 10 seconds or less? Yes Fail

SD6MSOP 25_D

Checklist for Main Flame Ignition Timing (MFIT) – Boiler#_____

The VA requires a maximum of 14 seconds for MFIT

What was the trial for main flame timing? Seconds

Was the Main Flame Ignition Timing 14 seconds or less? Yes Fail

Did the boiler lock out and annunciate “Flame Failure” Yes Fail

SD6MSOP 26_D

Checklist for Pre-Purge and Post-Purge Timing (PPT) - Boiler#____

*The VA requires a purge timer that is not adjustable

Make / Model of Purge Timer?

Boiler Make / Model?

Boiler Fireside Volume? (V)

Maximum Boiler Capacity (include any de-rating) (m)

Air changes Required (4 for Fire Tube) (AC)

Required Pre-Purge Time = m

VAC 270**

= seconds

Is the purge timing fixed (cannot be adjusted)? Yes Fail

*The VA requires a minimum of 4 air changes for a fire tube boiler and 8 air changes for a water tube boiler and 15 seconds of post purge

What was the pre-purge time from low fire to high fire? a. Seconds

What was the pre-purge time in high fire? b. Seconds

What was the pre-purge time from high fire to low fire? c. Seconds

( Use cells above to calculate) Equivalent pre-purge time = b ca

= Seconds

Number of seconds of post-purge Seconds

Check the Logic Was the equivalent pre-purge time equal to or greater than the required purge time. Yes Fail

Was the post purge time 15 seconds or greater? Yes Fail

Were all questions answered as “YES” Yes Fail

SD6MSOP 27_D

Checklist for Low-Fire (Lightoff) Proving Switch (LFPS)- Boiler#_____

*For single point positioning control systems, only one LFPS is required. All linkages where slip could occur must be drilled and pinned.

Type of combustion controller Parallel Position

Make of LFPS Gas

Make of LFPS Air Damper

Make of LFPS Oil

Are all linkages that could slip drilled and pinned? Yes Fail

Are all LFPS normally open and independent of firing rate control

(not a potentiometer)?

*The VA requires that all LFPS open at a firing rate no higher than 10% of load range.

What was the actuator position when LFPS Gas valve opened? %

What was the actuator position when LFPS Air damper opened? %

What was the actuator position when LFPS Oil valve opened? %

Did all LFPS (Gas, Oil, Air Damper) open at or less than 10% above light off?

Did disconnecting the LFPS prevent boiler from firing on all switches? Yes Fail

SD6MSOP 28_D

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

(FDDWOPS) – Boiler#_____

*The FDDWOPS must be normally open and independent of the firing rate control. The use of a potentiometer for a FDDWOPS is not allowed. The FDDWOPS must either be located at the final control element or, if located in the drive motor, require all linkages to be drilled and pinned. Purge count must be interrupted if the FDDWOPS is not made.

Make of FDDWOPS

Is the FDDWOPS located at the control element or are the linkages drilled and pinned?

Is the FDDWOPS NOT a potentiometer? Yes Fail

*The VA requires that the FDDWOPS closes at a firing rate higher 90%

What was the PV% when FDDWOPS switch makes? %

Was the actuator position when FDDWOPS closed greater than 90%?

Yes

Fail

Did disconnecting the FDDWOPS stop the purge count? Yes Fail

SD6MSOP 29_D

Checklist for Combustion Air Pressure Switch Boiler#_________ (CAPS)

The CAPS must be a normally open switch and set up as shown in the figure (5 th Edition).

Make of CAPS

Range of CAPS inwc

Type of fan speed control VFD

Is the high pressure tap after the fan and before any movable damper? Yes Fail

For a vfd fan, the VA requires that the CAPS open at a differential pressure of 35% or more of the maximum pressure difference across the fan during high fire purge.

What was the pressure difference during wide open purge? inwc

Required trip point= 0.35 X purge pressure difference? inwc

What was the CAPS trip point? inwc

Was the switch trip point more than 35% of the pressure difference during purge?

Did the CAPS shut the boiler down and annunciate properly? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 30_D

Checklist for Purge Air Flow Proving Switch Boiler#_________ (PAPS)

The PAPS must be setup to measure a fixed resistance across the boiler.

Make of PAPS

Range of PAPS

Is the low pressure in the stack before any moveable damper? Yes Fail

Is the high-pressure tap after the fan and after any movable damper? Yes Fail

Are the two test ports easy to access? Yes Fail

Is a lock open only isolation valve in place as shown? Yes Fail

Is the range of PAPS satisfactory? Yes Fail

The VA requires that the PAPS closes (makes) at a differential pressure higher than 80% of the maximum differential pressure. Purge count must be interrupted if PAPS is not made.

What was the pressure difference at purge?

What was the trip point?

Was the trip point more than 80% of the pressure difference at purge? Yes Fail

Did an open switch hold boiler in purge? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 31_D

Checklist for Forced Draft Motor Interlock Switches Boiler#____ (FDMIS)

*The FDMIS must be current relays (one on each three phase leg) that can be unlatched and removed for testing (split-core, hinged, clamp-on).

Current Relays Type?

Make and model of Current

Relays?

Is the proper NFPA 70E PPE equipment available for testing? Yes Fail

The VA requires that the FDMIS shut off boiler due to any significant drop in current in any of the three phases feeding the fan motor.

Are the FDMIS on all three phases? Yes Fail

Are the FDMIS all split-core, hinged, clamp-on? Yes Fail

Are the FDMIS all current relays? Yes Fail

Did the boiler shut down quickly for each of the three legs with the relay unlatched and removed when the boiler was turned on.

Yes Fail

SD6MSOP 32_D

Checklist for Low Flue Gas Oxygen Level Interlock Boiler#____ (LFGOLI)

Location and Plumbing *The LFGOLI must be an alarm and an interlock. The LFGOLI must continuously sense

%oxygen in the flue gas in the stack.

Make of Low Oxygen Alarm and Cutoff?

Is the LFGOLI an alarm and interlock sensing oxygen continuously in the stack? Yes Fail

Does LFGOLI have capability to be supplied with a test gas while the boiler is running?

*The LFGOLI must prevent boiler from operating with more than 200 ppm CO or combustibles in the flue gas.

What was the minimum %O2 found during tuning? % O2

What was the CO at the minimum %O2? PPM

What % O2 is the test gas? % O2

What was the alarm activation point? % O2

What was the cutout activation point? %O2

Did the Low O2 alarm occur above the cutoff % O2? Yes Fail

Did the Low O2 cutoff occur above the minimum % O2? Yes Fail

Did the Low O2 alarm and cutoff function properly and annunciate? Yes Fail

SD6MSOP 33_D

Checklist for Low Fuel Oil Pressure Cutoff Switch Boiler#_______ (LFOPCS)

Procedure Created: January 1, 2024 Procedure Expires: December13, 2028

*The VA required LFOPCS is a pressure switch that is downstream of the pressure regulator

Low Oil Pressure Switch Make

Low Oil Pressure Switch Range psig

Is the LFOPCS downstream of the low pressure pump? Yes Fail

Is the LFOPCS upstream of the metering pump? Yes Fail

Is there a LOO valve in place for easy testing? Yes Fail

*The VA requires that the LFOPCS trip point be greater than 80% of the regulated pressure.

Regulated pressure at low fire psig

Low Oil Pressure activation point psig

Required cutout Point=0.8 x LF regulated pressure = psig

Check the Logic Did BMS annunciate – “Low Oil Pressure”? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 34_D

Checklist for High Fuel Oil Pressure Cutoff Switch Boiler#_____ (HFOPCS)

*The VA required HFOPCS is a pressure switch that is downstream of the pressure regulator and upstream of the fuel oil flow control valve that is normally closed. The switch must be set up with a lock only open isolation valve and test port as shown in the figure.

High Oil Pressure Switch Make

High Oil Pressure Switch Range psig

Is the HFOPCS downstream of the low pressure pump? Yes Fail

Is the HFOPCS upstream of the metering pump? Yes Fail

Regulated Oil pressure at low fire psig

High Oil Pressure activation point psig

Required cutout Point=1.2 x regulated pressure = psig

Did BMS annunciate – “High Oil Pressure”? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 35_D

Checklist for Low Atomizing Media Pressure Switch Boiler#______ (LAMPS)

*The VA required LAMPS is a pressure switch that is downstream of the pressure regulator and atomizing media shutoff solenoid valve and upstream of the oil differential pressure regulator (if present) as shown in figure. The LAMPS must be normally open.

Low Atomizing Media Pressure Switch Make

Low Atomizing Media Pressure Switch Range psig

*The VA requires that the switch trip point must be greater than 80% of the minimum atomizing media regulated pressure.

Regulated pressure during purge psig

Regulated pressure at high fire psig

What was the minimum regulated pressure? psig

What was the LAMPS trip point? psig

Required cutout Point=0.8 x min regulated pressure= psig

Did the LAMPS trip at or above the required cutout point? Yes Fail

Check the Logic Did BMS annunciate properly? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 36_D

Checklist for Automatic Fuel Oil Shutoff Valves (AFOSV) - for Seat Leakage

*This test is leak testing the two AFOSOV. These valves must be set up for testing as shown in the figure with a test port downstream of each AFOSOV and a pressure gage to measure pressure between the two AFOSOV and after the downstream AFOSOV and before the manual valve.

Automatic Fuel Oil Shutoff Valve Make

*The VA requires that maximum allowable leak rate is 1 drop in 10 seconds for each valve

How many drops were observed in 10 seconds for the downstream AFOSOV seconds for the upstream AFOSOV

Were both AFOSOV without leaks? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 37_D

AFGSOV) – Oil - Boiler#____

*The VA requires POC-AFOSOV on both AFOSOV. The two switches must be wired in series. These valves must be set up for testing as shown in the figure with a test port downstream of each AFOSOV and a pressure gage to measure pressure between the two

AFOSOV and after the downstream AFOSOV and before the manual valve.

Make of POC-AFOSOV

Is a POC-AFOSOV present in both valves? Yes Fail

Are the POC-AFOSOV wired in series? Yes Fail

*The VA requires that the POC-AFOSOV open before gas pressure is sensed downstream of

Did both POC-AFOSOV open (voltage) before pressure was sensed? Yes Fail

Did the BMS annunciate – “T13 Fuel Valves open”? Yes Fail

SD6MSOP 38_D

Checklist for Oil Burner Position Switch (OBPS) – Boiler#____

The VA requires a OBPS only if the manufacturer supplied the switch initially. The OBPS must be normally open.

Make of Boiler

OBPS make

*The VA requires that the oil gun be completely inserted for the switch to make.

Did the OBPS prevent the boiler from going into purge with slight retraction of burner gun?

Yes Fail

Did the BMS annunciate properly? Yes Fail

SD6MSOP 39_D

Checklist for Secondary High Fuel Oil Pressure Cutoff Switch Boiler#_____

(HFOPCS)

*The VA required SHFOPCS is a pressure switch that is downstream of the low pressure pump and downstream of the fuel oil metering pump. The switch must be set up with a lock only open isolation valve and test port as shown in the figure.

Is the SHFOPCS downstream of the low pressure pump? Yes Fail

Is the SHFOPCS downstream of the metering pump? Yes Fail

Regulated Oil pressure at high fire psig

Secondary High Oil Pressure activation point psig

Did the SHFGPCS trip at or less than 120% of regulated pressure? Yes Fail

Did BMS annunciate properly? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 40_D

Checklist for Control Air Pressure Interlock (CAPI) – Boiler#____

* CAPI is required to be after any pressure regulator in line serving pneumatic devices

Control Air Pressure Switch Make

Control Air Pressure Switch Range psig

Is there a lock open only valve and test port installed for easy testing? Yes Fail

* Setpoint is required to be more than minimum pressure required to actuate any pneumatic control device.

Pneumatic control device minimum required pressure psig

Control air pressure activation point psig

Is the activation point of the CAPI above the minimum required pressure of the pneumatic device? Yes Fail

Did the boiler shut down and the BMS annunciate properly ? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 41_D

Checklist for High Furnace Pressure Cutoff Switch (FPI) – Boiler#____

* The FPI is only required on boilers with a modulating outlet stack damper. The required trip point is less than the greater of 1”wc or 120% of (maximum) boiler furnace pressure. The FPI must be normally closed. The switch must be set up with a lock only open isolation valve and test port as shown in the figure.

High Furnace Pressure Switch Make

High Furnace Pressure Switch Range “ wc

Is there a lock open only valve and test port installed for easy testing? Yes Fail

* The VA requires that the switch trip point be less than 120% of the max furnace pressure or

1” whichever is greater.

Max Furnace Pressure “wc

High Furnace Pressure activation point “wc

Required cutout Point=1.2 x Max Furnace pressure

(or 1’’ whichever is greater) = “wc

Is the activation point at or below the required cutout point? Yes Fail

Did the boiler shut down and the BMS annunciate properly ? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 40_D

Checklist for Secondary Low Atomizing Media Pressure Switch

Boiler#______ (SLAMPS)

*The VA required SLAMPS is a pressure switch that monitors atomizing media pressure.

Since the LAMPS is located sensing atomizing pressure near the Burner, then SLAMPS must sense pressure near the atomizing media source (On-board Compressor.) The SLAMPS must be normally open.

Secondary Low Atomizing Media Pressure Switch Make

Secondary Low Atomizing Media Pressure Switch Range psig

Regulated pressure at high fire psig

What was the minimum regulated pressure? psig

What was the SLAMPS trip point? psig

Is the switch installed with a LOO Valve and Test Port? Yes Fail

Did the SLAMPS trip at or above the required cutout point? Yes Fail

Is the range of the switch and test gage satisfactory? Yes Fail

Check the Logic Did the boiler lock out and BMS annunciate properly? Yes Fail

Are the LOO valves open and locked? Yes Fail

Boiler #2

SD6MSOP 15_D

Checklist for High and High-High Boiler Steam Pressure Limit Switches

Boiler#_________ (HBSPLS & HHBSPLS)

*This test involves two switches. Manual Reset is required after the activation of either Steam

Pressure Switch.

Make & Range of HBSPLS psig

Setpoint of HBSPLS psig

Make & Range of HHBSPLS psig

Setpoint of HHBSPLS psig

Normal Steam Pressure psig

Lowest Boiler Steam Safety Valve Set Point psig

Pressure Gage Calibration Date

Do both switches require a Manual Reset? Yes Fail

Are the ranges of the switches and gage satisfactory? Yes Fail

*The VA requires that the RBSPLS set point should be 10 psig or more higher than the normal steam pressure and the NRBSPLS set point should be 5 psig or more above the

RBSPLS set point & 5 psig or more below the lowest boiler steam safety valve set point

What pressure did the HBSPLS activate? psig

What pressure did the HHBSPLS activate? psig

Did HBSPLS activate 10 psig or more above the normal steam pressure Yes Fail

Did HHBSPLS activate 5 psig or more above that of the HBSPLS Yes Fail

Did HHBSPLS activate 5 psig or more below the lowest boiler SSRV set point? Yes Fail

Check the Logic Did HBSPLS require a manual reset ? Yes Fail

Did HHBSPLS require a manual reset ? Yes Fail

Checklist for Steam Safety Valves on Boiler (SVB) – Boiler#________

*This test is written for the normal setup of two steam safety valves per boiler. The VA required device is a minimum of two steam safety valves vented to the outside with individual adequate vent lines. The total capacity of all safety valves has to be more than the maximum capacity of the boiler. If fitted with multiple safety valves the relief capacity of each safety valve must be so that the boiler can lift all valves with steam pressure.

