Exhibit_5-_GSA_349 1 .pdf
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- Attached to
- Facility Maintenance Services -- Z Federal contract opportunity
- Solicitation number
- RRB15R0005
- Issued by
- Railroad Retirement Board
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Exhibit 5
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GENERAL SERVICES ADMINISTRATION
PUBLIC BUILDINGS SERVICE
INSPECTION REPORT OF BOILER
(Make separate report for each boiler)
CITY AND STATE BUILDING
REGION NUMBER DATE OF INSPECTIONHEADQUARTERS
1. NUMBER OF BOILERS IN BUILDING
SUBJECT TO INSPECTION
2. PLANT BOILER NUMBER
3. MANUFACTURED'S NAME 3A. MANUFACTURER'S NUMBER
4. TYPE OF BOILER
STEAM
HOT WATER
WATER TUBE
PACKAGE TYPE
SCOTCH
C. I. SECTIONAL
FIRE TUBE H.R.T.
OTHER (Specify type)
FIRETUBE FIREBOX
5. *TYPE OF SETTING
6. *DATE MANUFACTURED 6A. *DATE INSTALLED THIS
LOCATION
7. *STATE SERVICE (Lighting, pumping, heating, power, etc.)
8. MANUFACTURER'S RATING
CAPACITY
MAXIMUM ALLOWABLE WORKING PRESSURE
9. MAXIMUM STEAM PRESSURE UNDER WHICH BOILER IS OPERATED
LBS./SQ. IN.
9A. HOT WATER SUPPLY TEMPERATURE
OF
9B. RETURN TEMPATURE
OF (Minimum)
10. HAS WORKING PRESSURE BEEN REDUCED, BASED ON AN OFFICIAL RECOMMENDATION?
11. DATE OF LAST INSPECTION 12. NAME AND TITLE OF LAST INSPECTOR
13. FUEL USED
COAL OIL GAS
14. *NUMBER AND LENGTH OF GENERATING TUBE 15. *DIAMETER OF TUBES (O.D.)
16. *MATERIAL AND GAUGE OF TUBES
17. *GIVE SIMILAR DATA ON WATER WALL TUBES IF FITTED
18. *NUMBER AND SIZE OF SECTIONS FOR C.I. BOILER
19. GENERAL CONDITION OF SETTING
20. DOES BOILER CONTAIN GREASE?
YES NO NOYES
20A. DOES BOILER CONTAIN SCALE?
20B. IF SO, IS QUANTITY OF GREASE OR SCALE CONSIDERED SERIOUS?
YES NO
21. WAS EMBRITTLEMENT, GROOVING, PITTING, OR CORROSION APPARENT?
YES NO
21A. IF SO, TO WHAT EXTENT OF EACH?
22. DOES BOILER SHOW SIGNS OF BAGS OR BLISTERS?
YES NO
* To be recorded at first inspection only GSA 349FORM
NOV 62
YES NO
(B.H.P., SQ. FT. STEAM OR H.W., MBH. E.D.R. OR LB/HR)
LBS./SQ. IN.
INSIDE OUTSIDE
22A. IF SO, TO WHAT EXTENT
23. WAS HAMMER TEST MADE OF STAYS, RIVETS, ETC.?
23A. IF SO, STATE RESULTS
YES NO
24. HAS BOILER BEEN RECEIVING FEED WATER TREATMENT?
YES NO
24A. IF SO, WHAT TYPE AND TO WHAT EXTENT?
25. CONDITION OF TUBES
26. ARE THERE ANY WARPED TUBES?
YES NO
27. CONDITION OF THE NIPPLES
28. HYDROSTATIC PRESSURE OF
29. DID BOILER SHOW DEFECTS UNDER ABOVE PRESSURE?
29A. IF SO, WHERE, AND TO WHAT EXTENT?
YES NO
30. WAS TEST PRESSURE 1½ TIMES THE MAXIMUM ALLOWABLE PRESSURE AS RATED BY
YES NO
30A. IF NOT, WHY WAS MAXIMUM PRESSURE NOT APPLIED?
