D.3 National Board Form- 6.pdf

PDF 124 KB Posted

Attached to
J044--SF Boiler Plant Testing Inspections IDIQ Federal contract opportunity
Solicitation number
36C26325Q0155
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23

About this file

Written by GovTribe AI ·

This is Form NB-6, a standardized boiler-fired pressure vessel inspection report form issued by The National Board of Boiler and Pressure Vessel Inspectors for jurisdictions operating under the ASME Code (Rev.7, 03/14/23).

The two-page form captures comprehensive inspection details including: date of inspection, certificate expiration date, equipment location information, nature of business, type of inspection (internal/external), certificate business details, invoice information, vessel specifications (type, manufacturer, year built), usage details (power/process/steam heating/etc.), safety features (low water cutoff, high limit controls), combustion controls, pressure relief device information, and inspector certification. The form requires documentation of any adverse conditions found, specific requirements, and verification that requirements were explained to the responsible party. This appears to be a blank template that would be used for conducting and documenting boiler inspections at VA facilities as referenced in the associated contract opportunity.

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This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

FORM NB-6 BOILER-FIRED PRESSURE VESSEL

REPORT OF INSPECTION

Standard Form for Jurisdictions Operating Under the ASME Code

1. DATE INSPECTED: CERTIFICATE EXPIRATION DATE: CERTIFICATE POSTED: YES NO

(Month/Day/Year) (Month/Day/Year)

USER NUMBER: NAT’L BD NUMBER OR SERIAL # (IF CAST IRON)

FIRST INSPECTION: YES NO JURISDICTION NUMBER:

NATIONAL BOARD NUMBER: OTHER NUMBER:

2. EQUIPMENT LOCATION NAME:

EQUIPMENT LOCATION ADDRESS:

(Equipment Location Street) (Equipment Location City)

(Equipment Location State) (Equipment Location Zip Code)

NATURE OF BUSINESS:

KIND OF INSPECTION: INTERNAL EXTERNAL CERTIFICATE RENEWAL: YES NO

3. CERTIFICATE BUSINESS NAME:

CERTIFICATE CONTACT:

(NAME) (Email)

CERTIFICATE MAILING ADDRESS:

(Certificate Mailing Street) (Certificate Mailing City)

(Certificate Mailing State) (Certificate Mailing Zip Code)

4. INVOICE BUSINESS:

(Name)

CERTIFICATE INVOICE CONTACT:

(Name) (Email)

INVOICE ADDRESS:

(Invoice Address Street) (Invoice Address City)

(Invoice Address State) (Certificate Mailing Zip Code)

5. TYPE: FT WT CI OTHER: ASME/OTHER CODE:

MANUFACTURER: YEAR BUILT:

MANHOLE HANDHOLE NEITHER CERTIFICATE DURATION (MONTHS):

6. USE: POWER PROCESS STEAM HEATING HWH HWS OTHER

FUEL TYPE: METHOD OF FIRING:

LOCATION IN PLANT:

NB-6, Rev.7, (03/14/23)

This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors 1055 Crupper Avenue, Columbus, Ohio 43229-1183

7. LOW WATER CUTOFF INSTALLED: YES NO TESTED: YES NO

HIGH LIMIT TEMP/PRESSURE INSTALLED: YES NO WAS BOILER FIRED: YES NO

COMBUSTION CONTROLS: CSD-1 NFPA OTHER

COMBUSTION AIR VERIFIED: YES NO

8. ARE THERE ANY KNOWN OUTSTANDING (OPEN) VIOLATIONS FOR THIS EQUIPMENT? YES NO (IF YES, EXPLAIN FULLY UNDER

ADVERSE CONDITIONS FOUND)

LOG/RECORD REVIEW: YES NO

PRESSURE TEST: YES PSI: DATE: NO

9. STAMPED MAWP: MINIMUM PRD REQUIRED CAPACITY:

NUMBER OF PRD’S: TOTAL CAPACITY:

SET PRESSURE: CAPACITY:

SET PRESSURE: CAPACITY:

SET PRESSURE: CAPACITY:

10. INSPECTORS COMMENTS: (Verify any repairs were completed by a qualified repair company, and when applicable, the proper repair/ alterations forms are completed.)

11. ADVERSE CONDITIONS FOUND:

12. REQUIREMENTS:

13. PERSON TO WHOM REQUIREMENTS WERE EXPLAINED:

(Name) (Title)

(Email) (Phone Number)

14. I HEREBY CERTIFY THIS IS A TRUE REPORT OF MY INSPECTION:

NB COMMISSION NUMBER: EMPLOYED BY:

IDENTIFICATION NUMBER: SIGNATURE OF INSPECTOR:

NB-6, Rev.7, (03/14/23)

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