PREFUNCTIONAL TEST CHECKLIST

PIPE-_____
Specification Section _______
Project: __________________________________ Project No: __________

Components included (except at equipment):

___flanges/couplings, ___ valves, ___supports/hangers, ___vents, ___air separators,
___expansion tanks, ___flow meters, ___expansion joints,
___sensors/transmitters/gages

Associated Checklists:
___chillers, ___cooling towers, ___pumps, ___CHW pumps, ___AHUs, ___ emergency
power system
___Other_______________________

1. Submittal / Approvals
Submittal. The above equipment and systems integral to them are complete and
ready for functional testing. The checklist items are complete and have been checked
off only by parties having direct knowledge of the event, as marked below, respective to
each responsible contractor. This prefunctional checklist is submitted for approval,
subject to an attached list of outstanding items yet to be completed. A Statement of
Correction will be submitted upon completion of any outstanding areas. ___ List
attached.

_____________________ __________ _____________________ __________

Mechanical Contractor Date Controls Contractor Date

_____________________ __________ _____________________ __________

Electrical Contractor Date Plumb/FP Contractor Date

_____________________ __________ _____________________ __________

TAB Contractor Date General Contractor Date

Prefunctional checklist items are to be completed as part of startup & initial checkout,
preparatory to functional testing.
This checklist does not take the place of the manufacturers recommended
checkout and startup procedures or report.
Contractors assigned responsibility for sections of the checklist shall be
responsible to see that checklist items by their subcontractors are completed
and checked off.

Approvals. This filled-out checklist has been reviewed. Its completion is approved.

_____________________ __________ ____________________ __________

Commissioning Authority/Agent Date Owners Representative Date

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2. Requested documentation submitted
a) Shop drawings: Yes / No - date to be submitted _______
b) Performance data (friction loss, gaskets): Yes / No - date to be submitted _______
c) Installation inspection reports (x-ray, NDT, etc.):
Yes / No - date to be submitted _______
d) Flushing/water quality test results attached: Yes / No
e) Sterilization test results: N/A / Yes / No - date to be submitted _______
f) Bacterial test results: N/A / Yes / No - date to be submitted _______

3. Pipe Verification
Item Specified Submitted Installed
Pipe: Manufacturer
Material
ASTM No. / Grade / Type
Service
Fitting Type (Flanged,
welded, Victaulic, screwed,
etc.)

Joint Type (Flanged, welded,

Victaulic, screwed, etc.)

Gaskets

Pipe Coating
Wall Thickness/Sch. No.

Insulation Type

Insulation Thickness

External Wrap Type

External Wrap Thickness
Expansion Tank: Manufacturer
Model No.
Type
Air Separator: Manufacturer
Model No.
Type

4. Installation Checks
a) Piping and Supports/Hangers
i) Pipe installed per shop drawings: Yes / No
ii) Pipe installed per construction drawings: Yes / No

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iii) Installed routing is acceptable: Yes / No
iv) Supports/hangers/thrust blocks installed per shop drawings: Yes / No
v) Supports/hangers/thrust blocks installed per construction drawings:
Yes / No
vi) Vibration isolation devices installed and active: Yes / No
vii) Support/hanger/thrust block installation is acceptable: Yes / No
viii) Support/hanger/thrust block as-built drawings updated: Yes / No
ix) All supports/hangers/thrust blocks are active: Yes / No
x) Dissimilar metals isolated (pipe to pipe, pipe to support): N/A / Yes / No
xi) Flanges properly aligned: N/A / Yes / No
xii) Flange bolting complete and torqued per specifications/shop drawings:
N/A / Yes / No
xiii) Victaulic couplings installed per shop drawings: N/A / Yes / No
xiv) Victaulic couplings per construction/as-built drawings: N/A / Yes / No
xv) Welded joints/fittings installed per shop drawings: N/A / Yes / No
xvi) Other joints/fittings installed per shop drawings: N/A / Yes / No
xvii) Gaskets installed: N/A / Yes / No
xviii) Gasket material per shop drawings: N/A / Yes / No
xix) Gasket material per specifications: N/A / Yes / No
xx) Containment system installed: N/A / Yes / No
xxi) Low point drains installed: N/A / Yes / No
xxii) System fill connections installed: N/A / Yes / No
xxiii) Air vents installed: N/A / Yes / No
xxiv) Expansion joints or loops installed per drawings/specifications: Yes / No
xxv) Flexible connections installed at vibrating equipment: Yes / No
xxvi) Air chambers and/or shock absorbers installed: N/A / Yes / No
xxvii) Piping as-built drawings updated: Yes / No
xxviii) Minimum clearances from roof and vertical obstructions maintained:
N/A / Yes / No
xxix) Protective coating installed on pipe and supports/hangers per specifications:
N/A / Yes / No
xxx) Permanent identification installed: Yes / No