31. RECOMMENDED MAXIMUM SAFE WORKING PRESSURE AS A RESULT OF THIS TEST
32. *SAFETY VALUES
NUMBER TYPES SIZE
LBS./SQ. IN.WAS APPLIED
LBS./SQ. IN. GAGE
33. CONDITION OF SAFETY VALVES
34. EACH SAFETY VALVE SET TO OPEN AT
LBS. WATER PRESSURE
35. WAS PRESSURE TEST MADE OF SAFETY VALVES?
YES NO
35A. RESULTS OF PRESSURE TEST, EACH VALVE OPEN
35B. RESULTS OF PRESSURE TEST, EACH VALVE CLOSED
36. WERE SAFETY VALVES RESET?
YES NO
36A. IF SO, FOR WHAT PRESSURE?
37. CONDITION OF BOILER GAUGE
LBS./SQ. IN.
38. WHAT VARIATION IN PRESSURE EXISTED BETWEEN PRESSURE VESSEL GAUGE AND INSPECTOR'S TEST GAUGE AT WORKING
PRESSURE?
* To be recorded at first inspection only
39. WAS GAUGE CORRECTED? 40. WERE FUSIBLE PLUGS RENEWED?
YES NO YES NO
41. CONDITION OF FUSIBLE PLUGS
42. CONDITION OF GAUGE GLASS, WATER COLUMN AND TRY COCKS
43. CONDITION OF BOTTOM BLOW-OFF VALVES, AND LINE
44. CONDITION OF SURFACE BLOW AND/OR CONTINUOUS BLOW IF FITTED
45. WHAT TYPE OF BOILER FEEDING APPARATUS IS USED (PUMP, INJECTOR, RETURN TRAP, GRAVITY, ETC.)
45A. DESCRIBE SAME
46. CONDITION OF BOILER FEEDING APPARATUS
47. GENERAL INTERNAL CONDITION OF BOILER
48. CONDITION OF THE BAFFLES
49. CONDITION OF THE CALKING BETWEEN TUBE HEADERS
50. GENERAL CONDITION OF THE MOUNTING, ATTACHMENTS, SETTINGS, BREECHING, BAROMETRIC DAMPER, STACK, ETC.
51. IF COAL IS USED FOR FUEL, HOW IS BOILER FIRED?
HAND STOKER
52. IF STOKER, DESCRIBE SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS
53. IF OIL OR GAS IS USED FOR FUEL, DESCRIBE SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS
53A. FIRING EFFICIENCY 53B. FLUE GAS TEMPERATURE
%CO2
54. IF HAND FIRED, GIVE TYPE, SIZE AND CONDITION OF GRATES
55. WHAT REPAIRS OR ALTERATIONS HAVE BEEN MADE SINCE LAST INSPECTION AND WHY WERE THEY MADE?
56. HAS ADEQUATE PROVISIONS BEEN MADE FOR FIRE FIGHTING?
57. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE?
