OFFICE OF THE STATE FIRE MARSHAL

DIVISION OF BOILER & PRESSURE VESSEL SAFETY

1035 STEVENSON DRIVE

SPRINGFIELD, IL  62703-4259

(217)782-2696

FAX:  (217)782-1062

Operational and Maintenance Log

Building:

Month:

Year:

Steam Heating Boilers

Address:

Fuel Type:

Person(s) to be Notified in Emergency (Name and Telephone No.)

Illinois No.:

CHECKS (Enter Date)

1

2

3

4

5

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7

8

9

10

11

12

13

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31

(1) Observe Water Level

(2) Record Pressure.

(3) Record Flue Gas Temp.

CHECKS (Enter Date)

(1) Test Low Water Cutoff

WEEK 1

WEEK 2

WEEK 3

WEEK 4

(2) Test Gage Glass

(3) Observe Flame Condition

CHECKS (Enter Date)

(1) Manual Lift Safety Valve

(A) Linkages

(F) Floor Drains

(B) Damper Controls

(G) Flame Detection Device

(2) Review Condition of

(C) Stop Valves

(H) Limit Controls

or Test Each Item

(D) Refractory

(I) Operating Controls

(E) Flue-Chimney Breeching

(3) Inspect Fuel Piping

(4) Combustion Air Adequate/Unobstructed

General Comments: