Fillable Printable Inspection Report Of Unfired Pressure Vessels
Fillable Printable Inspection Report Of Unfired Pressure Vessels
Inspection Report Of Unfired Pressure Vessels
PUBLIC BUILDINGS SERVICE
INSPECTION REPORT OF
UNFIRED PRESSURE VESSELS
(Make separate report for each pressure vessel)
CITY AND STATE
REGION NUMBER
3. MANUFACTURER'S NAME
4. TYPE OF PRESSURE VESSEL
5. *TYPE OF SUPPORTS
6. *DATE MANUFACTURED
7. TYPE OF SHELL CONSTRUCTION (Riveted, welded, etc.)
8. MATERIAL AND GAUGE OF SHELL
9. OVERALL DIMENSIONS OF SHELL
10. *STATE SERVICE (Boiler feed, domestic hot water, etc.)
11. MANUFACTURER'S RATING
12. MAXIMUM PRESSURE UNDER WHICH VESSEL IS NOW OPERATED
13. HAS SHELL OPERATING PRESSURE EVER BEEN REDUCED, BASED ON AN OFFICIAL RECOMMENDATION?
13A. IF SO, STATE DETAILS
14. DATE OF LAST INSPECTION
STEAMWATEROTHER (Specify)
TUBE NESTSPIRAL COILSRETURN BEND COILSOTHER (Specify)
F-12F-11AMMONIA
16. TYPE OF HEATING OR COOLING MEDIUM
17. *DESCRIPTION OF HEAT TRANSFER SURFACE
18. *AMOUNT OF TUBE SURFACE
19. *NUMBER AND LENGTH OF TUBES
21. *MATERIAL AND GAUGE OF TUBES
*To be reported at first inspection only
GENERAL SERVICES ADMINISTRATIONGSAFORM350PAGE 1(3-51)
20. *DIAMETER OF TUBES (O.D.)
15. NAME AND TITLE OF LAST INSPECTOR
CAPACITY
LBS./SQ. IN.
LBS./SQ. IN.
SQ. FT.
NOYES
LBS./SQ. IN.
(G.P.M.; LBS. P.M.; ETC.)
DESIGN PRESSURE (Shell)
MAXIMUM SAFE WORKING PRESSURE
6A. *DATE INSTALLED THIS LOCATION
BOILER FEED HEATER (Closed type)
LIQUID RECEIVER
CONDENSER, STEAM OR REFRIGERATION
COMPRESSED AIR TANK
OTHER (Specify type)
OIL HEATER
COOLER, REFRIGERATION OR COMP. AIR
DOMESTIC HOT WATER TANK
HYDRO-PNEUMATIC TANK
1. NUMBER OF UNFIRED PRESSURE VESSELS IN BUILDING SUBJECT TO INSPECTION
HEADQUARTERS
BUILDING
2. PLANT PRESSURE VESSEL NUMBER
DATE OF INSPECTION
3A. MANUFACTURER'S NUMBER
22. GENERAL CONDITION OF PRESSURE VESSEL
23. HAS INTERIOR OF SHELL BEEN PROTECTED AGAINST CORROSION?
23A. IF SO, DESCRIBE SAME
24. DOES VESSEL CONTAIN OIL?
24C. IF SO, TO WHAT EXTENT ARE QUANTITIES CONSIDERED SERIOUS?
25. WAS PITTING OR CORROSION APPARENT?
25A. IF SO, TO WHAT EXTENT?
26. DOES VESSEL SHOW SIGNS OF DISTORTION?
26A. IF SO, TO WHAT EXTENT?
27. HAS CORROSION INHIBITOR BEEN USED?
27A. IF SO, DESCRIBE SAME
28. CONDITION OF HEAT TRANSFER SURFACE
29. CONDITION OF TUBE SUPPORTS
30. SHELL (Hydrostatic) (Pneumatic) PRESSURE OF
31. DID PRESSURE VESSEL SHOW DEFECTS UNDER THIS PRESSURE?
31A. IF SO, WHERE AND TO WHAT EXTENT?
32. WAS TEST PRESSURE 1 1/2 TIMES THE MAXIMUM ALLOWABLE WORKING PRESSURE AS RATED BY THE MANUFACTURER?
32A. IF NOT, WHY WAS MAXIMUM PRESSURE NOT APPLIED?