COMPETENT DOUBTFUL INCOMPETENT
GIVE RECOMMENDATIONS REGARDING PERSONNEL
47A. GENERAL EXTERNAL CONDITION OF BOILER
58. IN YOUR OPINION IS THIS BOILER IN A SAFE CONDITION TO BE OPERATED?
YES NO
58A. IF ANSWER TO QUESTION 58 IS NO, THE INSPECTOR WILL NOTIFY THE CUSTODIAN, OR BUILDING SUPERINTENDENT, IMMEDI- ATELY IN WRITING, NOT TO USE SAME, AND GIVE COMPLETE DETAILS TO REGIONAL OFFICE BY WIRE
59. RECOMMENDATIONS AND REMARKS BY THE INSPECTOR (Include alterations, additions or repairs considered necessary)
59a. SIGNATURE OF INSPECTOR 59B. TITLE OF INSPECTOR
60. RECOMMENDATIONS AND REMARKS BY LOCAL OFFICER OR ENGINEER IN CHARGE
60A. SIGNATURE OF OFFICER IN CHARGE 60B. OFFICIAL TITLE OF OFFICER IN CHARGE
NOTE: Use additional sheets, if necessary, to supplement the above remarks
GSA WASH DC 63-6854
GENERAL SERVICES ADMINISTRATION
PUBLIC BUILDINGS SERVICE
INSPECTION REPORT OF BOILER
(Make separate report for each boiler)
CITY AND STATE
BUILDING
REGION NUMBER
DATE OF INSPECTION
HEADQUARTERS
1. NUMBER OF BOILERS IN BUILDING
SUBJECT TO INSPECTION
2. PLANT BOILER NUMBER
3. MANUFACTURED'S NAME
3A. MANUFACTURER'S NUMBER
4. TYPE OF BOILER
STEAM
HOT WATER
WATER TUBE
PACKAGE TYPE
SCOTCH
C. I. SECTIONAL
FIRE TUBE H.R.T.
OTHER (Specify type)
FIRETUBE FIREBOX
5. *TYPE OF SETTING
6. *DATE MANUFACTURED
6A. *DATE INSTALLED THIS
LOCATION
7. *STATE SERVICE (Lighting, pumping, heating, power, etc.)
8. MANUFACTURER'S RATING
CAPACITY
MAXIMUM ALLOWABLE WORKING PRESSURE
9. MAXIMUM STEAM PRESSURE UNDER WHICH BOILER IS OPERATED
LBS./SQ. IN.
9A. HOT WATER SUPPLY TEMPERATURE
OF
9B. RETURN TEMPATURE
OF (Minimum)
10. HAS WORKING PRESSURE BEEN REDUCED, BASED ON AN OFFICIAL RECOMMENDATION?
11. DATE OF LAST INSPECTION
12. NAME AND TITLE OF LAST INSPECTOR
13. FUEL USED
COAL
OIL
GAS
14. *NUMBER AND LENGTH OF GENERATING TUBE
15. *DIAMETER OF TUBES (O.D.)
16. *MATERIAL AND GAUGE OF TUBES
17. *GIVE SIMILAR DATA ON WATER WALL TUBES IF FITTED
18. *NUMBER AND SIZE OF SECTIONS FOR C.I. BOILER
19. GENERAL CONDITION OF SETTING
20. DOES BOILER CONTAIN GREASE?
YES
NO
NO
YES
20A. DOES BOILER CONTAIN SCALE?
20B. IF SO, IS QUANTITY OF GREASE OR SCALE CONSIDERED SERIOUS?
YES
NO
21. WAS EMBRITTLEMENT, GROOVING, PITTING, OR CORROSION APPARENT?
YES
NO
21A. IF SO, TO WHAT EXTENT OF EACH?
22. DOES BOILER SHOW SIGNS OF BAGS OR BLISTERS?
YES
NO
* To be recorded at first inspection only
GSA 349
FORM
NOV 62
YES
NO
(B.H.P., SQ. FT. STEAM OR H.W., MBH. E.D.R. OR LB/HR)
LBS./SQ. IN.
INSIDE
OUTSIDE
22A. IF SO, TO WHAT EXTENT
23. WAS HAMMER TEST MADE OF STAYS, RIVETS, ETC.?
23A. IF SO, STATE RESULTS
YES
NO
24. HAS BOILER BEEN RECEIVING FEED WATER TREATMENT?
YES
NO
24A. IF SO, WHAT TYPE AND TO WHAT EXTENT?
25. CONDITION OF TUBES
26. ARE THERE ANY WARPED TUBES?
YES
NO
27. CONDITION OF THE NIPPLES
28. HYDROSTATIC PRESSURE OF
29. DID BOILER SHOW DEFECTS UNDER ABOVE PRESSURE?
29A. IF SO, WHERE, AND TO WHAT EXTENT?