Boiler maximum capacity lbs/hr

Boiler maximum allowable working pressure (MAWP) psig

Setpoint of HHBSPLS psig

Safety Valve # 1 (SVB1) Make

Safety Valve # 1 (SVB1) Setpoint psig

Safety Valve #1 (SVB1) Capacity lbs/hr

Safety Valve # 2 (SVB2) Make

Safety Valve # 2 (SVB2) Setpoint psig

Safety Valve #2 (SVB2) Capacity lbs/hr

Normal Operating Pressure of boiler psig

Are there at least two safety valves? Yes Fail

Is there a satisfactory individual vent line? Yes Fail

Is the range of the gage satisfactory? Yes Fail

Is the capacity of all safety valves combined more than the boiler capacity? Yes Fail

Is SVB1 stamped safety valve lift pressure more than 5 psig above the

HHBSPLS set point and more than 10 psig lower than the boiler MAWP?

Yes Fail

Is SVB2 stamped safety valve lift pressure at or more than 5 psig above the SVB1 stamped lift pressure and at or more than 5 psig lower than the boiler MAWP?

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

The VA requires that SVB1 should be set 5 psig higher than HHBSPLS and 10 psig or more below the boiler MAWP. The VA requires that SVB2 should be set 5 psig or higher than

SVB1 & and 5 psig or more below boiler MAWP. The maximum lift pressure of any SVB must not exceed 3% higher than the rated lift pressure. All SVB must re-seat at a pressure higher than the HBSPLS will re-set. The maximum accumulation pressure seen must not exceed

110% of highest SVB setpoint and never exceed boiler MAWP.

What was SVB1 lift pressure? Psig

What was the SVB1 reseat pressure? Psig

What was SVB2 lift pressure? Psig

What was the SVB2 reseat pressure? Psig

Did SVB1 lift at less than 103% of stamped set point? Yes Fail

Did the SVB1 reseat above the HBSPLS Re-Set pressure? Yes Fail

Did SVB2 lift at less than 103% of stamped set point? Yes Fail

Did the SVB2 reseat above the HBSPLS Re-Set pressure? Yes Fail

Was the maximum pressure in accumulation test less than 110% of SVB2 stamped safety valve lift pressure?

Yes Fail

If required – Were repairs made to all items marked fail? Repaired Not Repaired

Explain:_______________________________________________________________________

SD6MSOP 17_D

Checklist for Low Fuel Gas Pressure Cutoff Switch (LFGPCS) Boiler#_____

*The VA required LFGPCS is a pressure switch that is downstream of the pressure regulator

Low Gas Pressure Switch Make

Low Gas Pressure Switch Range

Is the LFGPCS downstream of the pressure regulator? Yes Fail

Is the LFGPCS upstream of the flow control valve? Yes Fail

Is there a LOO valve installed for testing? Yes Fail

* The VA requires that the LFGPCS trip point be greater than 80% of the regulated pressure.

Regulated pressure at low fire

Low Gas Pressure activation point

Required cutout Point=0.8 x LF regulated pressure =

Did the LFGPCS trip the boiler offline and lockout? Yes Fail

Was the annunciation proper? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 18_D

Checklist for High Fuel Gas Pressure Cutoff Switch (HFGPCS) – Boiler#____

* The VA required HFGPCS is a pressure switch that is downstream of the pressure regulator and upstream of the fuel gas flow control valve. The HFGPCS must be normally closed. The

High Gas Pressure Switch Make

High Gas Pressure Switch Range

Is the HFGPCS downstream of the pressure regulator? Yes Fail

Is the HFGPCS upstream of the flow control valve? Yes Fail

Regulated gas pressure at low fire

High Gas Pressure activation point

Did BMS annunciate – High Gas Press? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 19_D

