Chiller Startup Checklist Form
Use this form to record pre-startup checks, operating conditions, startup observations, and completion notes for a chiller system.
Chiller Identification and Job Details
Chiller/System Name or ID
*
Location / Site
*
Startup Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Startup Time
*
Hour Minutes
AM
PM
AM/PM Option
Technician / Operator Name
*
First Name
Middle Name
Last Name
Supervisor / Contact Person
First Name
Middle Name
Last Name
Work Order / Service Ticket Number
Pre-Startup Equipment Inspection
Power Supply Verified
*
Yes
No
Not Applicable
Electrical Disconnect Status Checked
*
Yes
No
Not Applicable
Control Panel Inspected
*
Yes
No
Not Applicable
Refrigerant Lines Inspected
*
Yes
No
Not Applicable
Oil Level Checked
*
Yes
No
Not Applicable
Water Flow Confirmed
*
Yes
No
Not Applicable
Pumps Inspected
*
Yes
No
Not Applicable
Valves in Correct Position
*
Yes
No
Not Applicable
Filters/Strainers Inspected
*
Yes
No
Not Applicable
Visible Leaks or Damage Noted
No Issues Observed
Leaks Observed
Damage Observed
Leaks and Damage Observed
Inspection Findings and Issues Discovered
Operational Startup Conditions
Ambient Temperature (°F)
*
Chilled Water Supply Temperature (°F)
*
Chilled Water Return Temperature (°F)
*
Condenser Water Supply Temperature (°F)
Condenser Water Return Temperature (°F)
Setpoint Value (°F)
*
Control Mode
*
Manual
Auto
Remote
Other
System Status at Startup
*
Ready
Not Ready
Partial
Startup Checklist and Performance Readings
Compressor start confirmed
*
Yes
No
Pump operation confirmed
*
Confirmed
Fan operation confirmed (if applicable)
Confirmed
Abnormal noise or vibration observed
*
Yes
No
Electrical current / amperage reading
*
Suction pressure reading
Discharge pressure reading
Overall startup status
*
Pass
Fail
Needs attention
Comments on abnormalities or corrective actions
Completion and Sign-Off
Checklist Completion Status
*
Completed
Completed with Notes
Incomplete
Pending Follow-Up
Final Remarks / Corrective Actions Taken
Follow-Up Required?
*
Yes
No
Follow-Up Details / Next Action Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Technician Name / Completion Acknowledgment
Submit Checklist
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