YES
NO
30. WAS TEST PRESSURE 1½ TIMES THE MAXIMUM ALLOWABLE PRESSURE AS RATED BY MANUFACTURER?
YES
NO
30A. IF NOT, WHY WAS MAXIMUM PRESSURE NOT APPLIED?
31. RECOMMENDED MAXIMUM SAFE WORKING PRESSURE AS A RESULT OF THIS TEST
32. *SAFETY VALUES
NUMBER
TYPES
SIZE
LBS./SQ. IN.WAS APPLIED
LBS./SQ. IN. GAGE
33. CONDITION OF SAFETY VALVES
34. EACH SAFETY VALVE SET TO OPEN AT
LBS. WATER PRESSURE
35. WAS PRESSURE TEST MADE OF SAFETY VALVES?
YES
NO
35A. RESULTS OF PRESSURE TEST, EACH VALVE OPEN
35B. RESULTS OF PRESSURE TEST, EACH VALVE CLOSED
36. WERE SAFETY VALVES RESET?
YES
NO
36A. IF SO, FOR WHAT PRESSURE?
37. CONDITION OF BOILER GAUGE
LBS./SQ. IN.
38. WHAT VARIATION IN PRESSURE EXISTED BETWEEN PRESSURE VESSEL GAUGE AND INSPECTOR'S TEST GAUGE AT WORKING
PRESSURE?
* To be recorded at first inspection only
39. WAS GAUGE CORRECTED?
40. WERE FUSIBLE PLUGS RENEWED?
YES
NO
YES
NO
41. CONDITION OF FUSIBLE PLUGS
42. CONDITION OF GAUGE GLASS, WATER COLUMN AND TRY COCKS
43. CONDITION OF BOTTOM BLOW-OFF VALVES, AND LINE
44. CONDITION OF SURFACE BLOW AND/OR CONTINUOUS BLOW IF FITTED
45. WHAT TYPE OF BOILER FEEDING APPARATUS IS USED (PUMP, INJECTOR, RETURN TRAP, GRAVITY, ETC.)
45A. DESCRIBE SAME
46. CONDITION OF BOILER FEEDING APPARATUS
47. GENERAL INTERNAL CONDITION OF BOILER
48. CONDITION OF THE BAFFLES
49. CONDITION OF THE CALKING BETWEEN TUBE HEADERS
50. GENERAL CONDITION OF THE MOUNTING, ATTACHMENTS, SETTINGS, BREECHING, BAROMETRIC DAMPER, STACK, ETC.
51. IF COAL IS USED FOR FUEL, HOW IS BOILER FIRED?
HAND
STOKER
52. IF STOKER, DESCRIBE SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS
53. IF OIL OR GAS IS USED FOR FUEL, DESCRIBE SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS
53A. FIRING EFFICIENCY
53B. FLUE GAS TEMPERATURE
%CO2
54. IF HAND FIRED, GIVE TYPE, SIZE AND CONDITION OF GRATES
55. WHAT REPAIRS OR ALTERATIONS HAVE BEEN MADE SINCE LAST INSPECTION AND WHY WERE THEY MADE?
56. HAS ADEQUATE PROVISIONS BEEN MADE FOR FIRE FIGHTING?
57. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE?