Checklist for Automatic Fuel Gas Shutoff Valves and Solenoid Vent Valve

Seat Leakage (AFGSOV & AFGSVV) – Main Gas Line – Boiler#____

Main Gas Valve Make

Vent Valve on Main Gas Line Make

Were both AFGSOV without leaks? Yes Fail

Was the AFGSVV without leaks? Yes Fail

Did the AFGSVV open with the boiler off? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 20_D

Checklist for Automatic Pilot Fuel Gas Shutoff Valves and Solenoid Vent

Valve Seat Leakage (APFGSOV & APFGSVV) – Pilot Gas Line – Boiler#____

Pilot Gas Valve Make

Vent Valve on Pilot Gas Line Make

Were both APFGSOV without leaks? Yes Fail

Was the APFGSVV without leaks? Yes Fail

Did the APFGSVV open with the boiler off? Yes Fail

Are the LOO valves open and locked? Yes Fail

SD6MSOP 21_D

AFGSOV) – Natural Gas – Boiler#_____

The VA requires POC-AFGSOV on both AFGSOV. The two switches must be wired in series.

Make of POC-AFGSOV

The VA requires that the POC-AFGSOV open before gas pressure is sensed downstream of

Is a POC-AFGSOV present in both valves? Yes Fail

Did upstream POC open (Shows Voltage) before pressure was sensed? Yes Fail

Did downstream POC open (Shows Voltage) before pressure was sensed? Yes Fail

Did the BMS annunciate properly? Yes Fail

SD6MSOP 22_D

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

*The VA required LPFGPCS is a normally-open pressure switch that is downstream of the pilot gas pressure regulator and upstream of the first pilot gas solenoid shut off valve. The

LPFGPCS must be wired in the running interlock.

Low Pilot Gas Pressure Switch Make

Low Pilot Gas Pressure Switch Range

Is the LPFGPCS downstream of the pilot pressure regulator? Yes Fail

*The VA requires that the LPFGPCS trip point be greater than 80% of the regulated pressure and that the boiler lights smoothly at a pressure slightly higher than switch trip point.

Regulated pressure during pilot =

Low Pilot Gas Pressure activation point =

Required cutout Point=0.8 x regulated pressure =

Did the boiler shutdown and lockout? Yes Fail

Was the annunciation proper? Yes Fail

SD6MSOP 23_D

Checklist for Flame Scanner Not Sensing Igniter Spark (FSNSIS) – Boiler#__

* The VA requires a UV-self checking scanner

Is the FSMFO a UV-self checking device? Yes Fail

The VA requires that the scanner does not sense the ignition spark

Flame Scanner Brand?

Model of Flame Scanner?

Did the Fireye not show a flame signal (Should be Zero/Nothing)? Yes Fail

UV Self

Checking

Scanner

(Compliant)

IR Scanner

(NOT Compliant)

SD6MSOP 24_D

Checklist for Igniter Timing (IT) – Boiler#_____

The VA requires a maximum of 10 seconds igniter time.

What was the igniter timing? Seconds

Was the igniter timing 10 seconds or less? Yes Fail

SD6MSOP 25_D

Checklist for Main Flame Ignition Timing (MFIT) – Boiler#_____

The VA requires a maximum of 14 seconds for MFIT

What was the trial for main flame timing? Seconds

Was the Main Flame Ignition Timing 14 seconds or less? Yes Fail

Did the boiler lock out and annunciate “Flame Failure” Yes Fail

SD6MSOP 26_D

Checklist for Pre-Purge and Post-Purge Timing (PPT) - Boiler#____

*The VA requires a purge timer that is not adjustable

Make / Model of Purge Timer?

Boiler Make / Model?

Boiler Fireside Volume? (V)

Maximum Boiler Capacity (include any de-rating) (m)

Air changes Required (4 for Fire Tube) (AC)

Required Pre-Purge Time = m

VAC 270**