b) Valves and Specialties

i) Components properly labeled: Yes / No
ii) Components installed in proper location: Yes / No
iii) Components installed in proper orientation and function as intended:
Yes / No
iv) Connections tight: Yes / No
v) Components insulated per specifications: N/A / Yes / No
vi) By-pass piping installed per shop and/or construction drawings: Yes / No
vii) ASME pressure vessel data sheet or certification tag posted, vessel stamped,
inspection complete: N/A / Yes / No
viii) Components accessible for maintenance, platforms and/or catwalks installed
as necessary: Yes / No
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ix) Wells for monitoring/control sensors, transmitters, and/or gages are installed
correctly: N/A / Yes / No
x) Monitoring/control sensors, transmitters, and/or gages are installed correctly:
N/A / Yes / No
xi) Test ports installed per shop drawings for monitoring/control
sensors/transmitters: N/A / Yes / No
xii) Valve chart completed: Yes / No

c) Electrical and Controls

i) DCP(s) power source(s) identified: N/A / Yes / No
ii) Panel(s) labeled with permanent label: N/A / Yes / No
iii) Power disconnect(s) in place and labeled: N/A / Yes / No
iv) Low voltage wiring in separate conduit as 120 vac: N/A / Yes / No
v) 120 vac lightning protection installed: N/A / Yes / No
vi) Low voltage lightning protection installed (underground only): N/A / Yes / No
vii) Pneumatic devices separated from controller and electronics: N/A / Yes /
No
viii) E-O-L devices labeled and wiring tagged per drawings: N/A / Yes / No
ix) Panel devices labeled and wiring tagged per drawings: N/A / Yes / No
x) I/O devices labeled and wiring tagged per drawings: N/A / Yes / No
xi) Digital inputs and outputs operational: N/A / Yes / No
xii) E-PROM images on LAN for each controller: N/A / Yes / No
xiii) Controller drawing and point summary log in panel: N/A / Yes / No
xiv) All electric connections tight: N/A / Yes / No
xv) Proper grounding installed for components and unit: N/A / Yes / No
xvi) Safeties in place and operable: N/A / Yes / No
xvii) Starter overload breakers installed and correct size: N/A / Yes / No
xviii) Sensors calibrated (see below) : N/A / Yes / No
xix) Control system interlocks hooked up and functional: N/A / Yes / No
xx) All control devices, pneumatic tubing and wiring complete: N/A / Yes / No

d) TAB
i) Installation of required system balancing devices complete: N/A / Yes / No
ii) Hydronic TAB completed and accepted: N/A / Yes / No

e) Final
i) Pressure test complete with acceptable results per specifications: Yes / No
ii) Containment system tested for leaks with acceptable results: N/A / Yes /
No
iii) Prefunctional testing complete for all connected equipment: Yes / No
iv) Flushing/water quality test complete: Yes / No
v) Water quality test results accepted by MDAD: N/A / Yes / No
vi) Piping system charged: Yes / No
vii) Water treatment test results accepted by water treatment company:
N/A / Yes / No
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viii) Sterilization test results accepted: N/A / Yes / No
ix) Bacterial test results accepted: N/A / Yes / No
x) Building and Zoning final inspection complete/approved: N/A / Yes / No
xi) MDAD approval obtained (attached) to open to existing systems:
N/A / Yes / No
6. Sensor and Actuator Calibration
All field-installed temperature and pressure sensors and gages, and all actuators shall
be calibrated.
All test instruments have had a certified calibration within the last 12 months:
Y/N______.

Sensor/Actuator Verification Table

Sensor or Location Thermometer BMS Value Instrument Pass (Y/N)
Actuator OK (Y/N) or Gage Measured
Value Value
Temp __
Temp __
Temp __
Temp __
Temp __
Temp __
Temp __
Temp __
Pressure __
Pressure __
Pressure __
Pressure __
Pressure __
Pressure __
Pressure __
Flow Meter ___
Flow Meter ___
Flow Meter ___
Flow Meter ___
Flow Meter ___

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Thermometer/Gage reading = reading of the permanent instrument on the equipment.

BMS = building management system. Instrument = testing instrument.

All sensors are calibrated within required tolerances ___ YES ___ NO

-- END OF CHECKLIST--

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