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Boiler Inspection Checklist Template

This boiler inspection checklist is used for inspecting oil or gas-fired boilers before issuance of certification. Converted using Lumiform, select Safe-At Risk-N/A when inspecting the internal, external, and operation of a boiler.

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Boiler Inspection Checklist Template

Boiler Inspection

Internal Inspection

Combustion Chamber
Brick Work
Fire Water Tubes
Burner Nozzle
Steam Drum
Stack Flue
Blow off Valve

External Inspection

Identify Programmer
Safety Relief Valve
Low Water Fuel Cutouts
Water Column
Pressure Gage
Review Record Logs (weekly, monthly)
Condensing Neutralizer Installed
Hydrostatic Test
Backflow Preventer
Date of last Combustion Tuning
Date of last waterside inspection
Date of last 150% Strength Hydro


Gas Boilers:
• Start in low Fire
• Loss of Combustion Air
• Low Gas Pressure
• High Gas Pressure
Fuel Oil Boilers:
• Start in Low Fire
• Loss of Combustion Air
• Loss of Atomizing Air
• Low Oil Pressure
• Burner Draw Switch (if applicable)
• Proximity Switch (if applicable)
All Boilers:
• Flame Sensor
• LWCO (left Right)
• Feed Pump Recirculating Pump
• Normal Trip
• Flame Pattern Inspection
• Water Treatment
• High Trip
• Emergency Stop
• Combustion Tuning
• Combustion (Air Fuel) Control System
• Test Relief Valve under Pressure

Boiler Efficiency

Boiler is:
Oxygen %
CO ppm
SO2 ppm
NO ppm
Stack Temp.
Safety/Relief Valve:
(check name not set)


Inspector: Name and Signature
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