COMPETENT
DOUBTFUL
INCOMPETENT
GIVE RECOMMENDATIONS REGARDING PERSONNEL
47A. GENERAL EXTERNAL CONDITION OF BOILER
58. IN YOUR OPINION IS THIS BOILER IN A SAFE CONDITION TO BE OPERATED?
YES
NO
58A. IF ANSWER TO QUESTION 58 IS NO, THE INSPECTOR WILL NOTIFY THE CUSTODIAN, OR BUILDING SUPERINTENDENT, IMMEDI- ATELY IN WRITING, NOT TO USE SAME, AND GIVE COMPLETE DETAILS TO REGIONAL OFFICE BY WIRE
59. RECOMMENDATIONS AND REMARKS BY THE INSPECTOR (Include alterations, additions or repairs considered necessary) 59a. SIGNATURE OF INSPECTOR
59B. TITLE OF INSPECTOR
60. RECOMMENDATIONS AND REMARKS BY LOCAL OFFICER OR ENGINEER IN CHARGE
60A. SIGNATURE OF OFFICER IN CHARGE
60B. OFFICIAL TITLE OF OFFICER IN CHARGE
NOTE: Use additional sheets, if necessary, to supplement the above remarks
GSA WASH DC 63-6854
8.2.1.3144.1.471865.466429
| 5. TYPE OF BOILER. STEAM: 0 |
| 5. TYPE OF BOILER. HOT WATER: 0 |
| 5. TYPE OF BOILER. PACKAGE TYPE: 0 |
| 5. TYPE OF BOILER. WATER TUBE: 0 |
| 5. TYPE OF BOILER. C. I. SECTIONAL: 0 |
| 5. TYPE OF BOILER. SCOTCH: 0 |
| OTHER (SPECIFY TYPE): 0 |
| 5. TYPE OF BOILER. FIRE TUBE H.R.T.: 0 |
| FIRETUBE FIREBOX: 0 |
| 13. FUEL USED. COAL: 0 |
| 13. FUEL USED. OIL: 0 |
| 13. FUEL USED. GAS: 0 |
| 20. DOES BOILER CONTAIN GREASE? YES: 0 |
| 20. DOES BOILER CONTAIN GREASE? NO: 0 |
| 20A. DOSE BOILER CONTAIN SCALE? YES: 0 |
| 20A. DOES BOILER CONTAIN SCALE? NO: 0 |
| 20B. IF SO, IS QUANTITY OF GREASE OR SCALE CONSIDERED SERIOUS? YES: 0 |
| 20B. IF SO, IS QUANTITY OF GREASE OR SCALE CONSIDERED SERIOUS? NO: 0 |
| 21. WAS EMBRITTLEMENT, GROOVING, PITTING, OR CORROSION APPARENT? YES: 0 |
| 21. WAS EMBRITTLEMENT, GROOVING, PITTING, OR CORROSION APPARENT? NO: 0 |
| 22. DOES BOILER SHOW SIGNS OF BAGS OR BLISTERS? YES: 0 |
| 22. DOES BOILER SHOW SIGNS OF BAGS OR BLISTERS? NO: 0 |
| 10. HAS WORKING PRESSURE BEEN REDUCED, BASED ON AN OFFICIAL RECOMMENDATION? YES: 0 |
| 10. HAS WORKING PRESSURE BEEN REDUCED, BASED ON AN OFFICIAL RECOMMENDATION? NO: 0 |
| CITY AND STATE: |
| BUILDING: |
| REGION NUMBER: |
| HEADQUARTERS: |
| DATE OF INSPECTION. Enter 2 digit month, 2 digit day and 4 digit year.: |
| 2. PLANT BOILER NUMBER: |
| 3. MANUFACTURED'S NAME: |
| 3A. MANUFACTURER'S NUMBER: |
| 5. TYPE OF SETTING: |
| 6. DATE MANUFACTURED. Enter 2 digit month, 2 digit day and 4 digit year.: |
| 6A. DATE INSTALLED THIS LOCATION. Enter 2 digit month, 2 digit day and 4 digit year.: |
| 7. STATE SERVICE (LIGHTING, PUMPING, HEATING, POWER, ETC): |
| 8. MANUFACTURE'S RATING. CAPACITY: |
| 8. MANUFACTURE'S RATING. MAXIMUM ALLOWABLE WORKING PRESSURE: |
| 42. CONDITION OF GAUGE GLASS WATER COLUMN AND TRY COCKS: |
| 8. MANUFACTURER'S RATING. LBS./SQ. IN.: |
| 9. MAXIMUM STEAM PRESSURE UNDER WHICH BOILER IS OPERATED.: |
| 9A. HOT WATER SUPPLY TEMPERATURE: |
| 9A. HOT WATER SUPPLY TEMPERATURE. OF: |
| 9B. RETURN TEMPATURE. (OF MINIMUM): |
| 11. DATE OF LAST INSPECTION. Enter 2 digit month, 2 digit day and 4 digit year.: |
| 12. NAME AND TITLE OF LAST INSPECTOR.: |
| 14. NUMBER AND LENGTH OF GENERATING TUBE.: |
| 15. DIAMETER OF TUBES (O.D.): |
| 16. MATERIAL AND GAUGE OF TUBES: |
| 17. GIVE SIMILAR DATA ON WATER WALL TUBES IF FITTED.: |
| 18. NUMBER AND SIZE OF SECTIONS FOR C.I. BOILER: |
| 21A. IF SO, TO WHAT EXTENT OF EACH?: |
| 19. GENERAL CONDITION OF SETTING. INSIDE: |
| 19. GENERAL CONDITION OF SETTING. OUTSIDE: |
| 1. NUMBER OF BOILERS IN BUILDING SUBJECT TO INSPECTION: |
| OTHER (Specify type): |
| 23. WAS HAMMER TEST MADE OF STAYS, RIVETS, ETC?. YES: 0 |
| 23. WAS HAMMER TEST MADE OF STAYS, RIVETS, ETC? NO: 0 |
| 24. HAS BOILER BEEN RECEIVING FEED WATER TREATMENT? YES: 0 |
| 24. HAS BOILER BEEN RECEIVING FEED WATER TREATMENT? NO: 0 |
| 26. ARE THERE ANY WARPED TUBES? YES: 0 |
| 26. ARE THERE ANY WARPED TUBES? NO: 0 |
| 29. DID BOILER SHOW DEFECT UNDER ABOVE PRESSURE? YES: 0 |
| 29. DID BOILER SHOW DEFECTS UNDER ABOVE PRESSURE? NO: 0 |
| 30. WAS TEST PRESSURE 1 1/2 TIMES THE MAXIMUM ALLOWABLE PRESSURE AS RATED BY MANUFACTURER? YES: 0 |
| 30. WAS TEST PRESSURE 1 1/2 TIMES THE MAXIMUM ALLOWABLE PRESSURE AS RATED BY MANUFACTURER? NO: 0 |
| 35. WAS PRESSURE TEST MADE OF SAFETY VALVES? YES: 0 |
| 35. WAS PRESSURE TEST MADE OF SAFETY VALVES? NO: 0 |
| 36. WERE SAFETY VALVES RESET? YES: 0 |
| 36. WERE SAFETY VALVES RESET? NO: 0 |
| 22A. IF SO, TO WHAT EXTENT: |
| 23A. IF SO, STATE RESULTS: |
| 24A. IF SO, WHAT TYPES AND TO WHAT EXTENT?: |
| 25. CONDITION OF TUBES: |
| 27. CONDITION OF THE NIPPLES: |
| 28. HYDROSTATIC PRESSURE OF : |
| LBS./SQ. IN. WAS APPLIED: |
| 29A. IF SO, WHERE, AND TO WHAT EXTENT?: |
| 30A. IF NOT, WHY WAS MAXIMUM PRESSURE NOT APPLIED?: |
| 31. RECOMMENDED MAXIMUM SAFE WORKING PRESSURE OF THIS TEST: |
| LBS./SQ. IN. GAGE: |
| 32. SAFETY VALUES. NUMBER: |
| 32. SAFETY VALUES. TYPES: |
| 32. SAFETY VALUES. SIZE: |
| 33. CONDITION OF SAFETY VALUES: |
| 34. EACH SAFETY VALVE SET TO OPEN AT: |
| LBS. WATER PRESSURE: |
| 35A. RESULT OF PRESSURE TEST, EACH VALVE OPEN: |
