J-1605000-06 SAMPLE NAVFAC BOILER AND UPV INSPECTION FORM AND INSPECTION CERTIFICATE.pdf

This document is a sample NAVFAC boiler and unfired pressure vessel (UPV) inspection report and inspection certificate template based on UFC 3-430-07 (24 July 2003, including Change 5, 07 May 2019). The inspection report serves as a standardized form for documenting boiler and UPV inspections conducted by NAVFAC inspectors at military installations. The report captures essential equipment identification information including building number, equipment type, vessel classification, ASME symbols, capacity, fuel type, and manufacturing details. It documents inspection dates, expiration dates of certificates, inspector credentials (NAVFAC number and license number), and any repairs made since the last inspection.

The report includes detailed sections for Type A (Internal/External) inspections, Type C (Operational Safety) inspections, and pressure tests. The Type C section requires documentation of combustion analysis, safety checks (flame detection/failure, ignition, pilot loss, primary LWO, high water cutout, draft limit PSI, high limit/lock-out PSI, operating temperature, high temperature/lock-out, fuel PSI, high gas/lock-out PSI, draft/air flow, emergency stop, and electrical disconnect), and condition assessment with options to mark equipment as "Not Inspected or not Applicable," "Fully Acceptable," "Needs Minor Repair," or "Requires Major Repair/Replacement." The report also requires documentation of safety and relief valves, other components (pressure gauges, sight glasses, thermometers, gas valves, fuel valves, steam valves, control dampers, isolation valves, vent piping, external conduit/cables, and flow meters/regulators). Quality assurance findings are recorded with checkboxes for satisfactory or unsatisfactory results. The accompanying inspection certificate, issued by the Department of the Navy Naval Facilities Engineering Command, certifies that the boiler or vessel has been inspected and approved for operation at a specified pressure and must be posted under glass near the equipment per UFC-03-430-07.