Version 1, 15 June 2020, Page
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Galvin Engineering Thermostatic Mixing Valve or
Tempering Valve Commissioning/Maintenance Report
The following information is to be provided by the site manager/owner/occupier.
Valve size and installation recommended by : ______________________________________________________
Valves supplied by: ___________________________________________________________________________
Date of Installation: _________________________________ Drawing No. _______________________________
Service Manual on Site:
Yes
□
No
□
Commissioning Tests for new installation or valve replacement. Yes
□
This set of testing procedures and report received and witnessed by (Print Name): _________________________
___________________________________________________________________________________________
Temperature setting at completion of commissioning _______________ C
Position: ________________________________Signature: ______________________
Date:_______________________
Maintenance Tests. Yes
□
Date of Previous Service: ______________________________________________________________________
Previous Service carried out by: _________________________________________________________________
Reason for Maintenance Tests: _________________________________________________________________
This Test and report Witnessed by: _______________________________________________________________
The valve has been operating/performing satisfactorily for the previous 12 months:
Yes
□
No
□
Comment on monthly Temperature Tests carried out by the owner______________________________________
___________________________________________________________________________________________
Temperature setting at time of completion: _________C
Current Report received and witnessed by:
Name: _____________________________________________________________________________________
Position: ____________________________________________________________________________________
Signature: _____________________________ Date: _______________________________________________
