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REPORT
OF TECHNICAL CONDITION OF BOILER ROOM, CENTRAL HEATING SYSTEM AND FIRST START-UP OF THE BOILER
User's name and surname:...........................................................................................................................................................................
Detailed address: .........................................................................................................................................tel.:...............................................
Boiler type........................................................Serial number ..........................................................Boiler power..........................kW
Note!
UNDER NO CIRCUMSTANCES THE BOILER CANNOT BE STARTED in the case when abnormalities or connections
inconsistent with the mandatory regulations are stated. If the boiler is started up despite the contraindications, its
guarantee becomes invalid, and the person starting up the boiler accepts responsibility for the boiler and becomes a
guarantor for the b
oiler, as well as loses technical permission issued by DEFRO R. Dziubeła sp. k.
I. BOILER ROOM
Notes
ventilation
pressure ventilation in accordance with PN-B/02411:1987
exhaust ventilation in accordance with PN-B/02411:1987
chimney dimensions
height [m]
cross-section [cm
2
]
other items
tightness of boiler connection to the flue
lighting allowing for boiler maintenance/repair
location of boiler in the boiler room
distance from gear-motor to wall on the side of the container
II. CENTRAL HEATING SYSTEM
Notes
central heating system open
leading of expansion pipe in accordance with PN-B/02413:1991
location of connection of expansion pipe in accordance with PN-B/02413:1991
diameter of expansion pipe in accordance with PN-B/02413:1991
diameters of supply pipes
diameters of return pipes
diameters of pipes of boiler circulation system
closed central heating system
safety fittings in accordance with PN-EN 12828
safety valve
manometer
air vent
BVTS valve
cooling coil pipe
capacity of membrane expansion vessel in accordance with PN-EN 12828
protection of boiler return temperature
four-way valve
boiler temperature valve 55°C
dosing-mixing pump
other,
what?..........................................................................................................................................................................................
diameter of four-way valve
location of four-way valve /above boiler power outlet/
other elements of central heating system
gravitational by-pass
domestic hot water tank - capacity in litres
additional heating source
other,
what?
..........................................................................................................................................................................................
system anti-freeze protection
25
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