Yearly Boiler Inspection Report SL Series Boilers Boiler Details: Model Number_____________ Serial Number ______________Years of boiler Installation Date of Installation Address of installation User contact information Installer Information Company Address Phone/Fax/E mail ______________________________________________________________ Combustion Readings: On arrival High Fire CO2______ % O2_______% CO _______ ppm CO/O2 _______ ppm Flue temperature EX air______% Return water temperature (measure simultaneously with flue temp.) (G1 or G2) Remove the Blower control wire allow the blower to operate at its Max RPM. Record the fan pressure. Found under "Diagnostics -> Fan Operation". ~ ______ Compare this value yearly. (G3 revision boiler) tap the "Vent Test" tab and use your magnehelic attached to the vent pressure port of the heat exchanger. ______ Compare this value yearly. Without a call for heat: ______________________________________________________________________________ As a general rule: if all of the combustion values are good and the ignition of the burner is “normal”. Do not remove the igniter, for a yearly inspection. Do not remove the burner for yearly inspection. Look through the sight glass and inspect the combustion and heat exchanger. If there is an excessive amount of debris and build up observed, reference the fan pressure above for yearly increases of the fan pressure value. If it is determined that the Heat exchanger must be inspected, remove the burner assembly. Inspect the ignitor, and burner. Clean the HX as needed. Safety and Fitness Inspection: List external safteys _______________________________ Fuel ⃝ Natural Gas ⃝ Propane Gas Supply Pressure (Static)______Inches w.c. Measured ∆P at ignition (>1”w.c.)______Inches w.c. Gas Supply Pressure (high fire)_______Inches w.c. Measured Rate of Input (high fire)______Btu/hr Leak testing completed ⃝ gas piping ⃝ venting system ⃝ Fan and combustion components ⃝ Type/concentration of any glycol_______________________ Chemistry checked ⃝ Inhibitor added ______ System Filled (PSIG) ____ Air purge completed ⃝ TDS _______ Grains of Hardness ________ PH _______ Relief Valve correctly installed and piped ⃝ Relief valve “try lever” test performed _________ Condensate trap emptied and inspected ⃝ Condensate trap Clip installed ⃝ Condensate trap filled ⃝ Condensate drain clear and free flowing ⃝ Condensate Neutralization? Yes/No Ignition Safety Shutoff test completed ⃝ 1 of 2 Exit notes and signature lines are found on the second page of this document. This document is not complete without signatures. Yearly Boiler Inspection Report SL Series Boilers Combustion Readings: At Exit, High Fire CO2______ % Flue temperature O2_______% CO _______ ppm CO/O2 _______ ppm EX air______% Return water temperature (measure simultaneously with flue temp.) Flame current reading - High fire _______ µA Low fire ______ µA Yearly inspection has been completed as listed on this report - Owner Signature Yearly inspection has been completed as listed on this report - Servicer Signature Notes:________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ ____________________________________________________ 2 of 2 Exit notes and signature lines are found on the second page of this document. This document is not complete without signatures.