33. RECOMMENDED MAXIMUM SAFE WORKING PRESSURE AS A RESULT OF THIS TEST
34. *PRESSURE RELIEF VALVES
35. ARE THESE VALUES ALSO DESIGNED FOR TEMPERATURE PROTECTION?
36. IF NOT, IS THERE ANY TEMPERATURE PROTECTION OR CONTROL?
36A. DESCRIBE SAME
24A. DOES VESSEL CONTAIN GREASE?24B. DOES VESSEL CONTAIN SCALE?
NO
YESNOYESNOYESNO
YES
NO
YESNO
LBS./SQ. IN. WAS APPLIED
LBS./SQ/ IN
NUMBERTYPESIZE
YESNO
YESNO
YES
NOYES
NO
YES
NO
YES
GSAFORM350PAGE 2(3-51)
37. STATE CONDITION OF PRESSURE AND/OR TEMPERATURE RELIEF VALVES
38. DESCRIBE ANY OTHER CONTROLS AND STATE THEIR CONDITIONS
39. WERE RELIEF VALVES RESET?
39A. IF SO, FOR WHAT CONDITIONS?
40. CONDITION OF PRESSURE VESSEL GAUGES AND THERMOMETERS
42. WERE GAUGES AND THERMOMETERS CORRECTED OR RENEWED?
43. DOES VESSEL CONTAIN SAFETY PLUGS?
43A. IF SO, STATE CONDITION
44. WERE SAFETY PLUGS RENEWED?
45. CONDITION OF GAUGE GLASS, IF FITTED
46. CONDITION OF PIPE CONNECTIONS AND ATTACHMENTS
47. CONDITION OF HEAT TRANSFER HEADER MANIFOLD
48. WAS HEAT TRANSFER SYSTEM TESTED FOR TIGHTNESS?
48A. IF SO, DESCRIBE METHOD AND GIVE RESULTS
49. WHAT REPAIRS OR ALTERATIONS HAVE BEEN MADE SINCE LAST INSPECTION AND WHY WERE THEY MADE?
50. IF TOXIC GASES ARE USED IN PRESSURE VESSEL, HAS ADEQUATE PROVISION BEEN MADE TO PROTECT PERSONNEL?
51. HAS ADEQUATE PROVISION BEEN MADE FOR FIRE FIGHTING?
52. HOW DO PERSONNEL IN CHARGE OF THIS EQUIPMENT GRADE?
GIVE RECOMMENDATIONS REGARDING PERSONNEL
41. WHAT VARIATION IN PRESSURE AND/OR TEMPERATURE EXISTED BETWEEN PRESSURE VESSEL GAUGES AND THERMOMETERS AND
INSPECTOR'S TEST GAUGE AND THERMOMETER AT WORKING PRESSURE AND TEMPERATURE?
NO
YES
NO
YESNO
COMPETENTDOUBTFULINCOMPETENT
YES
NO
YES
NOYES
NO
YES
GSAFORM350PAGE 3(3-51)
GSAFORM350PAGE 4(3-51)
53. IN YOUR OPINION IS THIS UNFIRED PRESSURE VESSEL IN A SAFE CONDITION TO BE OPERATED?
54. RECOMMENDATIONS AND REMARKS BY THE INSPECTOR (Include alterations, additions or repairs considered necessary)
54A. SIGNATURE OF INSPECTOR
54B. TITLE OF INSPECTOR
55. RECOMMENDATIONS AND REMARKS BY LOCAL OFFICER OR ENGINEER IN CHARGE
55A. SIGNATURE OF OFFICER IN CHARGE
55B. OFFICIAL TITLE OF OFFICER IN CHARGE
NOTE: Use additional sheets if necessary, to supplement the above remarks.
53A. IF ANSWER TO QUESTION 53 IS NO, THE INSPECTOR WILL NOTIFY THE CUSTODIAN, OR BUILDING SUPERINTENDENT, IMMEDIATELY
IN WRITING, NOT TO SUE SAME AND GIVE COMPLETE DETAILS TO REGIONAL OFFICE BY WIRE.
YESNO