| 35B. RESULT OF PRESSURE TEST, EACH VALVE CLOSED.: |
| 36A. IF SO, FOR WHAT PRESSURE?: |
| LBS./SQ. IN: |
| 37. CONDITION OF BOILER GAUGE: |
| 38. WHAT VARIATION IN PRESSURE EXISTED BETWEEN PRESSURE VESSEL GAUGE AND INSPECTOR'S TEST GAUGE AT WORKING PRESSURE?: |
| 39. WAS GAUGE CORRECTED? YES: 0 |
| 39. WAS GAUGE CORRECTED? NO: 0 |
| 40. WERE FUSIBLE PLUGS RENEWED? YES: 0 |
| 40. WERE FUSIBLE PLUGS RENEWED? NO: 0 |
| 51. IF COAL IS USED FOR FUEL, HOW IS BOILER FIRED? HAND: 0 |
| 51. IF COAL IS USED FOR FUEL, HOW IS BOILER FIRED? STOCKER: 0 |
| 57. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE? COMPETENT: 0 |
| 57. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE? DOUBTFUL: 0 |
| 57. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE? INCOMPETENT: 0 |
| 41. CONDITION OF FUSIBLE PLUGS: |
| 43. CONDITION OF BOTTOM BLOW-OFF VALVES AND LINE: |
| 44. CONDITION OF SURFACE BLOW AND /OR CONTINUOUS BLOW IS FITTED: |
| 45. WHAT TYPE OF BOILER FEEDING APPARATUS IS USED (PUMP, INJECTOR, RETURN TRAP, GRAVITY, ETC): |
| 45A. DESCRIBE SAME: |
| 46. CONDITION OF BOILER FEEDING APPARATUS: |
| 47. GENERAL INTERNAL CONDITION OF BOILER.: |
| 48. CONDITION OF THE BAFFLES: |
| 49. CONDITION OF THE CALKING BETWEEN TUBE HEADERS: |
| 50. GENERAL CONDITION OF THE MOUNTING, ATTACHMENTS, SETTINGS, BREECHING, BAROMETRIC DAMPER, STACK, ETC.: |
| 52. IF STOCKER. DESCRIBED SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS: |
| 53. IF OIL OR GAS IS USED FOR FUEL, DESCRIBED SAME: GIVE CONDITION, INCLUDING SAFETY CONTROLS: |
| 53A. FIRING EFFICIENCY. %CO2: |
| 53B. FLUE GAS TEMPERATURE: |
| 54. IF HAND FIRED, GIVE TYPE, SIZE AND CONDITION OF GRATES.: |
| 55. WHAT REPAIRS OR ALTERATION HAVE BEEN MADE SINCE LAST INSPECTION AND WHY WERE THEY MADE?: |
| 56. HAS ADEQUATE PROVISIONS BEEN MADE FOR FIRE FIGHTING?: |
| 57. HOW DO PERSONNEL IN CHARGED OF THIS EQUIPMENT GRADE? GIVE RECOMMENDATIONS REGARDING PERSONNEL.: |
| 47A. GENERAL EXTERNAL CONDITION OF BOILER.: |
| 58. IN YOUR OPINION IS THIS BOILER IN A SAFE CONDITION TO BE OPERATED? YES: 0 |
| 58. IN YOUR OPINION IS THIS BOILER IN A SAFE CONDITION TO BE OPERATED? NO: 0 |
| 59. RECOMMENDATIONS AND REMARKS BY THE INSPECTOR (INCLUDE ALTERATIONS, ADDITIONS OR REPAIRS CONSIDERED NECESSARY): |
| 59B. TITLE OF INSPECTOR: |
| 60. RECOMMENDATIONS AND REMARKS BY LOCAL OFFICER OR ENGINEER IN CHARGE.: |
| 60B. OFFICIAL TITLE OFFICER IN CHARGE: |
| 60A. SIGNATURE OF OFFICER IN CHARGE: |
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