Form V372, Rev. 12
- 8 -
12/18, ECN4334
BY
STARTUP AND CERTIFICATION CHECKLIST
DATE: ________________
Pump S/N: ________________________________________________________________________
Equipment ID/Tag#: _________________________________________________________________
Nozzle S/N’s ______________________________________________________________________
Project Name: _____________________________________________________________________
Project Location: ___________________________________________________________________
Startup Performed By: _______________________________________________________________
Customer Contact Info _______________________________________________________________
Contractor Contact Info ______________________________________________________________
Engineer Contact Info _______________________________________________________________
Vaughan Co. requires the Startup & Certification Checklist pages, with the job specific Vaughan
Rotamix tank drawing marked up with nozzle locations, nozzle angles, nozzle elevations, and
confirmation of all bolt torques, to be sent to Vaughan Engineering. All verified dimensions should be
indicated by a circle or check mark on that dimension.
Rotamix Drawing No. _____________________________
Is drawing attached?
Yes ____ No ____
Is drawing marked up to show each verified nozzle location?
Yes ____ No ____
Is drawing marked up to show each verified nozzle angle?
Yes ____ No ____
SYSTEM DATA
Tank Geometry: ___________________________________________________________________
Type of process being mixed: _________________________________________________________
%Solids: _______________
Tank Type: New: __________
Retrofit: ___________
If Retrofit, previous system? __________________________________________________________
Sloped Floor: Yes ______ No ______
If sloped, slope = __________ degrees/depth
NOZZLE ASSEMBLY DATA
Contractor’s piping is properly installed and supported?
Yes ____ No ____
Is Contra
ctor’s piping properly aligned and bolted to assembly?
Yes ____ No ____
Flange bolts are properly torqued?
Yes ____ No ____
Couplings have been checked and torqued to 80 ft/lb after nozzle adjustment?
Yes ____ No ____
Grouting complete and Assembly Base set level?
Yes ____ No ____
Anchor bolts are installed and properly torqued?
Yes ____ No ____
